At Kelly Vision in NYC and Long Island, dry eye disease is a core clinical specialty. Dr. James Kelly, Board-Certified Ophthalmologist and Director of Refractive Surgery Education at Northwell Health, and Dr. Ashley Brissette, double board-certified ophthalmologist who has authored peer-reviewed publications and lectured internationally on dry eye disease, routinely manage complex ocular surface disorders referred from throughout the region. Many patients arrive frustrated. They use artificial tears consistently, yet the burning, grittiness, and fluctuating vision persist.
Artificial tears are not ineffective; they are limited. Chronic dry eye is commonly driven by inflammation, meibomian gland dysfunction, tear instability, hormonal influences, or autoimmune disease. Drops add temporary moisture but do not correct these underlying mechanisms, so relief fades quickly. In this blog, we explain why symptoms continue and what truly restores lasting stability.
Why Artificial Tears Are Not Always Enough
Artificial tears primarily supplement the watery component of the tear film. Chronic dry eye, however, is rarely caused by low tear volume alone.
Contributing factors often include:
- Meibomian gland dysfunction: Obstructed or underperforming oil glands allow tears to evaporate too quickly.
- Ocular surface inflammation: Ongoing inflammation disrupts healthy tear production and weakens tear stability.
- Hormonal influences: Menopause, pregnancy, thyroid disorders, and certain medications can alter tear quality.
- Autoimmune conditions: Diseases such as Sjögren’s syndrome directly impair the body’s ability to produce tears.
- Environmental stress: Extended screen time, low humidity, and constant airflow accelerate evaporation.
Without treating these drivers, drops provide brief symptom relief rather than meaningful improvement. In moderate to severe cases, frequent use of preserved artificial tears may further irritate the ocular surface.
The Importance of Advanced Diagnostics
Persistent dryness requires a structured ocular surface evaluation. At Kelly Vision, our assessments may include tear osmolarity testing, detailed meibomian gland imaging, inflammatory marker evaluation, and high-resolution corneal surface analysis. These tools allow us to identify whether evaporation, inflammation, aqueous deficiency, or a combination of factors is responsible.
Dry eye disease is commonly multifactorial. Gland obstruction, surface inflammation, and tear instability often coexist. By isolating each component, we develop a treatment strategy aimed at restoring tear balance and protecting long-term ocular surface integrity rather than temporarily masking discomfort.
Targeted Treatments That Address the Cause
Treatment is guided by the specific mechanisms identified during testing. In many cases, a combination approach produces the most stable results.
Advanced therapies may include:
- OptiLIGHT IPL: FDA-approved intense pulsed light therapy that reduces eyelid inflammation and improves meibomian gland function.
- LipiFlow thermal pulsation: Controlled heat and pressure applied to evacuate blocked oil glands and enhance tear stability.
- OptiLIFT radiofrequency: Radiofrequency treatment designed to support gland performance and improve eyelid structure that contributes to tear evaporation.
- Prescription anti-inflammatory medications: Therapies that reduce surface inflammation and support healthier tear production.
- Autologous serum eye drops: Customized drops derived from a patient’s own serum to promote ocular surface healing in more advanced disease.
- Punctal occlusion: Tear conservation techniques that slow drainage and increase natural tear retention.
Long-term stability depends on correcting gland dysfunction, calming inflammation, and improving tear quality together.
Why Persistent Dryness Should Not Be Ignored
Chronic dry eye is more than a minor irritation. Ongoing tear film instability can lead to corneal surface damage, light sensitivity, fluctuating vision, and increased infection risk. Vision that clears briefly with blinking often reflects tear instability rather than a refractive change.
Early evaluation allows for structured treatment that protects visual quality and preserves corneal health over time.
Find a Long-Term Solution for Persistent Dryness
If your eyes still feel dry despite regular artificial tear use, the cause has likely not been fully addressed. At Kelly Vision, Dr. Kelly and Dr. Brissette apply advanced diagnostic testing and clinically validated therapies to identify and treat dry eye at its source. Schedule a comprehensive dry eye consultation today for a personalized evaluation and a targeted plan focused on long-term ocular surface stability in New York City or Long Island.
