Dry Eye and Tear Clinic
Discover treatments for dry, itchy or watery eyes
What is Dry Eye?
Dry Eye Syndrome means your eyes don’t make enough tears or the right kind to stay wet and comfortable. They may not always feel ‘dry’. You might experience irritation, redness, a gritty feeling, watering/excessive tears, blurry vision, light sensitivity or trouble wearing contact lenses.
Types & Causes of Dry Eye
To effectively manage dry eye syndrome, it is important to identify the type of dry eye you have and target the underlying cause.
Decreased Tear Production
Known as “aqueous-deficient dry eye“. Tear production naturally decreases with age, however blepharitis, some underlying health conditions, certain medications and previous surgical procedures can also reduce tear film production.
Evaporative Dry Eye
This occurs due to a lack of lipids (oils) in the tear film. You’ll notice symptoms in certain environments such as wind, air conditioning, or prolonged screen time. Meibomian Gland Dysfunction (MGD), a condition where glands in the eyelid become blocked, can also decrease the amount of oil in tears. Early detection and treatment can prevent permanent loss of gland function.
Imbalance in Tear Composition
Tears are made up of three layers: oil, water, and mucus. If there is an issue with any of these layers, the tears won't be as effective at keeping your eyes lubricated. Some eye drops for other eye conditions can (as a side effect) cause this imbalance.
Data-driven Diagnostics
Understanding the underlying cause of dry eye is key to managing it effectively. Using specialised instruments, we can offer a comprehensive assessment of your symptoms, risk factors, ocular surface, eyelid hygiene, meibomian gland function and tear quality.
High Definition Slit-Lamp Photography allows us to capture detailed videos and photographs of your eyelids and ocular surface.
Interblink Interval (IBI) records how often you blink. This reveals information about your corneal sensitivity and the distribution and evaporation of your tear film.
Tear Meniscus Height (TMH) determines whether you are producing enough tears and how uniform the tears are at the base of your lower eyelid.
Non-Invasive Tear Break-Up Time (NITBUT) assesses the stability of your tear film following a blink. We can measure when the tears begin to dissipate and when more than 5% of your tear film has dissipated.
Meibography is specialised imaging of the meibomian glands using infrared light to assess any damage, inflammation and loss of glands.
Your tear clinic assessment will include all of the above diagnostic tests to reliably diagnose the type of dry eye you have. From this we can create a bespoke treatment plan and recommendations for any in-house treatments as well as home-based management plans.
In-House Treatments
Blepharoexfoliation
A technique used to gently exfoliate the eye lid margin and remove bacteria, biofilm and debris that causes eyelid inflammation. We recommend this treatment for patients with signs of anterior blepharitis, capped meibomian glands and lid margin inflammation. Our optometrists use the BlephEx device to help you maintain healthy eyelids.
Gland Expression
A technique used to apply gentle pressure to either side of the eyelid margin using special forceps. This treatment is recommended for meibomian gland dysfunction/damage and evaporative dry eye. The treatment is more effective if heat is regularly applied to the eyes. We suggest wearing a heat mask at least once daily for a few weeks before your appointment.
Lid Margin Debridement
This can be performed using the BlephEx device or a special single-use tool. Lid margin debridement is used to remove accumulated debris and keratinised cells, clearing the opening of the meibomian glands.
Use of local anaesthetics
Eye drops will be used to numb the surface of your eye and eyelid margin during all of our treatments. This ensures that you can keep your eyes open without excessive blinking and our optometrists can carry out the treatment while keeping you comfortable.
Simple, at-home treatments (such as eye drops, heat masks and lid hygiene regimen) may be sufficient for mild cases or may be recommended alongside in-practice treatments.
Book your Assessment
Following your assessment our optometrists will discuss a management plan, consisting of a mix of at-home and in-practice treatments tailored to you.
Tear Clinic Assessment (£75) - An initial assessment to discuss symptoms and perform diagnostic tests. The optometrist will identify your dry eye type, carry out any initial treatments appropriate for that stage, and outline a management plan.
Tear Clinic Follow-Up (£39, or £75 with repeat treatment) - During this visit the optometrist will review any ongoing dry eye symptoms you are experiencing and repeat diagnostic tests to measure the effectiveness of your current management plan. Repeat treatments can also be performed if required. The optometrist may fine tune your management plan and suggest when to come back for another review.
Call 01249 653292 to book
In-Depth: Dry Eye Causes & Risk Factors
Dry eye syndrome is caused by a variety of factors.
Aging: Tear production naturally decreases with age.
Medications: Antihistamines, blood pressure medications, antidepressants and oral contraceptives can affect tear production. Some eye drops used to treat other eye conditions, e.g. Glaucoma, may also increase the risk of developing dry eye syndrome.
Anterior Blepharitis: Inflammation of the anterior (front) part of the eyelid, where the eyelashes grow from the eyelid margin. This is often caused by bacterial infections, skin conditions, demodex infestation, poor eyelid hygiene, eye make-up and some systemic conditions.
Meibomian Gland Dysfunction (MGD): A condition where the meibomian glands in the eyelids become blocked or produce poor-quality oil. These glands are responsible for producing the oily layer of the tear film, which helps to prevent the tears from evaporating too quickly. In MGD the glands can become blocked and inflamed, and if left untreated, the glands can shrink and become permanently damaged.
Systemic Conditions: E.g. thyroid disorders, Sjogren's syndrome and Rosacea.
Contact Lens Wear: Wearing contact lenses can exacerbate dry eye syndrome.
Eye Surgery: Some eye surgeries can affect the tear glands, corneal nerves and corneal integratory leading to dry eye problems.
Climate, lifestyle and Environment: Wind, smoke, dry air, or exposure to air conditioning can cause the tear film to evaporate too quickly. Long-term exposure to screens can lead to decreased blinking, which reduces tear distribution. Smoking or being exposed to smoke can also increase dry eye symptoms.