Dry Eye Syndrome

Dry Eye→ Dry Eye Syndrome, Chalazions

Do You Have Dry Eye Syndrome?

Do your eyes ever feel dry, gritty, irritated, red, watery, or tired—especially after reading, computer work, or time outdoors? You may be experiencing Dry Eye Syndrome, one of the most common (and often underdiagnosed) conditions we see at Cohenmehr Optometry.

Symptoms can include:

Burning, stinging, or itching
A sensation of sand or foreign body in the eyes
Redness or light sensitivity
Blurred or fluctuating vision
Watery eyes (a reflex response to dryness)

Dry eye can result from many factors, including decreased tear production, poor tear quality, meibomian gland dysfunction, environmental stress, contact lens wear, and even hormonal changes.

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Advanced Dry Eye Diagnostics

At Cohenmehr Optometry, we go beyond surface symptoms to identify the root cause of your dryness. Our office uses state-of-the-art diagnostic imaging to analyze the meibomian glands, which are responsible for producing the oily layer of the tear film. Damage or obstruction in these glands is one of the most common causes of chronic dry eye.

With advanced testing, we can evaluate tear film stability, gland structure, and ocular surface health — allowing us to create a personalized treatment plan tailored to your specific needs.

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Treatment Options

1. Punctal Plugs

Punctal Plugs — Long-Lasting Moisture with Gentle, Dissolvable Options

Punctal plugs are a simple way to help with aqueous-deficient dry eye (when your eyes don’t make enough tears).

We use tiny, soft dissolvable plugs that gently sit at the corner of the eye where tears normally drain, so your own natural tears stay on the surface longer instead of washing away too quickly.

At our Los Angeles office on the Santa Monica border, we use 3-month and 6-month dissolvable plugs instead of older permanent styles.

Why We Prefer Dissolvable Plugs

Our plugs slowly melt away over time, which comes with important safety benefits:

Lower risk of infection or blockage
Because they don’t live in the tear duct forever, there’s less chance of long-term blockage, chronic tearing, or infection that can sometimes happen with permanent plugs left in for years.
Less irritation from a “foreign body”
Permanent plugs can occasionally rub or become exposed. Dissolvable plugs are soft and temporary—they do their job and then naturally disappear.
Gentle on your tear drainage system
Using 3- and 6-month plugs lets us support and protect the eye surface while still being kind to the natural drainage system.

If you do well with them, we can repeat the 3- or 6-month plugs as needed to keep your eyes comfortable over time—without committing to a permanent implant.

What It Feels Like

This is a quick, in-office treatment that most patients describe as a little “drop at the corner of the eye” and then it’s done.
No surgery, no needles, and people don’t feel the plugs once they’re in.

For the right patient, 3- and 6-month dissolvable punctal plugs can provide steady, long-lasting moisture with minimal risk and minimal maintenance, and they work especially well alongside IPL, prescription dry eye drops, and eyelid therapies.

In many cases, punctal plugs are covered by medical insurance when dry eye is properly diagnosed. If you’re unsure about your benefits, contact our office and our team will be happy to check your coverage for punctal plugs before your visit and review your options with you.

2. Intense Pulsed Light (IPL) Therapy

For most of our dry eye patients in Santa Monica and West Los Angeles, the main issue isn’t that they don’t make enough tears — it’s that their meibomian glands (the oil glands along the eyelids) are clogged, inflamed, or starting to shut down. This is called meibomian gland dysfunction (MGD) and it’s the #1 cause of evaporative dry eye.

For patients whose dryness stems from meibomian gland dysfunction (MGD) or inflammation, Intense Pulsed Light therapy is a cutting-edge, non-invasive treatment. IPL gently heats and clears the meibomian glands, improving oil flow and reducing inflammation around the eyelids.

IPL uses gentle pulses of light on the skin around the eyelids to melt thick oils, reduce inflammation, and improve gland function. Over a series of treatments, patients often notice:

Less redness and irritation
More stable tears
Reduced dependency on artificial tears

At Cohenmehr Optometry, Intense Pulsed Light (IPL) is a cornerstone of our dry eye program.

Step 1: High-Resolution Meibomian Gland Imaging

Before we treat, we image your meibomian glands using advanced meibography. This allows us to:

See gland structure, dropout, and atrophy
Measure how much gland loss has already occurred
Track your glands over time as treatment progresses

This is what makes your plan truly customized — we are not guessing which treatment you need; we’re looking directly at the glands.

Step 2: IPL to Treat MGD & Ocular Rosacea at the Source

IPL is a non-invasive, in-office procedure that uses pulses of light on the skin around the eyelids to:

Heat and liquefy thick, stagnant oils inside the meibomian glands
Close abnormal, leaky blood vessels that feed inflammation (common in ocular rosacea and eyelid telangiectasia)
Reduce inflammatory mediators at a molecular level, helping to break the chronic inflammatory cycle driving your dry eye

Step 3: Gland Expression & Lid Care

Right after IPL, we often manually express the meibomian glands while the oils are warm and fluid, helping them function more normally again. Depending on your case, we may combine IPL with:

Thermal gland treatments
Professional eyelid exfoliation / ABMax® to remove debris and biofilm
Targeted therapies for Demodex blepharitis and eyelid mites, when present

By using IPL as the foundation and then supporting it with the right lid therapies, we can restore gland health, protect against further gland loss, and give you longer-lasting relief than drops alone can provide.

Over a series of sessions, patients often notice:

More stable, comfortable tears
Less burning, stinging, and light sensitivity
Reduced redness around the eyes and cheeks
Fewer styes and eyelid flare-ups

Treatments are typically quick, done right in our Los Angeles optometry office, with no needles and minimal downtime.

If you’re struggling with burning, redness, or fluctuating vision and suspect meibomian gland dysfunction (MGD) or ocular rosacea, our dry eye specialists are here to help.

Our office is located in West Los Angeles, right on the border of Santa Monica, and we serve patients from across Los Angeles, Santa Monica, Brentwood, Beverly Hills and the Westside.

At your IPL dry eye evaluation, we will:

Perform a complete dry eye exam
Capture high-resolution meibomian gland imaging
Review your gland health and degree of gland loss
Design a personalized IPL-based treatment plan just for you

3. Amniotic Membranes

Amniotic Membrane Therapy — For Scratches, Non-Healing Spots & Severe Dry Eye

Some dry eye patients don’t just feel “dry” — they feel sharp, stabbing pain, like a needle in the eye, or a scratch that never fully goes away.

You might notice:

Pain or stabbing sensation first thing in the morning when you open your eyes
A feeling like there’s glass, sand, or an eyelash stuck that you can’t rinse out
Sudden burning, tearing, or light sensitivity that comes and goes
A “spot” on the eye that keeps getting irritated over and over

This often happens when the front surface of the eye is damaged or not healing well because of severe dry eye, friction from the eyelids, prior injuries, or sleeping with the eyes slightly open.

That’s where amniotic membrane therapy comes in.

What Is Amniotic Membrane Therapy (In Normal-People Terms)?

Think of amniotic membrane as a supercharged healing bandage for the eye.

It’s an ultra-thin layer of natural tissue that is rich in healing and calming factors.
For you, it mostly just looks and feels like a special type of bandage contact lens that we place on the eye for a few days.
While it’s there, it protects the “scratchy” area and tells the eye to heal in a smoother, healthier way.

We commonly use it in our Los Angeles (bordering Santa Monica) dry eye clinic for:

Severe dry eye that has damaged the surface of the eye
Recurrent “scratches” (recurrent erosions) that keep coming back and causing intense pain

Non-healing spots on the cornea that just won’t fully close on their own

What Does It Feel Like?

Most patients are surprised by how simple it is:

We use numbing drops, then gently place the membrane on the eye — no shots, no operating room, no cutting.
It’s usually held in place by a contact-lens.
For a few days, it may feel like you’re wearing a thicker contact lens
Vision can be blurrier while it’s on, but the trade-off is that the surface is being intensely healed and protected the whole time.

Once we remove it (or it dissolves, depending on the type), the goal is that the eye surface is smoother, less fragile, and less likely to keep “re-scratching” itself.

Insurance & Coverage

Because this treatment is used for medical problems (like severe dry eye, non-healing scratches, or recurring erosions), it is often covered by medical insurance, not just vision plans.

At our office:

We document your condition with photos and testing,
We work with your medical insurance and, when needed, request prior authorization,
And we can check your coverage and go over expected costs before you decide.

For the right patient, amniotic membrane therapy can be a powerful way to finally calm that “needle in the eye” feeling, help stubborn spots heal correctly, and protect your vision—especially when combined with other advanced treatments like IPL, punctal plugs, and prescription dry eye medications.

4. Scleral Lenses — A Revolutionary Option

Scleral Lenses — Advanced Relief for Severe Dry Eye & Eyes That Don’t Fully Close

For some patients, dry eye is more than “a little dryness.” It’s constant burning, light sensitivity, and blurry vision that doesn’t improve with artificial tears, prescription drops, or even punctal plugs.

Scleral lenses are one of the most powerful tools we have for severe dry eye and exposure-related problems—including Bell’s palsy and other facial palsies where the eyelids don’t fully close.

These lenses are large, custom contact lenses that gently rest on the white part of the eye (the sclera) and vault over the cornea, creating a bowl that you fill with sterile saline before putting the lens on. That fluid stays between the lens and your eye all day, acting like a:

Liquid bandage that protects the surface
Continuous reservoir of moisture for severe dry eye
Smooth optical surface that often improves clarity and reduces glare

Many patients who thought they had “tried everything” finally get stable, all-day comfort with scleral lenses.

Ideal for Severe Dry Eye, Exposure & “Eyes That Don’t Close”

At Cohenmehr Optometry in Los Angeles (on the border of Santa Monica), we often recommend scleral lenses for:

Severe or treatment-resistant dry eye disease
Exposure keratopathy from Bell’s palsy or other facial nerve palsies (when the eyelids don’t close completely)
Eyes that sleep slightly open or don’t fully blink
Dry eye from autoimmune disease (e.g., Sjögren’s and other causes of very low tear production)
Ocular surface damage from long-standing dryness

If you also have keratoconus or other corneal conditions, scleral lenses can help with both comfort and vision. (We can link or point patients to a separate keratoconus/scleral page for more detail.)

Led by Brandon Cohenmehr, OD — Specialty Scleral Lens Expertise

All scleral lens evaluations and fittings in our office are personally overseen by Dr. Brandon Cohenmehr, OD.

Dr. Cohenmehr has advanced training in specialty contact lenses and scleral lens design, with a particular passion for helping patients with Keratoconus, Bell’s palsy, facial palsy, and severe ocular surface disease using custom lenses.
He authored a scleral lens case report, “An A+ Solution to Triple A Syndrome: Scleral Lenses,” showing how scleral lenses restored comfort and function in a patient with a rare condition causing extreme tear deficiency (Triple A / Allgrove Syndrome).
He has also been recognized by the SUNY Chancellor’s Award for Excellence, the highest honor in the SUNY education system, for his commitment to innovation and improving clinical outcomes.

This combination of hands-on clinical experience and research makes Dr. Cohenmehr a trusted resource for complex dry eye and exposure cases in West Los Angeles and Santa Monica.

5. Medication based therapy

Medication-Based Therapy — Prescription Drops & Sprays for Dry Eye

For many patients in Los Angeles and Santa Monica, prescription medications are a key part of a dry eye treatment plan, especially when artificial tears and basic home care aren’t enough.

At Cohenmehr Optometry, we focus on treating the root causes of dry eye—inflammation, poor tear production, and fast evaporation—using a combination of prescription drops, sprays, and short-term anti-inflammatory “boosts.”

1. Anti-Inflammatory Drops (Restasis®, Cequa®, Xiidra®)

Chronic inflammation on the surface of the eye is a major driver of dry eye. To calm this down and help your eyes make healthier tears again, we often use:

Restasis® and Cequa® (cyclosporine drops)
These are some of our favorite long-term treatments for chronic dry eye. They help your own tear glands work better by quietly reducing inflammation over time.
- Work gradually over weeks to months
- Designed for long-term, everyday use
- Help many patients reduce burning, stinging, and constant “dry, tired eyes”
Xiidra® (lifitegrast)
Another prescription drop that targets inflammation in a slightly different way. Many patients notice improvement in burning, irritation, and sensitivity to wind or air conditioning.

These medications don’t just “coat” the eye—they change the environment of the surface, so your tears become more stable and comfortable with consistent use.

2. Tear-Stimulating & Evaporation-Focused Therapies

Some medications focus on getting more tears flowing or making them last longer on the eye:

Tyrvaya® (nasal spray)
A prescription nasal spray (not an eye drop) that stimulates certain nerves to signal your body to produce more natural tears. This can be especially helpful for patients who don’t tolerate drops well or who have very low tear volume.
Evaporation-focused drops (like Miebo® and similar therapies)
These are designed to support the oily layer of the tears, which is often weak in our dry, windy Southern California environment. By improving that layer, they help slow down evaporation, so tears don’t disappear seconds after you blink.

3. Short-Term Steroid “Boosts” (Loteprednol and Similar)

When inflammation is really flared up—red, painful, gritty eyes that just won’t calm down—we may add a short course of a mild steroid drop, such as loteprednol:

Quickly reduces redness, burning, and swelling
Often used to “jump-start” longer-term therapies like Restasis®, Cequa®, or Xiidra®
Always carefully monitored and limited in duration to keep things safe for your eyes

Think of this as a reset button for angry, inflamed eyes so that other treatments can work better.

4. Advanced Options for Severe Cases

For more advanced or stubborn cases, we may discuss:

Thicker nighttime gels or ointments for extra protection while you sleep
Prescription-strength combination regimens, pairing multiple medications with IPL, punctal plugs, or scleral lenses
(In select cases) autologous serum or biologic drops, which are made from your own blood components to support healing of the ocular surface

These are reserved for patients with significant surface damage or long-standing disease who need more than standard therapies.

5. New therapeutic eye drops

Tryptyr® (acoltremon) — Neuromodulator Drop to Boost Natural Tears

In our Los Angeles and Santa Monica dry eye office, we also offer Tryptyr® (acoltremon ophthalmic solution 0.003%), a newer neuromodulator eye drop for adults with dry eye disease.

Tryptyr is the first FDA-approved TRPM8 agonist for dry eye disease. It works on “cool” receptors (TRPM8) on the surface of the eye and along the trigeminal nerve to stimulate your own natural basal tear production, rather than simply coating the eye.

Used as one drop in each eye twice a day
Comes in preservative-free, single-use vials
Designed to treat both the signs and symptoms of dry eye disease

How We Use Tryptyr in Our Los Angeles and Santa Monica Office

Our dry eye specialists in Los Angeles typically consider Tryptyr for:

Patients with moderate to severe dry eye disease who still have low tear production despite artificial tears and other prescription drops
Patients who need more rapid improvement in natural tear volume, especially in our dry, windy Southern California climate
Individuals whose symptoms don’t fully respond to cyclosporine (Restasis®, Cequa®) or lifitegrast (Xiidra®), or who want an option with a different mechanism of action

We usually integrate Tryptyr into a comprehensive treatment plan that may also include IPL, punctal plugs, lid therapies, or scleral lenses, depending on your exam findings and overall dry eye picture.

What Results Do We Expect?

With Tryptyr, many patients:

Show increased natural tear production on testing over the first several weeks
Notice improvements in burning, stinging, and fluctuating vision as their tear film becomes more stable

In our Los Angeles dry eye clinic:

We typically reassess patients 2–4 weeks after starting Tryptyr to check tear volume, corneal staining, and symptom relief
We then fine-tune your broader dry eye plan (IPL schedule, plugs, lid care, etc.) based on how you respond

Insurance & How We Personalize Treatment

Most prescription dry eye medications are medical treatments, not cosmetic, and are often covered by insurance (sometimes with prior authorization). Coverage varies, but our team in West Los Angeles, near Santa Monica:

Reviews your exam findings and dryness type
Chooses medications that fit your specific pattern of dry eye
Helps navigate insurance, prior authorizations, and alternatives when needed

We rarely rely on just one medication. Instead, your dry eye specialist will build a custom medication plan designed to work alongside your other treatments—like IPL, punctal plugs, eyelid therapies, amniotic membranes, or scleral lenses—to get you the most comfortable, stable eyes possible.

Experience Relief and Clarity

At Cohenmehr Optometry, we combine advanced diagnostics, modern technology, and compassionate care to manage dry eye at every stage. Whether your symptoms are mild or severe, our team will help you find the most effective solution to restore comfort, vision, and quality of life.

Schedule a dry eye evaluation today and discover how personalized care can help your eyes feel and perform their best.

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