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Home » St. Louis, MO Dry Eye Center

Dry Eye Syndrome and Treatment in St. Louis, MO

Dry eye syndrome is very widespread, and the St. Louis area is no exception. For some people, the symptoms of dry eyes are a mild irritant. Perhaps a bit of soreness. For others, however, Dry Eye Syndrome can be a chronic eye condition that is debilitating and makes day-t0-day- living painful and difficult.

The symptoms of dry eye syndrome can vary somewhat, though they usually include one or more of the following:

  • Dry, scratchy eyes
  • Excessive Tearing
  • Redness
  • Itchiness or irritation
  • Inflammation or burning
  • A feeling of grit, or like there is something in your eyes
  • Pasty, gunky, or crusty eyes
  • Blurriness

In extreme cases, the eyes are very gunky and highly inflamed and painful. In such cases, the cornea itself can be damaged over time.

There is Hope for Dry Eyes in St. Louis!

Dr. Rosen and his team of eye doctors have extensive experience and the most advanced methods to diagnose the cause of your dry eyes. A custom treatment solution will be put together for you, so you can get the relief you need, fast.

What Causes My Dry Eyes?

There are numerous causes and risk factors that contribute to the development of dry eye syndrome.

What Is Dry Eye Syndrome?

Dry eye syndrome is a chronic eye condition that is characterized by dry eyes and other symptoms including:

  • Dryness
  • Tearing
  • Redness
  • Itchy eyes
  • Burning
  • A gritty sensation
  • The sensation of a foreign body in the eye
  • Crusty eyelids
  • Blurred vision

Your tears comfort your eyes in many ways. Water moisturizes, an outer layer of oils lubricates and prevents evaporation, and proteins help protect against infection. Dry eye strikes when your eyes can’t produce enough tears for lubrication or the moisture in your tears evaporates too quickly.

What is Meibomian Gland Disorder?

In 80% of cases, Dry Eye Syndrome is caused by some problem with the meibomian glands, which produce the lipids (oils) essential for proper eye lubrication and for maintaining the appropriate breakup time (evaporation rate) of tears. The glands can get blocked or even atrophy by infection, environmental factors, and lifestyle.

Does Dry Eye Affect Many People?

Dry Eye is a very common condition which we treat in our practice. Some recent research by Harris Interactive indicates that about 70% of people with dry eye don’t ever see an eye care professional, despite the fact that nearly half of all Americans suffer from dry eye symptoms to some extent on a regular basis. This is unfortunate as most patients stand to benefit immensely by appropriate treatment for dry eyes. At our St. Louis eye clinic, we develop a custom treatment plan for you, tailored to treat the specific causes of your dry eyes.

Why is Dry Eye so Prevalent Today?

Dry Eye Syndrome has probably always existed, especially in the presence of environmental factors such as dust, cold, dryness, and, pollution. However, it seems to been getting more common and more severe, particularly over the last decade. 

One likely reason is the explosion in the use of digital devices. More and more, we spend many hours of the day continually looking at computers, smartphones, and digital televisions. This makes us stare for long periods of time while blinking much less than normal. Infrequent blinking, in turn, causes our meibomian glands to be blocked and even atrophy, resulting in serious and chronic dry eye syndrome.

The widespread use of contact lenses is likely also a contributing factor. Long days of use, combined with improper care and cleaning irritates the eyes and contributes to dryness and discomfort.

Various medications, becoming more widespread, also have side effects including dry eyes. Lastly, age is the most common contributor to developing dry eyes. As we live longer and longer, the rates of dry eyes are bound to increase.

How is Dry Eye Diagnosed? InflammaDry and Tear Lab

At Rosen Optometry, we use the latest technology to test the makeup of your tears. This includes:

  • how quickly tears break down and evaporate
  • The chemical and pH balance of tears
  • the lipid (oil) to water ratio
  • and more.

The technology we employ at our St. Louis Dry Eye Clinic includes:

  • Visual examinations
  • TearLab
  • InflammaDry
  • Fluorescein dye

Dr. Rosen answers your questions about TearLab

TearLab measures the salt concentration of the tears and is used in the diagnosis and management of Dry Eyes. The higher a patient's salt concentration is in their tears, the more likely they are to have Dry Eye symptoms.

What is it about this particular technology that you find most exciting; the component that made you feel you need to invest in this for your practice?

The great thing about the Tear Lab is that for the first time we can get a number that measures Dry Eye. Then, when we treat our patients, we can get a follow-up number that helps us determine how much progress we are making. The TearLab helps us quantify the severity of Dry Eye and helps us determine when we should stay with our current treatment or when we should change course. Many patients are motivated to be compliant with our recommendations because they want a good TearLab "score" at their next visit. There are many tests to help with Dry Eye, but TearLab results are very specific and have a very strong correlation with patients' symptoms.

Can you describe the patient experience when using the TearLab?

This is a very easy test for the patient.  A tiny amount of tears is collected right above the lower lid of each eye. It only takes a couple of seconds and there is very little, if any, sensation. Patients appreciate this technology because, just like us, they can more easily see their progress. They have more confidence in our ability to help them.


Can you share a particular story, in which by using the TearLab, you were able to detect and treat a case of dry eye that would have otherwise gone undetected?

While we usually don't test patients who aren't having symptoms, sometimes we have a patient who has only mild complaints, yet when we test them, we find a bigger problem than we anticipated. I recently had such a patient. She was the type of person who is just not a complainer. After discovering she had a high number and initiating treatment, she came back a few weeks later and really told us how much better she was feeling.


Another tool used by our dry eyes experts is InflammaDry, which tests the level of inflammation in your eyes. This dry eyes diagnostic tool tests whether or not a patient has elevated levels of something called MMP-9 in their tears from the inner lining of the lower eyelid. MMP-9 is a protein which indicates inflammation, which is fairly common for anyone suffering from dry eyes.

Our St. Louis eye doctor will typically prescribe steroids in order to get the eye inflammation under control.

Fluorescein Dye Test

Dr. Rosen, or another of our dry eye doctors, will also test your tear-breakup time. Essentially, if the makeup of your tears are off, they will sometimes simply evaporate before they can work effectively. Our eye doctors test your tear breakup time, using a fluorescein orange dye ― which is also useful in spotting other corneal diseases, conditions, or foreign bodies. Our optometrist will gently touch your eye with a tiny amount of special blotting paper. As you blink, the dye will spread and painlessly coat the tear film which covers the cornea. Using a blue light to contrast with the orange dye, the eye doctor is able to see problems revealed in green.

Does Staring at a Screen Cause Dry Eye?

Continuous staring at a fixed object, such as a phone or computer screen, usually results in a decreased blink rate. The lack of blinking actually causes the eyes not to replenish the tears often enough. The meibomian glands, therefore, can become blocked or even atrophy and die.

Does Drinking More Water Help with Dry Eye?

The main component of tears is water. Most of us don’t drink enough water. If you are dehydrated or not drinking enough, then you may not produce enough tears to keep your eyes moist. Snapple, Coke and other caffeinated drinks like coffee and tea may feel like they quench your thirst, but they actually dehydrate the body. Your body needs water to prevent dry eyes symptoms.

Antihistamines and Dry Eyes

Certain medications are known to contribute to dry eyes. In particular, anti-histamines (allergy) medication. Prolonged use of antihistamines will often lead to dry eye symptoms developing.

Beta-Blockers and Dry Eyes

Typically prescribed for controlling blood pressure, beta-blockers are proven to cause or exacerbate existing dry eye symptoms. If you are taking beta-blockers and experiencing symptoms, let us know! Your Burling dry eye doctors can help.

A recent study about the correlation between migraines and dry eyes has interesting results. Comparing migraine sufferers to people without headaches. The results showed a much greater prevalence of dry eye in the migraine group than in those without headaches. So, researchers are speculating that some migraines may worsen when dry eye symptoms are present. It has been recently hypothesized that when people report on headaches these could actually be caused by dry eyes, amongst other factors.  However, it is unclear whether one causes the other, or whether computer use is a contributing cause of both headaches and dry eyes.

As we age, we experience hormonal changes. These changes are known to cause or contribute to dry eyes. While this is true of both men and women, it seems that women over 50 are particularly more prone to developing dry eye symptoms.

The following environmental factors are known to play a huge role in causing or contributing to dry eyes:

  • Smoke
  • Pollution
  • Cold-climate and central heating
  • Dry climate
  • Sandy or dusty conditions

Various diseases contribute to dry eyes. Autoimmune diseases are a known factor. Rheumatoid arthritis, and Sjogren’s syndrome – a common symptom that rheumatologists treat can also contribute to dry eyes. Diabetics or those with Glaucoma that requires medication are more likely to have dry eye syndrome.

One of the main reasons people discontinue contact lens usage is due to dry eyes. The good news is there have been major improvements across all the brands with special contacts that are aimed at preventing dry eye symptoms.

What Treatments for Dry Eye Are Recommended?

Lifestyle Changes & Common Treatments for Dry Eye

Lifestyle Changes to Manage Dry Eye

There are many ways to treat dry eye. The first recommendation is to prevent dry eye symptoms. Blink a lot and drink a lot. Avoid eye irritants, use lubricating eye drops if you are taking medication that puts you at risk for dry eye. Over the counter eye drops for dry eye are widely available. Maintain a healthy lifestyle with a focus on vitamins like Omega 3.

  • One of the most common treatments we recommend is simple. Just BLINK! Blink regularly. Good, hard, fully closed blinks help restore the tear film.
  • The 20-20-20 Rule! During prolonged computer or digital device use take 20 seconds, every 20 minutes, to look at an object at a distance of at least 20 feet away. This gives your eyes a needed rest.
  • Drink adequately. Women need at least 91 oz. of water a day. Men need even more.
  • Omega 3 fatty acids have been shown to decrease dry eyes symptoms. Fish and flax are good natural sources of Omega 3 fatty acids, also available in tablet form.
  • If using a medicine that is known to contribute to dry eyes, like antihistamines or beta blockers, it’s important to combat dry eye with over the counter teardrops.
Omega 3 & Dry Eye

Omega 3 vitamins are very well-known to be good for general health, and heart health, but they are also helpful in treating dry eyes. There are even formulations specific for dry eyes. These usually consist of Omega 3 with DHA from flaxseed oil and includes vitamin C, vitamin E, Vitamin B6, magnesium, and a variety of other vitamins specifically geared toward patients with dry eyes.

Restasis and Xiidra: Prescription Eye Drops for Dry Eyes

In cases of chronic dry often, we often see patients who have a decreased ability to produce tears. This occurs because of the constant inflammation they experience. Unlike simulated tears, Restasis and Xiidra are prescription eyedrops which are both proven to increase the eye’s ability to make its own tears. Instead of having to constantly replenish your eyes’ moisture, with Restasis or Xiidra you are actually stimulating your eyes to make more tears over time.

When do I need prescription eye drops and when is a dietary supplement enough?

Typically, Restasis or Xiidra is used for chronic cases, while a recommended omega-3 supplement usually can and should be used in most cases even as a preventative measure and to maintain optimal eye health.

Our eye doctors are experts in treating dry eye syndrome and will diagnose and guide you through the right treatment plan for you. You don’t have to continue to suffer. Book an appointment with our St. Louis dry eye specialist today.

Restasis vs. Xiidra for Dry Eyes

Restasis has been in use for a number of years. It is an eye drop that is used twice a day. It’s the teardrop form of cyclosporine, an autoimmune suppressant which is prescribed for many chronic conditions, and it has been found to alleviate the symptoms of dry eyes by reducing the inflammation and increasing tear production. However, Restasis doesn’t necessarily help to improve the outflow of the oil that needs to be produced on top of the tears so that the tears don’t evaporate. Right now some of the studies are suggesting that over 50% of people with dry eyes actually have meibomian gland dysfunction. So, if the first lines of treatment are failing to manage dry eye symptoms, consider more rigorous treatments for dry eyes and blepharitis. Restasis also has side effects, with some patients experiencing burning and discomfort.

Xiidra is a newer drug that has recently received FDA approval for the treatment of Dry Eyes. Clinical studies have shown it to be significantly effective in alleviating symptoms, and it works far faster than Restasis, providing significant relief within as little as 2 weeks without the side effects of Restasis. However, the long-term benefits for dry eyes have yet to be conclusively proven. Nonetheless, it is considered a very safe drug.

Punctal Plugs for Dry Eyes Treatment

At our St. Louis eye clinic, our optometrists occasionally use punctal plugs to treat dry eyes. For those suffering from dry eyes caused by a lack of tears (as opposed to meibomian gland disorder) can often benefit from punctal plugs. These are small devices that are inserted into the tear ducts to slow or even block the drainage of tears. This increases the tear-film and moisture present in the eyes.

In most cases, the procedure is quick, painless, and uneventful. Find out if punctal plugs are right for you.

Scleral Lenses for Dry Eye
Scleral lenses for treating dry eye in Burlington, NJ

A scleral lens sitting on the eye

Scleral lenses are a special contact lens that is large. It sits on the sclera, rather than the cornea, leaving a pocket of space over the cornea. In our St. Louis eye clinic, our optometrists use scleral lenses to treat a variety of eye conditions, including keratoconus and for people with sensitivity to regular contacts.

Scleral lenses are highly useful in treating Dry Eyes. Studies have shown that the use of scleral lenses is effective in treating moderate to severe dry eyes. In more than 50% of cases, patients fitted with scleral lenses report reduced discomfort and dry eye symptoms, decreased use of artificial tears and improved visual acuity.

Alipour F, Kheirkhah A, Behrouz M. Use of mini-scleral contact lenses in moderate to severe dry eye. Cont Lens Anterior Eye. 2012 Dec;35(6):272-6. 

Amniotic Membrane Treatment

This is a revolutionary treatment that has been developed in the past few years for treating severe and chronic cases of dry eye. Amniotic membranes are collected during elective cesarean births from the placenta. Amniotic membranes protect and nurture the baby in the womb. When placed over the eye, this membrane dramatically heals the eye surface which has been damaged by prolonged dry eyes. Absolutely no sale of body parts is involved, and absolutely NO harm comes to the infant or the mother in extraction.

The results of using an amniotic membrane to treat dry eye are dramatic. At our dry eye clinic, we make use of both wet and dry membranes, which differ slightly in use. Both types offer significant, dramatic, and real healing and relief for inflamed and scarred eyes due to dry eyes. The use of amniotic membranes is a gamechanger in the treatment of dry eyes.

Wet Amniotic Membrane

The "Wet" amniotic membrane is a thin membrane held together by a small plastic ring. Applied directly to the eye, the ring holds it in place right where the eyelid meets the sclera (the white part) of the eye. The healing from this method is very fast. Usually, the membrane needs to be worn for no more than a week before dramatic improvement occurs. 

Dry Amniotic Membrane

Looking more like a thin dry bit of tiny corrugated cardboard, the dry membrane is placed right on the cornea and held in place with something called a "bandage contact lens" on top.

Do You Live in St. Louis, Affton, Crestwood, or South County and suffer From Dry Eyes?

Dr. Steven Rosen, and his wife, Dr. Karen Rosen, are the founders of Rosen Optometry in St. Louis, Missouri.

Dr Rosen dry eye doctor st. louis

Dr. Steven Rosen received his Doctor of Optometry degree from the Indiana University School of Optometry in 1979. He also received his undergraduate degree from IU, as well. “Dr. Steve” is a member of the American Optometric Association, the Missouri Optometric Association, the Heart of America Contact Lens Society, the St. Louis Optometric Society (President ’04-’05) and the Orthokeratology Association of America. The St. Louis Optometric Society named Dr. Steve Optometrist of the Year for 2008. Dr. Rosen served as an examiner for the National Board of Examiners in Optometry for many years. Dr. Rosen is also a member of BNI, an international business networking group.

Dr. Rosen has practiced in South St. Louis County since 1985 with his wife, Dr. Karen Rosen. During this time, he participated in 19 International Missions to developing countries to examine and provide new and recycled eyeglasses to people in need. Some of the countries visited include India, Paraguay, South Africa, Laos, and the Philippines.

Dr. Rosen enjoys practicing with his wife in their new, modern location at Ronnie’s Plaza. “Being independent allows us to provide eye exams featuring the newest advances in diagnostic technology as well as new spectacle lens technology. This lets us provide greater levels of customized services, eyeglasses, and contact lenses than we ever could before. The end result: Happier Patients!”

Rosen Optometry, under the leadership of Dr. Rosen, seeks to utilize the very latest technology to diagnose, alleviate, and treat the symptoms of Dry Eyes.

Our St. Louis eye clinic has seen a large increase over the past few years in contact lens wearers who suffer from Dry Eyes. One of the reasons for the increase in Dry Eyes symptoms is the increase in screen time on computers, cell phones, and TV, which causes excessive drying of the eye. Due to the extensive experience of our eye doctors with many specialty contact lens products, our eye doctors have had considerable success in treating contact lens-related dry eye.

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