17/07/2026
Every dry eye protocol we've refined over the years comes back to one principle: treat the cause layer by layer, not just the symptom.
A patient walks in with gritty, burning eyes. The temptation is to throw lubricants at it and review in six weeks. But when we image the meibomian glands, measure tear break-up time, and assess inflammatory markers properly, we often find three or four contributing factors stacked on top of each other β lid margin disease, incomplete blink patterns, environmental triggers, even medication side effects from antihistamines or antidepressants.
Our tiered approach now runs: Zest treatment for demodex and lid debris, targeted heat therapy for meibomian gland expression, then tailored anti-inflammatory regimens where needed. The order matters. Skipping straight to expensive treatments without sorting the foundation is like painting over damp walls. Has anyone else found that sequencing β getting the basics properly addressed first β makes the bigger interventions actually stick?