The tear film on the surface of the eye is composed of different components. Each of these components is vital to nourish and lubricate the surface of the Cornea. The eyelids and tears work together to wash away debris and bacteria from the surface of the eye. The tear film consists of mucous, oil and water. When the components of the tear film are not balanced, the patients will often experience tearing, foreign body sensation, burning, irritation; sensitivity to light and most importantly, blurred vision. Therefore, if you are experiencing tearing it could be related to the tear production or tear outflow. An experienced Oculoplastic Surgeon can appropriately identify which category you are in. A dry eye patient and a tear drain blockage are treated very differently. A simplistic way to look at tearing is to consider the eye like a bathtub; is the faucet leaking or is the drain not functioning.




A common misconception is that dry eyes will not cause tearing. In fact, up to 80% of tearing patients referred for a surgical procedure actually have dry eyes. The brain will sense that the eye is irritated and dry. The brain then tells the main tear gland to produce more tears. The end result is tearing often while doing normal daily activities. Patients will notice difficulty in windy conditions, driving, working on the computer, watching TV and reading. There are multiple contributory factors to dry eyes. Over time, the tear production can gradually decrease with age and menopause. However, inflammatory conditions like Rheumatoid Arthritis and Sjogrens disease need to be ruled out by examination. The condition of Rosacea contributes to inflammation along the oil glands on the eyelid. This condition will cause early evaporation of the tears. Dr. MacQuaid has presented at national meetings on the best way to treat this condition. Dr. MacQuaid works in conjunction with dermatologists to treat not only your eyes, but also the underlying condition of your dry eyes.




Upper Eyelids: The skin on the upper eyelids is thin and loses elasticity as we age. This leads to excess skin and a tired appearance.


Lower Eyelids: The skin on the lower eyelids also stretches with time. The tensile strength of the eyelid decreases which results in a mild to moderate eyelid droop. Orbital fat protrudes which leads to a “puffy bag” on the lower eyelids. The volume around the eye also decreases leading to “hollowness” around the lower eyelids.


Eyebrows: With time, the soft fatty tissue beneath the eyebrows lessens. The fat in the temples also dissipates leading to a mild brow droop.


Midface: Loses volume and descends. Making the face look aged and tired. This creates lines around the mouth. A full midface creates a more youthful appearance.


Lips: Get thinner and lose volume as we age.


Nasolabial: The nasolabial lines is the line from the corner of your nose to the outer corner of the mouth. As we age, it becomes prominent because the midface droops and we lose volume.


Jawline: The jawline becomes less defined as we age.



We are available Monday - Friday

9:00 am - 4:30 pm.

Hunt Valley Location

Severna Park Location



Dr. MacQuaid is a Board Certified Ophthalmologist and Oculoplastic Surgeon.  An Oculoplastic Surgeon is someone who specializes exclusively in reconstructive, revision and cosmetic surgery of the eyes and surrounding tissue. She completed her fellowship at the prestigious Wilmer Eye Institute at Johns Hopkins Hospital.


Dr. MacQuaid's services range from cosmetic surgery of the eyelids and eyebrows to the midface. Dr. MacQuaid is a renowned expert in reconstructive surgery of the eyelids, eyebrows, tear duct surgery, thyroid eye disease, and tumors. She has advanced training in non-surgical facial rejuvenation such as Botox®, Restylane®, Juvéderm®, Radiesse® and Laser Resurfacing. She offers the latest technology available to patients.


Dr. MacQuaid is currently a member of the American Academy of Ophthalmology and is a Fellow of the American College of Surgeons. Aside from Ophthalmology, Dr. MacQuaid is a former Division One college athlete. In her free time, she enjoys playing tennis and spending time with her husband Jerry and their two children.


Board Certified Ophthalmologist

and Oculoplastic Surgeon


9 Schilling Road Suite LL8

Hunt Valley, Maryland 21031


479 Jumpers Hole Road Suite 106

Severna Park, MD 21146







© 2023 MacQuaid Eye Institute

The material contained on this site is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Always seek the advice of your physician or other qualified health care provider.