Dry Eye

Below is information about the condition and how best to treat it. A PDF version is available at the bottom of the page.

What is it?

Dry eye is a common medical condition and is caused by a problem with the drainage, evaporation or production of tears. Tears are moved across the eye when you blink to lubricate the front surface of your eye, wash away debris, protect against infection and to help stabilise vision.

Tears are made up of three main components: an outer lipid layer which prevents tears from evaporating and eyelids from sticking together, a middle watery layer which carries nutrients and oxygen, and an inner mucous layer which allows the tears to wet the cornea. Each layer is produced by different glands in and around the eyelids.

It is possible to be diagnosed with dry eye even if you have very watery eyes; this can be due to a problem with one of the layers of the tears. Dry eye can usually be easily managed.

What causes it?

Dry eye may be caused by pregnancy, some medications (such as Antihistamines and Beta Blockers), or some medical conditions such as Rheumatoid Arthritis, Sjogren’s Syndrome or stroke.

Symptoms can also occur as a result of other eye conditions such as Blepharitis (inflammation of the eyelids), Chalazia (inflammation of the meibomian gland within the eyelid), ectropion (outward turning of the eyelid margin) and entropion (inward turning of the eyelid). Tears are drained through tiny tear ducts which are connected to the nose; problems with drainage of tears can also cause dry eye.

Windy weather, air conditioning, smoking, and activities where you may blink less such as using a computer for long periods can also cause dry eye.

What are the symptoms?

Symptoms of dry eye may include your eye feeling irritated, with blurring, grittiness or itching of the eye. Brief or intermittent blurring of vision, discomfort in bright light and red eyes may also be noticed. If you use contact lenses they may become increasingly uncomfortable to wear.

How is it treated?

Your Optometrist can use the following tests to diagnose dry eye.

  1. Slit lamp – to look at the eye, tears and surrounding area
  2. Tear film assessment – a dye is placed in the tears to allow assessment of their quality and quantity. Your eye is observed with a slit lamp to measure how long after blinking your eyes start to dry and the dye highlights any damaged cells
  3. Your blink rate

There is no real cure for dry eye, but symptoms can be managed. Increasing your blink rate usually has a positive effect on the number of tears produced. Wearing glasses to protect eyes from the elements and frequent breaks when using a computer may help.

If you wear contact lenses, your Optometrist will advise on treatment. Changing lens type, solution, or a break from contact lenses may reduce symptoms.

What can I excpect to happen?

Your Optometrist will offer treatment advice, such as eye drops. Eye drops will keep the eye moist and reduce symptoms. Your Ophthalmologist may reduce the amount of tears which are drained away by plugging drainage channels; but you may still need drops. Extreme cases may require surgery.

Failure to treat dry eye may result in complications such as damage to the cornea.

What we can do to help?

We are pleased to be able to offer a new Dry Eye Assessment using the latest technology.

The TearLab uses sophisticated probes to take a tiny sample of tears from the edge of the lid and measures the tear osmolarity (how concentrated the tears are). This, along with other information gained from examining your eyes, allows us to target the most appropriate treatment for you to improve your comfort and reduce your symptoms.

During our Dry Eye Assessment we will:

  • Ask you to complete a comprehensive dry eye questionnaire
  • Examine your eyelids, tear drainage system, conjunctiva and cornea, pre-corneal tear film integrity and volume, along with other tests to determine specific cause(s) of your symptoms
  • Use TearLab to assess the osmolarity of your tears
  • Discuss with you and devise a treatment plan based on your very specific need
  • Arrange a review after an appropriate time to assess the results of your treatment plan

The full Dry Eye Assessment and follow up appointment are not part of a normal Eye Examination and are not paid for by the NHS.

If you have any queries please feel free to contact us.