Dr. Christian Hester, M.D.

After graduating as the valedictorian from Magnolia High School in Magnolia, Ark., Dr. Hester attended Hendrix College in Conway, Ark. There he served as president of the Student Senate and founded Arkansas EDU, an organization that united all 19 four-year colleges and universities in the state with the goal of advocating for higher education issues in the State Legislature. He graduated from Hendrix College with a Bachelor of Arts degree in Economics and Business and was awarded the Mosley Economics and Business Award — the highest academic award given to a Department of Economics graduate and Business. He also received the President’s Medal, which is the highest academic award a graduating Hendrix senior can receive.

Dr. Hester received his Doctor of Medicine degree and completed his internship at the University of Arkansas for Medical Sciences, where he served as president of his medical school class. While at UAMS, Dr. Hester received numerous awards, including the Ethel Brickey Hicks Scholarship, Dean’s Office Scholarship, and was inducted into the national Alpha Omega Alpha Honor Society. Dr. Hester completed an ophthalmology residency at the California Pacific Medical Center in San Francisco, where he served as chief resident.

In order to learn advanced subspecialty surgical techniques, Dr. Hester completed a fellowship in cornea, refractive, and anterior segment surgery at the Cullen Eye Institute at the Baylor College of Medicine in Houston. And he spent a month in Madura, India, to focus on manual small incision cataract surgery. Dr. Hester has served on the Arkansas Medical Society and California Academy of Eye Physicians and Surgeons Board of Trustees. He also held several leadership positions in the American Academy of Ophthalmology. Dr. Hester is married to Tammy and they have one child, Catherine Cardell Hester.

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Dry Eyes – Are you Dry, Droopy, or Dysfunctional?

 
Millions of Americans are affected by dry eye disease. While a person may have mild dry eyes with little bother, another person may have a severe form that can cause blindness. Most patients with dry eye diseases can be divided into one of three categories: dry, droopy or dysfunctional. So when I evaluate a patient with dry eyes, I ask myself, “Is my patient dry, droopy, or dysfunctional?”

Here is how I can tell if a person’s eyes are dry, droopy or dysfunctional and the common treatments to fix the problem.
 

Dry.

In the dry category, people have dry eye disease because they don’t produce enough aqueous (watery) component for tears.

First-line treatments include minimizing environmental irritants, lubricating eyes with over-the-counter artificial tears up to four times a day, and/or placing plugs in the opening of the tear drainage duct so that tears stay longer. Common environmental factors include increased screen time and fans. When we look at a computer or TV screen for hours, our blink rates decrease. Every now and then you should look away and blink several times. While fans keep us cool during the summer, the circulating air can dry the eyes’ surface. If you need to use a fan and have dry eyes, make sure that it is not blowing toward the eyes.

Second-line treatments include prescription medicines such as Restasis (cyclosporine) and increasing the frequency of artificial tears. Restasis is thought to increase tear production by decreasing inflammation. If you use artificial tears more than four times a day, you should use preservative-free artificial tears (they come in clear individual vials) since excessive amounts of preservatives can damage to the eye’s surface.

Third-line treatments include serum tears and the PROSE lens. For serum tears, a patient’s blood is drawn, processed, and stored in small tubes. Serum tears contain growth factors, fibronectin, and other components produced by our bodies that promote healing of the eye’s surface. The PROSE (Prosthetis Replacement of the Ocular Surface Ecosystem) lens is a customized prosthetic device that maintains a reservoir of fluid over the eye’s surface. This treatment is a viable option when all other treatments have failed.
 

Droopy.

Gravity and age have a way of conspiring against us and unfortunately, eyes are not immune either. An under-recognized cause of dryness on the eye’s surface is a condition called conjunctivochalasis. In this condition, the transparent membrane that overlies the white of the eye becomes droopy. As a result, tears get trapped in the tissue folds and cannot properly distribute across the eye’s surface. This condition can be corrected with an in-office “nip-tuck” procedure.
 

Dysfunctional. 

When it comes to dysfunctional eyes, meibomian gland dysfunction is most common. We have approximately 75 tiny glands that reside just behind our eyelashes. Dysfunction of these glands commonly results in an imbalance in the tear-film and damages the eye’s surface through inflammation. First-line treatments include warm compresses several times a day, lid scrubs with baby shampoo or commercial cleaning cloths, and increasing the amount of omega-3 fatty acids in your diet through changes in eating habits and over-the-counter supplements. I particularly like the HydroEye supplement since it contains GLA, which has been shown to be helpful in treating dry eyes. Second-line treatments include the use of steroid eye drops and oral or topical tetracyclines in order to reduce inflammation and improve the quality of the glands’ secretions. Finally, the glands’ function may be improved by mechanical expression of the clogged glands.

A less common but difficult dysfunction to treat is a dysfunctional blink that traumatizes the eye’s surface. After traditional treatments have failed, the eye’s surface can be restored to normal health by injecting Botox into the eyelid muscles to weaken the muscles responsible for blinking. This intervention results in decreased blink frequency, blink force and eyelid pressure on the eye’s surface.

Dry eye disease can be a complicated eye condition to treat. In order to determine the best treatment plan, a patient should undergo a specialized dry eye evaluation. If you think you might be suffering from dry eyes or would like to learn more, contact us to schedule a quick appointment.

About the Author:  Dr. Christian Hester is fellowship-trained in cornea and refractive (e.g., LASIK) surgery. As part of his fellowship training, he worked with Dr. Stephen Pflugfelder, one of the world’s experts in dry eye disease.

 

What is Dry Eye and How Do You Treat It?

According to the National Eye Institute, dry eye affects nearly 5 MILLION Americans who are 50 years of age and older. While your risks increase with age, anyone can experience dry eye. Sometimes it’s a mild case that is simply irritating; but other times it can lead to severe damage to the eye. I got to discuss the risks and what you need to know about dry eye with Alyse Eady on THV Channel 11. You can view the interview and read more in-depth information below.

WHAT IS DRY EYE?

There are two main factors to dry eye.  The first is quantity — meaning you simply don’t produce enough tears to keep your eyes adequately hydrated and comfortable. The second is quality — it’s not enough to just produce tears to avoid dry eye, the tears have to be the right consistency and can’t evaporate too quickly.

Dry eye can be temporary, for example a woman might suffer it during pregnancy. Or it can be a chronic, life-long condition like if the person has a gland dysfunction affecting the eye lids.

WHO IS MORE LIKELY TO DEVELOP DRY EYE?

Women are more likely to suffer. Of the five million who have severe dry eye in this country, three million of them are women. Pregnancy and menopause can affect a woman’s tear production.

Other risk factors for inducing dry eye include:

  • Allergies
  • LASIK
  • Contacts
  • Certain Medications
  • Computer Screens
  • Autoimmune Disorders

 

WHAT ARE THE SYMPTOMS?

  • Stinging/Burning
  • Feels Like Something Is In Your Eye
  • Stringy Discharge
  • Pain/Redness
  • Blurred Vision
  • Heavy Eyelids
  • Eye Fatigue

 

HOW IS DRY EYE TREATED?

To effectively treat a patient’s dry eyes, you have to identify the cause. I like to group people into three categories: dry, droopy, or dysfunctional. If a person is dry, we can use artificial tears in mild cases but serum tears (artificial tears made from their blood) in more severe ones. Punctal plugs may also be placed in their tear drainage system in order to reduce the clearance of the tears.

Droopy conjunctiva occurs when the transparent membrane that overlies the white part of the eye blocks tears from properly distributing over the surface of the eye. The excess tissue can be removed through an in-office procedure.

Some people have dysfunctional meibomian glands, which are glands that are found in people’s eyelids. The lipids released from the glands mix with the water component of tears in order to reduce the rate tears evaporate. Changes in diet, nutritional supplements, and medications can be used to correct meibomian gland dysfunction. Also, in the dysfunctional category, people may have damage and drying of the eye surface due to dysfunctional blinking. Repetitive abnormal blinking can cause significant damage to the eye’s surface. When all else fails, we can cure these patients with Botox injections in the eyelids.

Be sure to check back next week for more information on dry eyes  and how to manage them, whether they’re feeling dried out, droopy or dysfunctional.

Little Rock Eye Clinic Hires Dr. Christian Hester

20130519_999_96Little Rock Eye Clinic is adding Dr. Christian Hester to its team of eye care physicians in July. Dr. Hester is a highly experienced ophthalmologist who will be servicing patients specifically in cornea and exterior disease surgeries.

A valedictorian graduate of Magnolia High School, Dr. Hester grew up in southwest Arkansas and attended Hendrix College in Conway, Ark., for his undergraduate degree. He received his Doctor of Medicine from the University of Arkansas for Medical Sciences in Little Rock and completed his residency at the California Pacific Medical Center in San Francisco, Calif., where he served as chief resident.

Dr. Hester recently completed his fellowship at the Cullen Eye Institute at the Baylor College of Medicine in Houston, Texas, in cornea, refractive and anterior segment surgery. Dr. Hester said he is excited to return to Arkansas and help Little Rock Eye Clinic expand its surgical practice. Dr. Hester is scheduled to begin seeing patients July 10.

“My wife, Tammy, and I are very excited to be back in Arkansas after spending half a decade away for my ophthalmic training,” Dr. Hester said. “I plan to work hard in order to bring medical and surgical treatments previously unavailable in Arkansas to the state. It is a true privilege to have the opportunity to join Dr. Michael Roberson and the other physicians at Little Rock Eye Clinic in providing the highest level of ophthalmic care.”