Lasting relief for dry, burning, gritty or watering eyes. Dr. J.C. Mungar uses LipiFlow thermal pulsation and BlephEx eyelid therapy to treat the cause of dry eye at the gland, rather than managing symptoms with drops indefinitely.
Dry eye is one of the most common conditions we see, and one of the most misunderstood. The name suggests a shortage of tears, but the majority of cases are not about tear volume at all.
A healthy tear film has three layers. The outermost is an oily layer produced by the meibomian glands along the rim of your eyelids, and its job is to stop the tears underneath evaporating. When those glands block up, the oil layer thins and your tears evaporate faster than they can be replaced. That is evaporative dry eye, and it accounts for most of what walks through the door.
This is why artificial tears so often disappoint. Adding more water to a tear film that cannot hold onto water is a temporary fix, and it does nothing about the blocked glands causing the problem. Dry eye is usually picked up during a routine comprehensive eye exam, though you can book an assessment directly.
Symptoms range from mildly irritating to genuinely disruptive. The one that surprises people most is watering. Eyes that stream are often dry eyes flooding themselves with reflex tears because the surface is irritated.
If several of these sound familiar, a dry eye assessment is the place to start. Screen heavy work and Ontario winters both make it worse, so symptoms that come and go seasonally are still worth investigating. Related screen symptoms are covered on our digital eye strain page, and persistent redness or irritation is sometimes a sign of something else entirely, which is covered under eye disease management.
Dry eye is usually the result of several factors stacking up rather than one single cause, which is why the assessment matters more than the label.
Screen use Blink rate drops by more than half while concentrating on a screen, so the tear film is not being spread across the eye often enough.
Hormonal change Particularly common in women over 40. Hormonal shifts affect both tear production and the quality of the oil layer.
Medication Antihistamines, antidepressants, beta blockers, diuretics and some acne treatments all reduce tear production as a side effect.
Environment Ontario winters, forced air heating, air conditioning and car vents all strip moisture from the eye surface.
Contact lens wear Long term wear can disrupt the tear film and irritate the lid margin. Treating the dry eye usually makes lens wear comfortable again.
Age and general health Gland function declines over time, and conditions such as rosacea, thyroid disease and diabetes all raise the risk.
Treating dry eye without diagnosing the type of it is guesswork. The assessment establishes which mechanism is driving your symptoms before anything is recommended.
What you notice and when, plus medications, screen habits, contact lens wear and any general health conditions that raise the risk.
How quickly your tear film breaks up after a blink, and whether the volume of tears is adequate. This separates evaporative from aqueous deficient dry eye.
A slit lamp look at the meibomian glands and lid margins to check for blockage, biofilm and inflammation, and to assess how much gland function remains.
Dr. Mungar explains what he found and recommends a course of treatment with realistic expectations about what it will and will not fix.
LipiFlow and BlephEx are not available at every optometry clinic. Both are performed here in Oakville, so there is no need to travel into Toronto for specialist level dry eye care.
An FDA cleared device applies controlled warmth to the inner eyelid while gently massaging the outer surface, melting and clearing the hardened oil blocking your meibomian glands. Twelve minutes, no anaesthetic, and most patients notice meaningful change within a few weeks as gland function recovers.
A medical grade micro exfoliation of the lid margin and lash line, removing the bacterial biofilm behind blepharitis. Fifteen to twenty minutes, painless, and often gives immediate relief from itching and crusting. Frequently done alongside LipiFlow.
For inflammatory dry eye, Dr. Mungar can prescribe medicated drops directly, since he holds therapeutics certification. Alongside that, guidance on omega 3 supplementation, warm compress routines, humidity and screen breaks to maintain results between visits.
Both treatments on site LipiFlow and BlephEx require real investment and most clinics have neither. You get specialist level treatment without leaving Oakville.
Diagnosis before treatment The type of dry eye is established first. Treating evaporative dry eye as though it were aqueous deficient is why so many people conclude nothing works.
Medication prescribed directly Therapeutics certification means inflammatory dry eye can be treated here rather than referred on. More on Dr. Mungar's background.
A consistent care team Dry eye is a chronic condition managed over years, so continuity matters. Your dry eye care stays with our optometrists and in one record, alongside your regular eye exams. See the full range of services or find the clinic.
The most common cause is meibomian gland dysfunction, where the oil producing glands along the eyelid become blocked and tears evaporate too quickly.
Other contributors include hormonal changes, prolonged screen use, contact lens wear, medications such as antihistamines and antidepressants, and environmental factors like air conditioning and dry winter air. Most patients have several of these at once.
This is the most common source of confusion. When the eye surface becomes irritated from a poor quality tear film, it triggers a flood of reflex tears. Those tears are mostly water with little oil, so they run off rather than coating the eye.
Watering, streaming eyes are therefore often a dry eye symptom, not evidence against it.
Because in most cases the problem is not a shortage of water. If your meibomian glands are blocked, the oil layer that stops tears evaporating is missing, so added drops evaporate as quickly as your own tears do.
Drops can genuinely help as part of a plan, but on their own they treat the symptom rather than the blocked gland causing it.
LipiFlow and BlephEx are not covered by OHIP, though they are often partially reimbursable through extended health benefits or a Health Spending Account.
The diagnostic assessment may be covered depending on your plan, and is covered by OHIP if you have a qualifying medical condition. Call the clinic for current pricing and we will help you work out what applies.
Most patients get significant relief from a single LipiFlow or BlephEx treatment. Those with more advanced gland dysfunction may benefit from a repeat after about twelve months.
Dr. Mungar assesses how much gland function remains during your appointment and will set realistic expectations rather than promising a cure.
No. No anaesthetic is needed. Most patients describe it as a warm, gentle massage of the eyelids. The device is designed so that the heat is applied to the inner lid surface without contacting the cornea.
There is no downtime and you can drive and return to work straight afterwards.
Usually yes, with the right lens and routine. Daily disposables are generally the best tolerated. In many cases treating the underlying dry eye first is what makes contact lens wear comfortable again.
Generally not. Meibomian gland dysfunction tends to progress, and glands that stay blocked for long enough can stop functioning permanently. That loss is not reversible.
This is the main argument for assessing it sooner rather than waiting to see whether it settles. Treatment is considerably more effective while gland function remains.
You do not have to accept dry, uncomfortable eyes as part of daily life. With the right diagnosis, most patients see meaningful improvement after one or two visits. No referral needed.
