Dr Shibal Bhartiya is a Dry Eye Specialist in Gurgaon. Fellowship-trained. Evidence-based. Focused on finding the root cause, not just adding more drops.
Dry eye is one of the most undertreated eye conditions in India.
Many patients spend months, sometimes years, using drops that do not work. They see multiple doctors. They get the same prescription. Nobody explains why their eyes are dry, or whether the cause has been properly identified.
Dr Shibal Bhartiya is a dry eye specialist in Gurgaon with a focused approach to dry eye disease. She combines advanced diagnostic testing, meibography, TBUT; with targeted treatment options including punctal plugs, Intense Pulsed Light (IPL) therapy and autologous serum drops.
Why Your Drops May Not Be Working
Dry eye is not a single disease. It has different causes, and each cause needs a different treatment.
The most common reason drops fail is that the underlying problem has not been identified.
There are two main types of dry eye:
Aqueous-deficient dry eye: the eye does not produce enough tears. This is less common.
Evaporative dry eye: tears evaporate too quickly, usually because the meibomian glands (oil glands in the eyelids) are blocked or damaged. This accounts for 80% of all dry eye cases.
Most patients with evaporative dry eye are prescribed lubricating drops. Drops help temporarily, but they do not treat blocked meibomian glands. So the problem persists.
A proper dry eye evaluation identifies which type you have, and why. Treatment then targets the actual cause.
Dry Eye Diagnostic Tests We Use
A thorough diagnosis is the foundation of good dry eye care.
With me, a dry eye evaluation includes:
Meibography: imaging of the meibomian glands to assess their structure and whether they are damaged or atrophied.
TBUT (Tear Break-Up Time): measures how quickly your tear film breaks down. A short TBUT indicates evaporative dry eye.
Ocular surface staining: fluorescein dye reveals damage to the cornea and conjunctiva that standard examination misses.
Lid margin evaluation: detailed assessment of meibomian gland orifices, lid margins, and blink patterns.
These tests together give a complete picture. They guide treatment. And they allow us to track improvement over time, objectively, not just by feel.
Who We Treat
Screen-heavy professionals and IT workers
Long hours on screens reduce blinking. Incomplete blinking, where the eye does not fully close, is one of the most common drivers of meibomian gland disease. If your eyes feel worse at the end of a workday, or burn during video calls, this is likely contributing.
Glaucoma patients on long-term drops
This is an especially important group. Most glaucoma eye drops contain preservatives, most commonly BAK (benzalkonium chloride). Long-term preservative exposure damages the ocular surface. It causes dry eye, worsens existing dry eye, and can reduce a patient’s ability to tolerate the drops they need.
Dr Bhartiya has specific expertise in managing dry eye in glaucoma patients. She understands the interaction between glaucoma treatment and ocular surface disease, and can recommend preservative-free formulations, adjust drop regimens, and treat the surface while protecting the optic nerve.
Post-LASIK dry eye
LASIK surgery cuts corneal nerves during the procedure. This reduces the eye’s ability to sense dryness and trigger reflex tearing. Post-LASIK dry eye can persist for months to years. It is often undertreated because patients are not warned before surgery, or are told it will resolve on its own.
If you had LASIK and your eyes have felt dry ever since, a structured evaluation is warranted.
Menopausal and hormonal dry eye
Oestrogen and androgen levels strongly influence tear production and meibomian gland function. Dry eye worsens significantly around perimenopause and menopause. Many women are told their eyes are “just dry”, without any connection to hormonal change. Recognising this is the first step to managing it properly.
Ocular GVHD (Graft-Versus-Host Disease)
Ocular GVHD is a serious complication of bone marrow or stem cell transplantation. It causes severe dry eye, scarring of the conjunctiva, and progressive corneal damage. It requires specialist management, standard dry eye drops are rarely sufficient.
Dr Bhartiya sees patients with ocular GVHD and is experienced in the complexities of managing this condition, including autologous serum drops and liaison with transplant teams.
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (TEN)
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but severe reactions. They are usually triggered by medications or infections. They cause widespread blistering of the skin and mucous membranes, including the eyes.
The ocular damage can be permanent. Scarring of the conjunctiva, destruction of the goblet cells that produce the mucous layer of tears, and eyelid abnormalities all contribute to one of the most severe forms of dry eye disease.
Patients with SJS/TEN-related ocular disease need specialist care. Standard lubricating drops are rarely sufficient. Treatment typically involves autologous serum drops, aggressive anti-inflammatory therapy, amniotic membrane grafts, scleral contact lenses in acute cases, and long-term surface monitoring.
Early specialist referral, including during the acute phase, significantly improves long-term outcomes for the eye.
Treatment Options
Preservative-free lubricating drops
For patients who need lubrication without adding preservative load, especially those already on glaucoma drops. Preservative-free drops are the correct foundation for almost any dry eye patient on chronic ocular medications.
Intense Pulsed Light (IPL) therapy
IPL is a clinically proven treatment for meibomian gland dysfunction (MGD), the most common cause of evaporative dry eye.
Light pulses are applied to the skin around the eyelids. This reduces inflammation in the blood vessels that drive meibomian gland disease. It also melts solidified meibum and stimulates the glands to produce healthier oil.
IPL works best for patients with moderate to severe MGD, rosacea-associated dry eye, and those who have not responded adequately to drops and warm compresses.
A course of three to four sessions is typically recommended. Most patients notice improvement after the second session. Results can last six to twelve months, and maintenance sessions extend the benefit.
Autologous serum drops
Autologous serum drops are made from your own blood. A small blood sample is processed, diluted, and converted into eye drops. They contain growth factors, vitamins, and proteins that are naturally present in healthy tears, and absent from any commercial lubricant.
These drops are used in:
- Severe dry eye that has not responded to other treatments
- Ocular GVHD, Stevens- Johnsons Syndrome,
- Neurotrophic keratopathy
- Persistent corneal epithelial defects
They require coordination with a blood bank and regular preparation, but for the right patient, they are transformative.
What Happens at Your First Consultation
The first appointment focuses on understanding your full picture, not just your symptoms.
We will review your history, your current medications (including glaucoma drops, if relevant), your screen habits, your blink pattern, and any systemic conditions that may be contributing.
Diagnostic tests are done at the same visit where possible. You will receive an explanation of what the tests show, what type of dry eye you have, and what the treatment plan involves.
You will not leave with a repeat of the same prescription you came in with, unless it is genuinely the right one.
Frequently Asked Questions
My eyes water constantly. How can I have dry eye?
Watering is one of the most common symptoms of dry eye. When the surface is dry or irritated, the eye produces a reflex overflow of watery tears. These tears do not have the right composition, they do not lubricate. Watering eyes with a gritty, burning feeling underneath is a classic presentation of dry eye disease.
I have been using drops for months. Why are my eyes still dry?
Lubricating drops relieve symptoms temporarily. They do not treat the cause of dry eye. If your meibomian glands are blocked, damaged, or inflamed, drops will not resolve that. A proper evaluation can identify whether your glands are the problem, and then treatment can be directed at the glands, not just the surface.
Is IPL safe for Indian skin?
Yes. IPL settings are adjusted based on skin tone. The treatment is safe and effective across all Fitzpatrick skin types. At this clinic, settings are individualised at each session.
How many IPL sessions do I need?
Most patients need three to four sessions, spaced three to four weeks apart. Some patients with mild disease respond after two. Maintenance sessions every six to twelve months are recommended to sustain improvement.
Can dry eye be cured?
Dry eye is usually a chronic condition. It can be very well controlled, with the right diagnosis and appropriate treatment, most patients achieve significant symptom relief and improved quality of life. The goal is long-term management, not a one-time fix.
I am on glaucoma drops. Can you treat my dry eye without stopping them?
Yes. This is a common situation. The approach involves switching to preservative-free formulations where possible, treating the ocular surface, and monitoring both conditions carefully. Stopping glaucoma drops is rarely necessary and is never done without thorough risk assessment.
What is ocular GVHD and can it be treated?
Ocular GVHD occurs when immune cells from a donor attack the recipient’s eye surface after a stem cell or bone marrow transplant. It causes severe dry eye and can lead to vision-threatening corneal damage if untreated. Treatment is complex and includes autologous serum drops, intense lubrication, anti-inflammatory therapy, and close collaboration with the transplant team. Early referral is important.
Book a Dry Eye Consultation
Phone: +91 88826 38735 | +91 98187 00269
For patients outside Gurgaon, teleconsultation is available for initial report review and follow-up.
A Note on Dry Eye in Glaucoma
If you are being treated for glaucoma and have dry, gritty, or irritated eyes, the two are likely connected.
Glaucoma drops, used daily, often for decades, are the most common cause of chronic ocular surface disease in treated glaucoma patients. The preservatives in these drops damage the cells on the surface of the eye over time.
This matters for two reasons. First, it affects your quality of life. Second, if your eyes are too irritated to tolerate your drops, you may stop using them, and that puts your optic nerve at risk.
Managing the ocular surface is part of managing glaucoma well. It is not a separate problem.
Read the research articles
This article has been written by Dr Shibal Bhartiya, a glaucoma specialist in Gurgaon known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also a research collaborator with Mayo Clinic, Jacksonville, Florida, USA. Dr Bhartiya was a Senior Research Associate at AIIMS, New Delhi (Cornea & Glaucoma Services) where she worked extensively on ocular surface diseases, including dry eye, especially on patients of glaucoma; post corneal transplant glaucoma, and on ocular GVHD (Graft versus Host Disease).
She has published peer-reviewed research examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.
These peer-reviewed article discussing glaucoma treatment are benchmarks for glaucoma surgeons globally, and can be accessed on PubMed and Google Scholar
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