Weathering Dry Eyes

Retired hurricane hunter can see clearly after combination therapy.

Once a hurricane warning is issued, most Floridians secure their homes and brace for the high winds and torrential downpours that accompany the tempest. Not James Roles. He made his living defying the alarms and flying directly into the eye of the storm.

Photo courtesy of James Roles.

James Roles

Before retiring in January, James worked for 30 years as an electronics engineer for the National Oceanic and Atmospheric Administration, which operates a fleet of “hurricane hunter” aircraft for research and surveillance.

“My primary job was to manage the scientific instrumentation on the aircraft,” James describes. “There was radar; temperature, pressure and humidity sensors; as well as many prototype instruments.

“In addition, I served as a crewmember aboard the plane to operate the equipment during the flights. For the last 10 years of my career, I worked as a manager and didn’t fly as much. But for the first 20 years, I flew through most of the major hurricanes, including Gilbert, Hugo and Katrina.

“We didn’t count the number of hurricanes we flew through, but we did count the times we flew through the eye of a hurricane. I did that more than 250 times.”

Despite the dangerous nature of his work, James says his job rarely scared him. In fact, he can remember only one instance when he became truly frightened, in 1989.

“The scariest moment came during Hurricane Hugo,” he remembers. “Another plane that was flying at the same time as mine started having problems, and we almost lost it. I knew everybody on that plane so it was a pretty scary day.”

James took his perilous job in stride but grew uneasy last year when his eyes became so dry and irritated that he stopped wearing his contact lenses. James reports that his eyes have always been a little dry, a problem that got substantially worse five years ago. When it got so that he couldn’t wear his contacts, he broke down and consulted his doctor.

“The dryness seemed even worse at night,” James recalls. “Every hour or so, I had to put drops in my eyes, otherwise the dryness would wake me up. When it was really bad, I was getting up four or five times a night. And when I woke up, my eyes were irritated.

“My dry eye was worse at certain times of the year as well due to allergies. I worried that my eyes could be damaged if they stayed this dry for a long period of time.

“I talked to my doctor about my dry eye, and he recommended I visit an ophthalmologist. I did some research on eye doctors in the area and chose Brandon Eye Associates.”
That’s where he met Haroon Ilyas, MD, a board-certified, fellowship-trained eye surgeon.

“James came to us suffering from significant discomfort and fatigue in both eyes due to dry eye disease,” Dr. Ilyas recalls. “He tried over-the-counter drops to help with the discomfort and the blurriness in his vision, but they were unsuccessful. He came to us for alternative treatments, and I recommended a combination of therapies.”

Maintain Moisture

Dry eye disease is a common condition affecting 30 million to 40 million Americans, Dr. Ilyas reports. It is an inflammatory disorder where there is not enough moisture on the surface of the eyes to maintain comfort and provide for visual needs.

Symptoms of dry eye include burning, stinging and dryness. Some people with dry eye feel eye fatigue, especially toward the afternoon and evening hours. Blurred vision and fluctuating vision are common symptoms as well.

It is not uncommon for people with dry eye to have a condition called blepharitis, which can contribute to dry eye development. Blepharitis is a chronic infection and inflammation of the eyelids and lashes. James had significant blepharitis on his eyelids.

“In our office, we have several treatments for dry eye,” Dr. Ilyas notes. “One of them is the BlephEx®.

This is a small machine that thoroughly cleanses the eyelids and lashes to reduce the bacterial load that leads to the chronic infection of blepharitis.”

The second treatment is called MiBo. This uses a probe that delivers thermal pulsations to the eyelids to help the glands there secrete the oils they produce. This oil helps maintain a lasting tear film on the surface of the eye, keeping it moist.

“My eyes are definitely less dry than they were when I started treatment at Brandon Eye Associates. I definitely think my eyes are in better health.” – James

“The third treatment we have is called intense pulsed light, or IPL,” Dr. Ilyas explains. “This has been used by dermatologists for years, but ophthalmologists have found it useful to treat Meibomian gland disease along the lids and lashes. Meibomian gland disease contributes to dry eye by blocking the production of essential oils.

“IPL delivers light pulsations to the Meibomian glands so they create more of their natural oils and release them onto the surface of the eye.”

Since dry eye is an inflammatory disease, it can also be treated medically. Dr. Ilyas often uses anti-inflammatory eyedrops to calm the eyes’ immune cells. Examples of these medications include RESTASIS®, XIIDRA® and CEQUA™. LOTEMAX® is a another anti-inflammatory medication that is also a steroid.

“Punctal plugs are another treatment for dry eye that we often use,” Dr. Ilyas points out. “These are little plugs placed in the tear ducts to retain more moisture on the surface of the eye.”

“Definitely Less Dry”

As part of his combined treatment, James underwent three IPL treatments last summer.

“Dr. Ilyas also prescribed RESTASIS and LOTEMAX eye drops,” James explains. “He did a cleaning process on my eyelids and gave me a cleansing regimen to follow at home.
“I still use LOTEMAX, but only when I wear my contacts, which I don’t do much anymore. I plan to undergo three more IPL treatments this summer, and Dr. Ilyas will perform another assessment of my eyes after that.”

The therapies offered through Brandon Eye Associates significantly improve dry eye symptoms, but there is no cure for the inflammatory disease. Ongoing follow-up and treatment are typically necessary to maintain eye comfort and clear vision.

“My eyes are definitely less dry than they were when I started treatment at Brandon Eye Associates,” James relates. “For one thing, I wake up less at night to put drops in my eyes – maybe once a night compared to four or five times. And I definitely think my eyes are in better health.

“The treatment certainly helped, but it’s not a magic cure. Dry eye is something I’ll have to deal with for the rest of my life. But I think that if I hadn’t gotten treatment, it would eventually cause damage to my eyes.

“Dr. Ilyas is a very nice and knowledgeable doctor. Everyone at Brandon Eye Associates is nice, and it’s a big place with lots of people. When I went back for a follow-up visit after the reopening after COVID-19, the staff handled the situation very well and I felt safe.

“I recommend Dr. Ilyas and Brandon Eye Associates. The practice is very good. They have professionals that cover almost every aspect of the eyes. Dr. Ilyas is the only doctor I’ve seen, but he is very good. I’m very happy with his work.”

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    • Brandon Eye Associates, PA

      The doctors at Brandon Eye Associates use their hearts to help care for your eyes. In addition to being lauded, board-certified physicians at the height of their careers, your Brandon, Sun City Center and Plant City Ophthalmologists are car... Read More

    • Haroon Ilyas, MD

      Haroon Ilyas, MD, is board certified by the American Board of Ophthalmology. Dr. Ilyas completed his undergraduate studies at Duquesne University in Pittsburgh, PA, earning a bachelor’s degree in molecular biology. He attended medical school at... Read More