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Forsight Vision For Dry Eyes

Dry Eye Treatment

Even without knowing the term “dry eye” or “Dry Eye Syndrome“, if you suffer from it, then you are all too familiar with the soreness, discomfort, and even the constant misery that can come with dry eyes.

Dry Eye Specialist For You

Fortunately, there is a Long Grove Dry Eye Specialist seeking to bring relief and healing from Dry Eyes in its many forms to patients from the state of Illinois. With Dr. Todd Cohan & Dr. Jacqueline Cozzone at the helm, Forsight Vision, in Long Grove, specializes in treating the entire range of Dry Eye Syndrome, from mild to severe. Whether it’s an occasional irritant or a debilitating daily problem, we’re here to help, with years of experience specializing in treating dry eyes.

Advanced Diagnostic Equipment And Tools For Dry Eye

Forsight Vision uses the most advanced diagnostic equipment and tools to quickly and accurately pinpoint the cause and type of dry eye problem you’re suffering from. We don’t just throw any old drops at you either. We provide custom, tailored treatment plans designed to maximize the relief of your dry eye symptoms AND treat the underlying cause of your discomfort.

What Is Dry Eye?

Dry Eye Syndrome can range from a mild irritant to chronic problem. The symptoms of Dry Eye Syndrome may include:

  • Dry, irritated, or red eyes
  • Excessive tearing/watery eyes
  • Inflammation
  • Sore or sensitive eyes
  • Itchiness
  • Burning or inflammation
  • A gritty or pasty feeling in the eyelids
  • Crusty or gunky eyes
  • Blurriness

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What Causes Dry Eye?

Dry eyes, or, Dry Eye Syndrome, is a complex condition that can have multiple causes but tends to share common symptoms. Our optometrist, Dr. Todd Cohan & Dr. Jacqueline Cozzone, uses the latest technology to assess the cause of your dry eye symptoms, in order to provide the best possible care.

Poor Tear Quality

For tears to effectively moisturize and lubricate your eyes, they need to have the correct balance of:

  • Water
  • Lipids ― oils produced by the meibomian glands
  • Mucus

The water provides moisture and keeps the eyes clean while simultaneously delivering oxygen to the tissue of the eyes.

The lipids (oils) produced by the meibomian glands provide essential lubrication and control the rate at which the water of tears evaporates. The time it takes for the tear film to evaporate is referred to as the tear-film break-up time.

The mucus in tears keeps the tear-film evenly distributed and stable.  

When someone is suffering from Dry Eye Syndrome, one or more of these factors is unbalanced, leading to dry eye symptoms. In 85% of cases, Meibomian Gland Disorder is responsible for dry eye syndrome.

Meibomian Gland Disorder

Our eyes have glands which produce the lipids (fatty oils) essential for proper lubrication. These are referred to as the meibomian glands. The blockage or dysfunction of these glands causes a condition known as Meibomian Gland Disorder. This condition is responsible for roughly 85% of all instances of Dry Eye Syndrome.


Blepharitis is related to Dry Eye Syndrome and is often a contributing cause or a parallel condition. The major symptom is inflamed eyelids, particularly where the eyelashes grow. Blepharitis is usually caused by bacterial infections or other skin problems resulting in similar symptoms to dry eye syndrome in general.

Poor Tear Volume

A low supply of tears is a less common cause of Dry Eye Syndrome. This can be caused by a number of factors including medications or specific health conditions, which can result in dry eyes.

Age, Gender 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. Pregnancy is also known to contribute to or exacerbate dry eye syndrome.

Environmental Factors & Irritants

By increasing the rate at which our tears evaporate, the following environmental factors are known to play a huge role in causing or contributing to dry eyes:

  • Smoke
  • Allergens
  • Pollution
  • Cold-climate and central heating
  • Dry climate
  • Sandy or dusty conditions
  • Altitude
Contact Lenses & Dry Eye

Poor cleaning habits, not changing the contact often enough, and sleeping in contact lenses can all contribute to dry eyes. However, even for those who follow proper contact lens hygiene, lenses can still be a contributing cause of dry eyes. In fact, one of the main reasons people discontinue contact lens usage is due to dry eye symptoms. Good news for these patients is that there have been major improvements across all brands—with special contacts that are now targeted at preventing dry eye symptoms.

Medical Conditions

Various diseases contribute to or even cause, dry eyes. Autoimmune diseases like Rheumatoid arthritis and Sjögren’s syndrome – both have similar symptoms that can lead to low tears and eventually dry eyes. Diabetics or those with Glaucoma that require medication are also more likely to have dry eye syndrome.

Lifestyle & Dry Eyes

As with everything, proper balanced diet and exercise are important in preventing or managing dry eye syndrome. There are two specific activities that relate directly to Dry Eyes.

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.

Prolonged And Continuous Use Of Digital Devices Is Thought To Be The Likely Culprit In The Significant Increase Of Dry Eye Syndrome Throughout The General Population.

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. Juice, soda and other caffeinated drinks like coffee and tea may feel like they quench your thirst, but they contribute to dehydration. Your body needs water to prevent dry eyes symptoms.

Medications & Dry Eye

Whether prescription or over-the-counter, certain medications are known to decrease tear production or otherwise contribute to Dry Eye Syndrome. These include:

  • Beta-blockers / blood pressure medications
  • Antihistamines
  • Decongestants
  • Antidepressants
  • Oral contraceptives

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How Can I Improve My Lifestyle To Prevent And Treat Dry Eye Syndrome?

There are many ways to treat dry eye. However, the first recommendation is to prevent dry eye symptoms before they start, and to address lifestyle factors that could contribute to the problem.

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 daily 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 much needed rest.

Drink adequately. Women need at least 91 oz. of water a day. Men need even more. Poor intake of water directly contributes to a poor supply of tears, especially in hot and dry conditions.

A healthy diet is always essential for maintaining optimal health. Omega 3 fatty acids have been conclusively shown to help maintain good vision and eye health, as well as decrease dry eyes symptoms.

Fish and flax are good natural sources of Omega 3 fatty acids. Omega 3's are also available in tablet/supplement form. 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. Our Dry Eye doctor can recommend one or more of these for your specific needs.

How Is Dry Eye Syndrome Diagnosed?

Sometimes, a visual inspection of the eyes isn't enough. Since a problem with the meibomian glands (which produce those essential lubricating lipids) is most often to blame for chronic dry eyes, it's important to get the best digital image of the meibomian glands possible. That's why our dry eye specialists use the Oculus Keratograph 5M, which takes a high-resolution digital image of the lower AND upper glands.

Such imaging tells us a lot about how healthy your oil glands are. Are they healthy? Blocked? Dilating? Atrophied? Gunky? Is the oil cloudy or clear? ― cloudy oil indicates the presence of a bacterial infection which thickens the oils until they simply are no longer effective. This we can usually clear up with antibiotics.

Our Dry Eye Specialist in Long Grove provides today's most advanced treatment for dry eyes that's fully tailored to your specific situation. We diagnose and assess your eyes using the latest technologies, combined with industry best-practices for vision exams. Asking getting answers to strategic questions coupled with comprehensive patient care — we will get to the core cause of your condition. For example:

  • How effectively are you blinking? How often?
  • Are your tear ducts lined up properly?
  • What’s the osmolarity of your tears?
  • How fast do your tears break down?
  • What is your tear volume?
  • How well are your meibomian glands functioning? Are they blocked? Dirty? Infected? 

Our dry eye doctor will also conduct an in-depth assessment of indicators for other diseases and health problems which might be contributing to your dry eyes. We then develop a personalized treatment plan based on what we find, plus ongoing treatment and follow up visits to insure the treatment is working for you.

On every patient questionnaire, we ask if you are suffering from any of the typical symptoms of dry eyes. Do your eyes feel gritty? Sore? Do you feel like something is in your eye or that you just don't seem to have any tears? If you report symptoms of dry eye or appear to exhibit those symptoms, then we recommend beginning the dry eye exam process, which is quick, easy, and painless.

One of the first things we evaluate is the stability of the tear film. We use TearLab to test the osmolarity of your tears ― that is, the relative concentrations of salts, water, and lipids (oils). These lipids are produced by the meibomian glands. Most cases of dry eyes occur where there is a problem with these glands. They could be blocked, atrophied, or otherwise damaged. If your tears evaporate too quickly (which causes burning), it's usually caused by a lack of these lipids.

A strong imbalance between the osmolarity of one eye vs. the other is a strong indication that someone has dry eye disease.

Depending on the results of the TearLab, our Long Grove Dry Eye specialist will also want to see if the overall volume of tears could be the problem. In some cases, the meibomian glands are producing the lipids needed for lubrication, but there just isn't enough of the aqueous layer (this means tears) to spread it around effectively.

In order to test this, our optometrist places a thin piece of red thread draped over the eyes for a few seconds in order to measure how wet eye gets and compares the difference (if any) between the eyes.

Another tool in the arsenal of our dry eyes experts is InflammaDry, a specialized diagnostic test which measures whether or not a patient has elevated levels of MMP-9 in their tears using a tear sample from the inner lining of the lower eyelid. MMP-9 is a protein which indicates inflammation and elevated levels of this protein are fairly common for anyone suffering from dry eyes.

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

Our dry eye doctor will also test your tear breakup time. Sometimes, tears don't last long enough to work effectively or enough is not being produced. We may utilize two different tests to assess tear breakup time.

The Fluorescein Dye Test allows us to look at the corneal surface through a microscope. In order to test this, we use a fluorescein orange dye to test the breakup time (as well as any other corneal diseases, conditions, or foreign bodies). Using a small blotting paper, the optometrist will lightly touch your eye. As you blink, the dye spreads and gently coats the tear film covering the cornea. Using a blue light (the dye is orange), problems will be revealed to the eye doctor as green.

The Oculus Keratograph 5M is non-invasive and utilizes a high-resolution camera for imaging. Comparing patient images of the tear thickness against data in the software provides objective findings and thorough results.

How Is Dry Eye Treated?

Custom Treatment

Depending on the underlying cause or causes of your dry eyes, as well as the severity, our Long Grove Dry Eye Specialist will develop a custom treatment plan that is tailored to your specific needs. The following are some of the treatment options in our arsenal for treating dry eyes.

Our optometrists specialize in diagnosing and treating chronic dry eye syndrome. We will assess your condition to determine the cause of your dry eyes utilizing some of the most advanced diagnostic equipment available, and then find the best solution to relieve your symptoms and restore comfort to your precious eyes.

Based on your condition and the possible causes, our treatment may involve one of the following courses of action:

  • Finding the right brand and formulation of artificial tears or prescription eye drops.
  • Prescribing Steroid Eye Drops, Antibiotics or Lubricant Inserts.
  • Inserting Punctal Plugs—to plug the tear drainage ducts and keep the tear film intact on the surface of the eye.
  • Lipiflow® treatment for meibomian gland dysfunction, an in-office procedure that opens blocked meibomian glands which produce essential oils to lubricate the eyes.
  • Blephex Eye Lid Exfoliation for Blepharitis
  • Medication adjustments.
  • Adjusting your contact lens prescription or reducing wear during treatment.
  • Amniotic Disks by Prokera for severe eye damage due to dry eye
Artificial Tears

For those with tear-film insufficiency, artificial tears are a basic solution that literally introduces more tears into your eyes in the form of non-medicated (or lightly medicated) drops. While not enough for a severe case, these can help maintain overall hydration of the eyes.

Punctal Plugs

For cases of severe or chronic tear-film insufficiency, our Long Grove Dry Eye doctors will sometimes recommend punctal plugs. These small devices 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 and painless. Find out if punctal plugs are right for you.

Hot Compresses

For mild to moderate dry eyes resulting from Meibomian Gland Disorder or Blepharitis, a hot compress or eye mask can help alleviate symptoms. The warmth of the mask stimulates oil glands to open up, allowing for natural lubrication of your eye.

Amniotic Membrane

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 from volunteer donors. The purpose of the amniotic membrane is to protect and nurture the baby in the womb. When placed over the affected eye, this membrane creates a "womb-like" environment—protecting it from further harm and promoting healing from damage caused by prolonged dry eyes. 

The results of using an amniotic membrane to treat dry eye are dramatic. At our dry eye center, we make use of both wet and dry membranes, which differ slightly in use. Both types offer significant, dramatic 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.

Prescription Eye Drops

In cases of chronic dry eye, we often see patients who have a decreased ability to produce tears. This occurs because of the constant inflammation they experience. Unlike artificial tears, Restasis and Xiidra are medicated prescription eye drops which are both proven to increase the eye’s ability to make its own tears. Instead of constantly replenishing your eyes with moisture, Restasis and Xiidra stimulate your eyes to make more natural tears over time.

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

Typically, Restasis and Xiidra are 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. Get back to living without the symptoms of dry eye. Book an appointment with one of our Long Grove dry eye specialists today.

Restasis vs. Xiidra

Restasis has been available for a number of years. It is an eye drop that is used twice a day. It’s a teardrop form of cyclosporine, an autoimmune suppressant which is prescribed for many chronic conditions and has been found to alleviate the symptoms of dry eyes by reducing inflammation and increasing tear production. However, Restasis doesn’t help improve the outflow of the oil that needs to be produced on top of the tears to prevent tear evaporation. Some current studies suggest 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, it is important to 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.

Scleral Lenses

Scleral lenses are a special contact lens that is larger than traditional contacts. The lens sits on the sclera, rather than the cornea, leaving a pocket of space over the cornea. At our Long Grove office of optometry, we use scleral lenses to treat a variety of eye conditions, including keratoconus and for people with sensitivity to regular contacts.

Scleral lenses are also 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.

Allergan True Tears

New to the market in 2018, Allergan's product rethinks the traditional approach to temporary dry eye relief. Using a small nasal spray like device, True Tears stimulates nerves in the nasal cavity which tell the brain to produce more tears. While not a treatment of the underlying condition, True Tears is an effective and natural tool for temporary dry eye relief. 

BlephEx For Blepharitis

BlephEx is a painless in-practice procedure performed by a member of our optical team to treat blepharitis. Blepharitis is the infection and inflammation of the eyelids which is a common cause of severe dry eyes. At our Dry Eye Center in Long Grove, we make use of the revolutionary BlephEx handpiece, which precisely spins a medical grade micro-sponge along the edge of your lashes to exfoliate this delicate area of your eyelids.

The patented micro-sponge is disposable and a clean one is used for each individual eyelid so bacteria are not spread between the lids. The eyes are rinsed well afterward.

The procedure lasts about 6 -8 minutes and is well tolerated. Most patients simply report a tickling sensation. A numbing drop is usually placed in each eye prior to treatment for increased comfort.

After the procedure, the patient is instructed on how to maintain their clean eyelids with regular nightly lid hygiene. Since home treatments are only semi-effective, the procedure is typically repeated at 4-6 month intervals.

Lipiflow Treatment

Lipiflow for MGD in Long Grove, Illinois

85% of Dry Eye Syndrome is due to Meibomian Gland Disorder (MGD), where the glands essential for producing the lubricating oils for our eyes are blocked, clogged, dirty, infected, or atrophying.

Effectively treating MGD requires directly addressing the dysfunction in the meibomian glands. There are currently a number of treatments that attempt to stimulate the meibomian glands to produce more moisturizing and protective lipids. What LipiFlow does is directly massage and warm the meibomian glands in a safe, comfortable, and targeted way. LipiFlow is currently the only treatment which heats the meibomian glands directly from the undersurface of the upper and lower lids. LipiFlow uses vectored pulsation to simultaneously pump and express the blocked oil glands.

LipiFlow is the only electronic device to be FDA-approved for treating MGD. The procedure is backed up by significant research and clinical trials demonstrating that it is both safe and effective at treating chronic dry eyes and Meibomian Gland Dysfunction (MGD).

Until the LipiFlow, treatment of chronic MGD was mostly restricted to some combination of lubricating eye drops, hot compresses, and, in severe cases, the manual expression of the glands by an eye doctor. In such cases, these treatments are only rarely effective. What’s more, manual expression can be very painful and may only be partially effective.

Instead of a combination of painful or partially effective treatments, LipiFlow both massages out blockages while simultaneously applying heat. The process uses "Vectored Thermal Pulsation Technology". A patented algorithm of precise heat is applied to the inner eyelids with directed gentle massage to remove blockages from the meibomian glands. This treatment is designed to restore the natural oil flow to the tear film that covers the eye’s surface

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Meet Our Dry Eye Doctor

Todd Cohan, O.D. is a graduate of Indiana University, where he earned a Bachelor of Arts degree in Psychology. He earned both a Bachelor of Science degree in visual science and his Doctor of Optometry degree from the Illinois College of Optometrists (ICO) and was the sole recipient of ICO’s...
Dr. Jacqueline Cozzone is excited to join Forsight Vision and serve patients of all ages in the Long Grove community. After receiving her Bachelor’s degree in Biology/Pre-optometry from Augustana College, she earned her Doctorate at the Illinois College of Optometry in 2018. Her rotational experience provided her with advanced knowledge...

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Long Grove | Buffalo Grove | Arlington Heights | Palatine | and the state of Illinois