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Dry Eye Conditions

A normal tear film is made up of three layers:

  1. a mucus layer (closest to the eye) helps tears stick to the eye
  2. a watery layer – keeps the eye oxygenated and hydrated
  3. an oily layer (on the surface) stops the tears evaporating

If any of these three layers are not perfect, symptoms of dry eye can be caused such as grittiness, stinging, red eye and even excessive tearing/watering.

There are many causes of dry eye, including:

  • increasing age,
  • some medication,
  • air conditioning,
  • eyelid disorders such as meibomian gland dysfunction and blepharitis (see below), and
  • inflammatory conditions such as arthritis.

At a dry eye assessment, we will carry out a complete assessment of your dry eye problems to identify the cause and formulate a treatment plan. The assessment includes:

  • A detailed history of your symptoms
  • Observation of eyelid and anterior eye health
  • Evaluation of tear quality
  • Specialist techniques to assess corneal and conjunctival dryness
  • Discussion and formulation of a management plan

Depending on the management plan initiated, we will usually arrange a follow-up appointment with you to assess the effectiveness of any treatment.

Our optometrists and reception team would be happy to answer any of your questions or arrange your appointment.

There are about 25 to 30 meibomian glands located in the upper and lower eyelids. They normally slowly release oil into the tear film, helping to stop its evaporation – so preventing dry eye.

Blepharitis can be due to an over-reaction to the body’s normal bacteria at the eyelids, a disorder of the meibomian (oily) glands on the lid margins, or can be related to other skin conditions such as eczema or rosacea.

Sometimes the oil in the meibomian glands becomes slightly thicker than normal, which can lead to blockage of the narrow duct which takes the oil from the gland to the tear film. The oil continues to be made and this can lead to filling and swelling of the glands, causing dry eye since the oil cannot reach the tear film. Severe blockage can lead to much enlarged glands (a cyst) or even infection. Microscopic crusts can form at the base of the eyelashes, harbouring bacteria. It is therefore important to unclog the blocked glands, clean away the crusts and try to prevent the glands from becoming blocked again.

All our optometrists are able to offer advice in our dry eye clinics.

We stock a selection of eye drops for dry eye and allergy, and have a range of eyelid cleansing products to help with Blepharitis management. Our Optometrists will be happy to advise you on which ones are best to manage your particular symptoms as part of a Dry Eye Assessment.

Punctal Plugs and more permanent solutions: For extremely dry eyes that get little or no relief from artificial tear drops our Independent Prescribing Optometrist (Yvonne Nutt) can fit you with Punctal Plugs. These are small absorbable or permanent plugs inserted in to your tear ducts to help preserve as much of your natural tears as possible. Most people still need to use artificial tears as well, but significantly less.

Blocked Tear Ducts: If your eyes constantly water it may be caused by blocked tear ducts. Your tears normally drain in to your tear ducts and then to the back of your nose and throat, but if they become narrow or blocked it can cause your eyes to stream. As part of a specialist appointment our Independent Prescribing Optometrist (Yvonne Nutt) can check the patency of your tear ducts and even clear a blockage.

Our Eye Exam fees are here.