Dr. Y. Shira Kresch — Dry Eye Specialist

If you have been told your dry eye is “just part of getting older” or handed sample after sample of artificial tears without lasting relief, you have not had a proper dry eye consultation. A real consultation is not a five-minute add-on to a routine vision exam — it is a structured medical evaluation that identifies the root cause of your symptoms and produces a treatment plan you can actually execute.

At 1-800-Dry-Eyes Specialty Vision Institute, that is what Dr. Kresch does. This page explains what a dry eye consultation with her involves, who benefits from it, and how to schedule one.

About Dr. Y. Shira Kresch, OD MS

Dr. Kresch is a doctor of optometry with a Master of Science degree and a clinical focus on the medical management of dry eye disease and ocular surface conditions. She practices at 1-800-Dry-Eyes Specialty Vision Institute in Southfield, Michigan, serving patients from across the Metro Detroit region and the surrounding communities of Birmingham, Bloomfield Hills, Royal Oak, Farmington Hills, West Bloomfield, and beyond.

Her clinical interests include:

• Meibomian Gland Dysfunction (MGD) — the leading cause of evaporative dry eye
• Demodex blepharitis — chronic eyelid inflammation driven by mites
• Ocular rosacea — inflammatory eye disease associated with facial rosacea
• Aqueous-deficient dry eye and Sjögren-related ocular surface disease
• Post-surgical dry eye (after LASIK, PRK, or cataract surgery)
• Contact lens-induced dry eye and intolerance
• Scleral lens fitting for severe ocular surface disease

What a Dry Eye Consultation Involves

A consultation with Dr. Kresch is a structured, hour-long medical evaluation — not a routine eye exam. Here is what to expect:

Symptom and History Review

The visit starts with a detailed conversation about your symptoms — when they started, when they are worst, what makes them better or worse, what treatments you have tried, and what has changed in your life or health that might be contributing. Dry eye is rarely caused by one thing, so this conversation matters.

Advanced Diagnostic Imaging

Dr. Kresch uses several diagnostic technologies to map exactly what is happening on the surface of your eyes:

• Meibography — infrared imaging of every Meibomian gland in both eyelids, showing structure, density, and any atrophy
• Tear film breakup time — measures how quickly your tear film destabilizes between blinks
• Tear osmolarity testing — measures tear concentration, which correlates with disease severity
• Ocular surface staining — visualizes corneal and conjunctival damage using fluorescein and lissamine green dyes
• Lid margin and lash examination — checks for Demodex mites, anterior blepharitis, and lid wiper epitheliopathy
• Meibomian gland expression — clinical evaluation of how readily each gland releases oil under pressure

Diagnosis and Treatment Plan

You will see your own meibography images, understand what they show, and leave with a written treatment plan tailored to your specific case. The plan may include in-office treatments like IPL, radiofrequency therapy, low-level light therapy, manual gland expression, prescription eye drops, supplements, environmental adjustments, and at-home therapy — whatever your case actually needs.

Who Should Schedule a Consultation

A consultation with Dr. Kresch is appropriate if any of the following sound familiar:

• You have tried multiple over-the-counter or prescription eye drops without lasting relief
• You have been diagnosed with dry eye but never had your Meibomian glands imaged
• Your contact lenses have become uncomfortable or unwearable
• You experience burning, stinging, watering, or fluctuating vision that gets worse as the day progresses
• You have had LASIK, cataract surgery, or other eye procedures and developed dry eye afterward
• You have rosacea, Sjögren syndrome, or another autoimmune condition affecting your eyes
• Your current eye care provider has told you nothing more can be done

If any of these describe your situation, you are a good candidate for a proper evaluation — and you are almost certainly a candidate for treatment that goes beyond eye drops.

About the Practice

1-800-Dry-Eyes Specialty Vision Institute is the dedicated dry eye and specialty vision division of Michigan Contact Lens, located at 17000 West 10 Mile Road, Suite 151, Southfield, MI. The clinic is equipped with the diagnostic imaging and in-office treatment technology required to evaluate and treat moderate-to-severe dry eye disease — equipment most general optometry practices do not have on site.

Beyond dry eye, Dr. Kresch is also a corneal specialty lens expert. At our affiliated practice Michigan Contact Lens, she fits scleral and specialty contact lenses for keratoconus and irregular corneas — so patients who need both dry eye care and specialty lenses see the same doctor across both practices.