Dry Eye Treatment and Therapy Spa

 Understanding Dry Eyes

Dry eye syndrome or dry eye disease is the most common eye disease that eye doctors see in their office with as many as 30 to 40 million Americans effected by dry eyes. You have nearly a 10% chance of developing or having dry eye syndrome. The numbers are increasing significantly as people are spending more time starring at a variety of flat screen devices. These include smart phones, computer screens, iPads, and/or TVs. This is the result of them starring at these screens and diminishing their blinking which leads to their eyes drying out as they are not spreading their tears across their eyes. Teenagers are now developing dry eyes as many are spending hours starring at games on their flat screen device. As much as 3 billion dollars is spent on treating dry eye disease a year in the United States. 5 billion dollar a year loss in work productivity in the United States secondary to dry eye disease is becoming a significant problem.


What is Dry Eye, Dry Eye Syndrome or Dry Eye Disease?

There are more terms that are used for dry eye disease such as aqueous deficiency, evaporative tear deficiency, Keratoconjunctivitis sicca (KCS), dysfunctional tear syndrome, neurotropic epitheliopathy, and lacrimal keratoconjunctivitis. Dry eye disease in simple terms is the loss or reduction of the tear film that covers over the surface of the eye. The tissues that compose the surface of the eye require a specific amount of moisture or tear film for the tissue or cells on the surface of the eye to be healthy. A good or normal tear film is necessary for clear vision. If the level of the tear film present is insufficient, the outer surface tissues become sick, inflamed, irritated, and can eventually die. A normal tear film surface is necessary for clear vision as stated before as this is the first thing that light passes through on its way to be focused onto the retina in the back of the eye.

The Tear Film Consists of Three Layers

  • Aqueous Layer

    The middle tear film layer contains water, proteins, minerals and variety of protein. The water layer is produced by the lacrimal gland.

  • Mucous Layer

    The inner tear film layer contains mucin, which is produced by goblet cells, on the surface of the eye. The mucin coats the eye, provides a hydrophobic layer, and promotes even distribution of the tear film

  • Liquid Layer

    The outer tear film layer contains oils produced by the Meibomian gland located in the eyelids. The Meibomian glands secrete the oil onto the tear film. The oils provide a barrier to keep the liquid layer from evaporating from the eye and also help with lubrication.

Meibomian Gland Dysfunction

Meibomian gland disease of dysfunction is the cause of dry eyes in approximately 75% of dry eye cases. This is called evaporative dry eye.

Decreased Liquid Tear Production

The decreased production of the lipid layer comprises the other 25% of dry eyes.

Treatment of Dry Eyes

The treatment of dry eye needs to be based on the type of dry eye in the order to provide the most benefit to the patients.

Meibomian Gland

Diagnosing Dry Eyes

During the eye exam, the doctor examines the surface of the eye, and the quality of the tear film using a slit lamp microscope. A dye that stains the cell walls of damaged cells on the surface of the eye may be used to determine the extent of dry damage to the eye.

Diagnosig Dry Eyes

Tests for Dry Eyes

Tear Osmolarity

Our bodies contain a normal amount of salt, including the tear film and the surface of the eye. The is now a test that can measure the salt level in tears. An increase in the salinity of the tear film indicated the presence of dry eyes. Tear osmolarity can also be used to follow or monitor the success of the treatment.



LipiView is a machine that can image the tear film and evaluate the quality of the lipid level on the surface of the eye which can indicate Meibomian Gland Dysfunction. People with poor lipid levels on the surface of their tear film suffer from dry eyes.

Keratograph 5M

Meibomian Gland 3D Imaging

Meibomian gland imaging allows us view and image the glands to determine the health of the Meibomian Glands

Tear Break Up Time

The length of time that the tear film stays normal without blinking is a test to determine the severity of the dry eyes

Tear Meniscus Height

The height of the layer of tears that rests on the lid adjacent to the eye is measured. This is another measurement for the amount of tears present in the eye.

Lipid Layer

The color and structure of the lipid layer are measured to determine the status of the outer lipid layer of the tear film.

Tear Film Dynamics

The tear film practice flow characteristics and tear film viscosity is measured to evaluate the quality of the tear film.

Keratograph 5M

Treatment of Dry Eyes

Artificial Tears

There are many different artificial tears on the market: watery type drops, thicker gel-like drops and ointment. Artificial tear are the mainstay of treatment, especially in beginning.

Dry Eye Treatment in Florida
Warm Compresses

Warm Compresses

Warm compresses in the morning for 10 minutes can help the glands produce better tears. Tranquileyes is an excellent way to apply warm compresses to the eyes.


Restasis is a topical medication that is instilled into the eye twice a day. It improves the health of the cells around the eye that produce the tears.

HydroEye Supplement

Omega-6 with GLA from black current seed oil has been shown to improve symptoms from dry eye in several clinical studies

HydroEye Bottle Florida
Punctal Plug

Punctual Plugs

The ducts are located on the upper and lower eyelids near the nose that drain the tears from the eye into the nose. Small plugs can be placed in the ducts to block the drainage of the tears from the eye maintaining a better tear film.


This is the first FDA approved treatment for Meibomian Gland Dysfunction related to dry eyes. LipiFlow is a single office procedure that improve the dry eye symptoms in 90% of patients.

Lipid Layer

Meibomian Gland Probing

A tiny probe is inserted through the microscopic gland opening which has been scarred closed from Chronic Inflammation. This allows the Meibomian gland to secrete its lipid material on the tear film.

Testosterone Cream

It has been discovered that there are hormone receptors on the surface of the eye Post-menopausal women comprise the largest group of dry eye patients. Studies have shown that in post menopausal women, application of testosterone to the eyelid has improved the tear film of these patients.

The LipiFlow Treatment

Meibomian Gland Dysfunction may cause up to 85% of dry eye disease. The Meibomian glands are located in the upper and lower eyelids. They are responsible for producing the outer lipid layer of the tear film. The lipid layer products the underlying water portion of the tears and keep it from evaporating from the eye. The LipiFlow Treatment is the first of its kind and is a newly FDA approved procedures for treating Meibormian Gland Dysfunction.

LipiView Interferometer provides a quantitative analysis by specular reflection of the tear film. The LipiView displays its results on a monitor and reveals the status of the outer lipid layer of the tear film. If your lipid layer is deficient then you may be an excellent candidate for LipiFlow.

Lipiflow Florida
LipiFlow Florida

LipiFlow Treatment Experience

LipiFlow Treatment unblocks the obstruction of the Meibomian glands with a combination of localized heat and intermittent pressure. A sterile single-use component of an eye cup and lid warmer is placed in contact with the eyelids. The lid warmer contacts the inner eyelid surface and heats to a controlled temperature of 42.5°. The flexible bladder intermittently inflates in a precise manner on the outer surface of the eyelid to express the lipid material out of the glands. Both eyes can be treated at the same time. The treatment lasts approximately 12 minutes.

This is an exciting new treatment option for patients who are suffering from symptoms of dry eyes. Most patients feel relief or improvement of their symptoms within 2 weeks or sooner.

At 4 weeks after treatment, approximately 80% of patients reported improvement of their dry eyes. Most experience little or no discomfort with the procedure. We are one of the first practices in the United States to offer this important component of treatment in an Accredited Dry Eye Center.

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The Cataract & Refractive
Institute of Florida

James E. Croley III, M.D.

Office Hours

  • Monday

    7:30am – 4:00pm
    Dr. Croley sees patients at 7:30am in Cape Coral.

  • Tuesday

    8:00am – 4:00pm
    Dr. Croley performs surgeries on this day.

  • Wednesday

    7:30am – 4:00pm
    Dr. Croley sees patients at 7:30am in Cape Coral.

  • Thursday

    8:00am – 3:30pm
    Dr. Croley sees patients at 8:30am in Lehigh.

  • Friday

    8:00am – 3:30pm
    Dr. Croley alternates also in Bonita & Cape Coral.

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