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Dry Eye & Blepharitis

Are your eyes red, irritated, burning, stinging, scratchy?

The team at Del Negro & Senft Eye Associates will diagnose and treat your dry eye symptoms so you can get back to living your life free from irritation.

Dry Eye Syndrome

What is dry eye syndrome?

The eye depends on the flow of tears to provide constant moisture and lubrication to maintain vision and comfort. Tears are a combination of water (for moisture), oils (for lubrication), mucus (for even spreading), and antibiotics and special proteins (for resistance to infection). These components are secreted by special glands located around the eye. When there is an imbalance in this tear system, a person may experience the symptoms of dry eye syndrome.

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What are the symptoms of dry eye syndrome?

When tears do not adequately lubricate the eye, a person may experience:

  • Pain
  • Light sensitivity
  • A gritty sensation
  • A feeling of a foreign body or sand in the eye
  • Itching
  • Crusting of lashes on walking
  • Redness
  • Blurred vision
  • Watering or tearing
  • Eyelid and eye surface irritation

Paradoxically, a person with dry eye syndrome will have excess tearing. This “reflex tearing” actually occurs when the eye is not receiving sufficient lubrication. The eye sends a distress signal through the nervous system for more lubrication and, in response, the eye is flooded with reflex tears to try to compensate for the underlying dryness. These tears, however, are composed mostly of water and do not have the lubricating qualities or the rich composition of normal tears. They will wash away debris, but they will not coat the eye surface properly.

What causes dry eye syndrome?

In addition to a decrease in the production of lubricating tears by the tear glands, dry eye syndrome can be caused by the drying out of the tear film. This can be due to air conditioning, heat, or other environmental conditions. Other conditions that may cause dry eye syndrome are:

  • The natural aging process
  • Side effects of certain medications such as antihistamines and medications that treat high blood pressure and elevated cholesterol
  • Diseases that affect the ability to make tears, such as rheumatoid arthritis and collagen vascular diseases
  • Structural problems that prevent the eyes from closing properly
  • Blocked meibomian glands that secrete the natural oils needed for proper lubrication in the tear film

How common is dry eye syndrome?

“Dry Eye” is an extremely common eye condition, with incidences and symptoms that increase with age. In the United States, approximately six million women and three million men experience moderate or severe dry eye symptoms, and scientists estimate that an additional 20 to 30 million people in this country have mild cases of dry eye. Diabetes is the number one systemic disease implicated in dry eye.


Blepharitis, also known as eyelid margin disease, is a persistent and common condition that causes inflammation of the eyelids. We are pleased to offer a revolutionary treatment as part of our comprehensive Dry Eye Services Program. BlephEx™ is designed to provide a deep cleaning to lids 3-4 times a year to fight against the annoying and inconvenient symptoms of dry eye.


  • Eyelid and eye surface irritation
  • Itching of the eye
  • Redness of the eye
  • Gritty sensation like sand in the eye
  • Sensitivity to light
  • Crusting of lashes upon waking

With Blepharitis, oily particles and bacteria accumulate near the base of the eyelashes of both the upper and lower eyelids. This may cause itchiness, irritation, redness, and burning or stinging of the eyes. This condition frequently occurs in people who have a tendency toward dry eyes, oily skin, or dandruff. The condition can be difficult to manage because it tends to recur.

Causes of Blepharitis

Although everyone has bacteria on the skin’s surface, in certain people this bacteria thrives in the skin at the base of the eyelashes. Large amounts of bacteria around the eyelashes can cause scales and particles to form along the eyelid margins and lashes.

Since the eyelids are difficult to clean, this overgrowth of bacteria, biofilm, scurf and debris can accumulate over many years, and the exotoxin-induced inflammation can cause significant damage to the eyelid and tear glands.

Blepharitis also is associated with meibomitis— dysfunction and inflammation of the nearby oil glands of the eyelids (called meibomian glands). If Blepharitis is left untreated, eyelid glands can become clogged and infected. This can cause styes, dry eye syndrome, corneal ulcers and unsightly crusted scales and debris on the eyelids.

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Treatment options for Blepharitis

What is BlephEX?

BlephEx™ stands for microblepharoexfoliation, a painless procedure that safely and effectively removes the scurf and excess bacteria and biofilm that is responsible for the majority of low-grade inflammatory blepharitis, the primary cause of chronic dry eye disease.

With the BlephEx™ treatment Dr. Glatman and Dr. Wiedeman can precisely and safely clean and exfoliate your eyelids and lashes, which will almost immediately improve your symptoms. More importantly, by completely removing the exotoxin-laden biofilm along the lid margin, they can help you avoid the long-term inflammatory damage to your tear glands, preventing chronic dry eye syndrome.

If you are a candidate for the treatment, Dr. Glatman or Dr. Wiedeman can perform this painless, in-office procedure in under 10 minutes. The BlephEx™ handpiece is used to gently and carefully spin a medical grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris and exfoliating your eyelids. The disposable micro-sponge is used for each individual eyelid so bacteria is not spread between the lids. The eyes are then rinsed thoroughly with saline afterwards.

Dry Eye and MGD

Understanding MGD

Many commonly attribute their eye discomfort to dry eye, when a leading cause of the burning, scratching and redness is Meibomian Gland Dysfunction or MGD.

MGD occurs when there is a compromise to the function and/or structure of the Meibomian glands. These glands, located in the eyelids, produce the protective oily (lipid) layer of the tear film. This oil helps protect the surface of the eye from disease and prevents the watery part of the tears from evaporating when your eyes are open. Without these oils, the eyes become more susceptible to the negative effects that dry climates, air conditioning, computer use, reading and other daily activities can have on the long-term health of our eyes.

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Treating MGD with LipiFlow®

LipiFlow® is a treatment performed in-office designed to remove blockages from the Meibomian glands, allowing them to properly function and produce the oils that make up the top protective lipid layer of the tear film. LipiFlow® is supported by more than 30 patents with studies demonstrating its safe and effective results. 1 It is designed to minimize patient discomfort during a 12-minute treatment that gently massages the eyelids.

LipiFlow® Activators are single-use sterile devices that safely and comfortably deliver a combination of heat to the inner lids and simultaneous therapeutic motion to the outer lids, removing blockages from the Meibomian glands. 1 The Activators are contoured to avoid contact with the cornea, protecting the delicate structures of the eye.

Once the gland blockages are removed, the glands can resume normal oil or lipid production. This oil is essential for a healthy tear film, providing stable vision and ocular comfort. As normal gland function recovers, maximum results are usually experienced 6-8 weeks after treatment.

LipiFlow® treatment

1.Blackie C, Carlson AN, Korb DR. Treatment for meibomian gland dysfunction and dry eye symptoms with a single-dose vectored thermal pulsation: a review. Current Opinion in Ophthalmology. 2015; 26(4):306-13.

To learn if you are a candidate for this in-office treatment, please contact, 732-774-5566.

Customized Treatment Options

Improve overall eye and lid health with the customized treatment program your doctor develops specifically for you.

  • PRN Dry Eye Omega Benefits® (Omega-3s)
  • Warm compress (heat mask) – Combines moisture and heat to open clogged meibomian glands and prevent the evaporation of tears
  • Wash lashes with baby shampoo
  • Wipe eyelids with medicated lid scrubs – Pads saturated with eyelid cleanser that effectively removes oil, debris, pollen, and scaling or flaking skin from the eyelids that may cause irritation. Recommended for routine daily eyelid hygiene and mild-moderate conditions
  • Lubricating Tears
  • Restasis® or Xiidra® Drops that helps increase your eyes’ natural ability to produce tears, which may be reduced by inflammation due to Chronic Dry Eye
  • Gel Tears
  • Punctal plugs (tear savers) – Small plugs placed in the ducts that drain tears out of the eye. They help to “save” or “conserve” the eye’s natural tears to maintain lubrication, so tears do not drain too quickly. Our doctors may place silicone plugs to provide an adequate supply of tears
  • Topical antibiotics
  • Doxycycline – Oral antibiotic which can help to reduce the inflammation in the glands
  • Steroid eye drops
  • BlephEx™ in-office treatment with Lid Hygenix™ Foam Eyelid Cleanser – Painless treatment reduces scurf and bacterial debris, the main causes of inflammatory lid disease, and improves the overall health of the eyelid
  • LipiFlow – LipiFlow® is a treatment performed in-office designed to remove blockages from the Meibomian glands, allowing them to properly function and produce the oils that make up the top protective lipid layer of the tear film.