Dry Eye Clinic

What is dry eye?

“Dry eye”, sometimes known as Dry Eye Syndrome, is a common problem. For many people it’s a mild inconvenience, but for some people it’s incredibly disabling. 

The Tear Film

Our natural tears have many important roles, besides letting everyone know you’re feeling sad! Tears are important for providing the surface of your eye with water and oxygen to ensure the cells stay alive and healthy. Tears are also important for making sure that the surface of the eye is nice and smooth. If there are bumps, cracks or dry spots on the eye surface, your vision can blur. Tears help to wash away all of the dust and debris from the atmosphere that get caught in your eyes. If there were no tears to wash away dust, eyes would need to be regularly cleaned like window sills. Tears are also full of natural bacterial fighting enzymes to keep all the bugs away from your eye.

The tears have 3 main layers:

1. A mucous layer that acts like glue to stick the tears onto the eye, 
2. The main watery layer that is full of nutrients for hydrating and keeping the surface of the eye healthy, 
3. The oil layer on the top to make sure that the watery layer does not evaporate or dry up in the wind.

There are many environmental and lifestyle factors, as well as medical conditions and medications, that can affect the production of the three important tear layers. All three layers are required for the eye to feel comfortable in all environments. The eye gets very upset when the balance of tear layers isn’t quite right, causing a wide range of symptoms.

What Does Dry Eye Feel Like?

Everyone experiences dryness differently. Symptoms can include tired, scratchy, sandy, sore, red, burning, itchy or irritable eyes. The eyelid margins may become red, swollen and inflamed. Your vision can also fluctuate with blinking. Confusingly, dryness may also lead to watery eyes. Dry eyes may have crusty buildup/discharge when you wake up, causing the eyes to feel stuck together. The true underlying cause of all of these symptoms is a poor quality tear film.

Dry Eye Treatment Newcastle

Artificial Tears

A quick and simple option for managing dry eye symptoms are lubricating eye drops (artificial tears). The eye drops replace and supplement a tear film that is not being produced properly. There are many different formulations of artificial tears, and while all options are good, the best choice of drop will differ from person to person. Lubricating eye drops are considered to be a short term management option, requiring ongoing use to maintain long lasting comfort. 

Luckily, there are several other long term management options to be used in addition to lubricating artificial tear drops. These treatments aim to stop dry eye at its core, often reducing reliance on daily drops. Using technology, your optometrist can assess the health, stability and function of the tear layer, to identify and treat the root cause of the dryness.

Eyelid Care

Eyelids often collect a buildup of bacteria, excess makeup or tear debris, which can reduce the quality of tears produced. A poor quality tear layer will dry up quickly or cause symptoms of discomfort. Cleaning this debris with antibacterial eyelid hygiene products can make a big improvement to tear production. Using a hot/microwave heat mask on the eyelids, followed by a gentle massage can help improve tear oil production. Improving tear oil production and quality has shown to improve dry eye symptoms and reduce reliance on artificial tear drops.

Blephasteam

Blephasteam is a unique eyelid-warming steam goggle that delivers a standardised, latent moist heat therapy around the eyelids to unblock the Meibomian Glands. The meibomian glands produce the oily top surface of the tear film.

When the glands are blocked little to no oil is produced causing the eyes to dry out which can lead to irritation, stinging, watery eyes and redness in the eyes. Eyelid warming is important as it is used to melt the solid or blocked lipids into a more viscous oil again. This allows the natural oils in your tear film to flow freely again and to form the oily layer of the tears which improves tear quality and reduces evaporation.

Just imagine oil turning into butter. The heat delivered on your eyelids melts the “butter” to turn into oil so it can be secreted from the glands as we blink. Heating the oil secreting glands can be done at home with warm compresses. However, warm compress cannot deliver the precise temperature for a controlled duration as clinically demonstrated to be beneficial for unblocking clogged meibomian oils. Warm compresses require continued reheating which is unnecessary with Blephasteam.

Blephasteam’s dual action heats and melts the meibomian secretions and obstructions. This allows normal function of the upper lid, facilitating release of the oily secretions on lid closure and allows the tears to resurface. By unblocking the meibomian glands, tear quality is improved reducing the symptoms of dry eye, which in turn has positive benefits for eye health, vision and comfort.

Blephasteam® treatment is convenient, safe and allows clear vision during the treatment. Patients are able to carry out normal task activities such as reading or using digital devices whilst undergoing the treatment. 

After Blephasteam treatment, manual expression of the glands is also needed to unblock the glands fully. This gentle squeezing provides enough pressure to unblock the glands. Between 1 and 3 sessions with the Blephasteam goggles are often enough to maintain comfort for many months. 

Supplements & Other Treatments

Oral Omega-3 supplementation has been proven to help with dry eye. This means increasing the amount of oily fish, such as salmon, tuna, mackerel, trout, and sardines, in your diet. One study showed a 30% decrease in the risk of dry eyes for every extra 1g of Omega 3 consumed per day.  Read the nutrition label carefully, and talk to your GP before making large dietary changes, especially if you are on blood thinners or have liver disease or atrial fibrillation.

Other treatment and management options for dry eye include: liposomal spray, steroid eye drops, demodex (mite) treatment with tea-tree oil, manuka honey eye drops, scleral contact lenses, Lipiflow thermal pulsation system, IPL (intense pulsed light) therapy, punctal plugs, and others. These more involved management options work very well in cases where the normal treatments don’t work as well as we would like. We don’t offer all of these treatments to our patients, but they are listed here for completeness.

As Dry Eye tends to be very unique to each patient, an individualised approach to choosing artificial tears will bring the best results. Have a discussion with one of our optometrists to see what management is right for you.

How to Make an Appointment for a Dry Eye Assessment

Please contact us to arrange a dry eye assessment appointment along with your comprehensive eye & vision examination.