Artificial tears manage symptoms. We treat the cause. A dry eye evaluation identifies which layer of your tear film is failing and matches a treatment plan to the actual problem.
2601 S. IH-35, Suite C-100, Round Rock, TX 78664
Mon–Sat 9am–6pm
Walk-ins welcome
Dr. Nonso Nwankwo
Accepting new patients
Americans diagnosed with dry eye disease
of contact lens wearers experience dry eye symptoms
of dry eye cases involve meibomian gland dysfunction as a contributing factor
Artificial tears are the first thing most dry eye patients try, and for mild, occasional dryness they can help. The problem is that they address a symptom, not a cause. Dry eye is not simply a shortage of tears. It is a breakdown in the tear film, which has three layers: an outer oil layer produced by the meibomian glands, a middle water layer produced by the lacrimal glands, and an inner mucin layer that helps the tear film adhere to the eye surface.
When any of these layers fails, the result is dry eye — but the appropriate treatment depends entirely on which layer is the problem. A patient with aqueous deficiency needs a different treatment than a patient with meibomian gland dysfunction, and neither condition is resolved by adding more over-the-counter artificial tears to the same failing system.
blocked oil glands in the eyelids fail to produce the oil layer that prevents tear evaporation
the lacrimal glands do not produce enough water volume to maintain the tear film
AC, low humidity, wind, and smoke accelerate evaporation even in healthy tear films
reduced blink rate during screen time allows tears to evaporate before they are replenished
certain lens materials absorb moisture from the tear film, worsening dryness
menopause, thyroid conditions, and certain medications all affect tear production and composition
tear volume and oil gland function naturally decline with age, with symptoms most common after 50
seasonal and environmental allergens trigger inflammation that disrupts meibomian gland function
Supplement water volume temporarily. Relieve symptoms for minutes to hours. Do not address oil layer deficiency, gland dysfunction, or inflammation. Require frequent reapplication. May contain preservatives that worsen symptoms with daily use.
Targets the underlying cause. Prescription anti-inflammatory drops reduce eyelid inflammation. In-office warm compress therapy and gland expression restore oil layer function. Results last significantly longer than lubricating drops alone.
Cyclosporine (Restasis, Cequa) and lifitegrast (Xiidra) reduce inflammation that damages the cells responsible for tear production. Most patients see improvement within 3 to 6 months of consistent use.
Therapeutic heat applied to the eyelids liquefies hardened meibomian gland secretions, restoring oil flow to the tear film. In-office protocols are significantly more effective than at-home warm washcloths.
Manual or instrument-assisted expression clears blocked glands to restore oil layer function. Often combined with warm compress therapy in the same appointment for maximum effect.
Omega-3 fatty acid supplementation has strong clinical evidence for improving tear film stability and reducing MGD-related inflammation. We discuss appropriate dosing and formulation at your evaluation.
Tiny silicone plugs inserted into the tear drainage ducts slow tear drainage and increase tear volume on the eye surface. Used primarily for aqueous-deficient dry eye.
Ready to find out what’s actually causing your dry eye?
Billing note:
Dry eye evaluations and treatments are typically billed as medical visits, not vision visits, and are covered under most medical insurance plans. Prescription dry eye medications may require a prior authorization depending on your plan. Call your location before your first appointment to confirm coverage.
Accepting new patients
Dry eye disease is typically chronic, meaning it does not go away on its own — but it is very manageable. Most patients with a correct diagnosis and an appropriate treatment plan experience significant relief and can maintain comfort long-term.
We evaluate the quantity and quality of your tears, assess meibomian gland function and structure, examine the cornea and eyelid margins, and review your symptoms and history. The evaluation typically takes 30 to 45 minutes.
Yes, especially if daily drops are not providing lasting relief. That is a sign the underlying cause has not been addressed. A dry eye evaluation identifies what is actually happening in your tear film and allows us to target treatment appropriately.
Yes. Tear film instability causes the light entering your eye to scatter rather than focus cleanly on the retina. The blur is often variable — it clears momentarily when you blink and then returns. This is one of the most common and frustrating dry eye symptoms.
Contact lens wear can worsen dry eye or trigger symptoms in patients who had mild underlying dryness. Certain lens materials are more likely to cause problems than others. If your contacts have become uncomfortable, a dry eye evaluation and a lens type review can often resolve the issue without giving up contacts entirely.
Yes. AC removes humidity from indoor air, which accelerates tear evaporation throughout the day. Patients at Round Rock who work in heavily climate-controlled buildings often have the most persistent symptoms. Call 512-246-3937 to schedule.