Dry eye clinic

The Dry Eye Clinic at The Blackheath Hospital offers fast access to a wide range of diagnostic services and treatment for people in Greenwich, Lewisham or Bexley.

Dry eye syndrome is a common condition and occurs when your eyes do not produce a good quality or quantity of tears. This leads to chronic dryness and discomfort.

Your eyes are kept healthy and comfortable through a consistent and adequate layer of tears on your eye’s surface. These tears bathe your eye’s surface, which allows the surface to remain moist. Moreover, your tears remove any dust, debris and microorganisms that could damage your cornea and cause an eye infection.

A normal tear film consists of three important components which are:

An oily (lipid) component. These lipids prevent the tear film from rapidly evaporating and increases lubrication
A watery (aqueous) component
A mucus-like (mucin) component. Mucin helps anchor and spread your tears across your eye’s surface

There are different glands that are involved in producing each of these components:

Your meibomian glands that sit inside your eyes produce the oily component of your tear film
Your lacrimal glands, which are positioned above your eyes and underneath your eyelids, create the watery element of your tear layer
The glands in your conjunctiva (a transparent layer that covers the whites of your eye and the insides of your eyelids) create the mucus component of your tear film

A problem with any of these glands can cause tear instability and dry eyes.

The two primary forms of dry eye syndrome or dry eye disease are:

Evaporative dry eye

If your meibomian glands do not secrete enough oil (meibum), your tear film may evaporate too quickly. This is known as “evaporative dry eye” and is caused by Meibomian gland dysfunction. Unfortunately, Meibomian gland dysfunction occurs in more than 85% of dry eye diseases.

Aqueous deficiency

Sometimes, dry eyes can be caused by your lacrimal glands not producing enough watery fluid to keep your eyes moist. This is known as aqueous deficiency. It can be associated with certain medications or autoimmune conditions such as rheumatoid arthritis or Sjögren's syndrome (a chronic condition that affects the areas of your body that are responsible for producing spit or tears).

Unfortunately, if you have rosacea (a chronic skin condition that can cause redness) in your face, you can also suffer from rosacea in your eyes. This is known as ocular rosacea. It can cause irritation in your eyes, dry and bloodshot eyes, and inflamed eyelids. Sadly, the exact cause of rosacea is unknown but the condition can run in families.

Dry eyes can have several possible causes and these include:

You are more likely to develop dry eyes if you are over the age of 50 (ageing)
Using your computer, TV or mobile without regular breaks can also cause dry eyes
Laser refractive eye surgery, previous cataract surgery, or eyelid surgery
Certain forms of medications (anti-acne medication, some beta-blockers, oral contraceptives, antihistamines, diuretics, decongestants)
Blepharitis: this is an eye condition that causes itchy and swollen eyelids
Preservatives in eye medication: this includes medication for glaucoma

A number of factors can increase your risk of dry eyes; some of which are outlined below:

Computer use: Overuse can lead to greater tear evaporation and an increased risk of dry eye symptoms.
Contact lens wear: Dry eye discomfort is a primary reason why people discontinue contact lens wear.
Aging: Dry eye syndrome becomes increasingly more common later in life.
Menopause: Post-menopausal women are at greater risk of dry eyes.
Indoor environments: Air conditioning, ceiling fans and forced air heating systems can result it dry eye symptoms
Outdoor environments: Arid climates and dry or windy conditions increase your risk of developing dry eyes.
Frequent flying: The air in the cabins of airplanes is extremely dry and can lead to dry eye problems.
Smoking: In addition to dry eyes, smoking has been linked to serious eye problems.
Health conditions: Diabetes, thyroid-associated diseases, lupus, rheumatoid arthritis and Sjogren’s syndrome can all contribute to dry eye problems
Medications: Many prescription and non-prescription medicines increase the risk of dry eye symptoms.
Eyelid problems: Incomplete closure of the eyelids when blinking or sleeping can cause severe dry eyes.

Dry eye symptoms include:

A scratchy feeling, like there’s something in your eye
Stinging or burning feelings in your eye
Red eyes
Sensitivity to light
Blurry vision

In most cases, treatment for your dry eye depends on the cause of your symptoms. There are different treatments that can relieve your symptoms and keep your eyes healthy.

Over-the-counter eye drops

Eye drops or artificial tears are the most common treatment used to relieve mild dry eyes. You do not need a prescription for these. Over-the-counter moisturising gels and ointments can also help alleviate your symptoms.

Prescription medication

But if you have a more serious form of dry eye, your eye doctor might give you a prescription for a medication called cyclosporine. These are eye drops that can help your eyes produce more tears.

Lifestyle changes

If your environment or a lifestyle issue is causing your dry eyes or aggravating them, your doctor may recommend certain changes to protect your eyes.

Lifestyles changes that could help alleviate your symptoms include:

Having a humidifier to prevent your environment’s air from becoming too dry.
Reducing the amount of time you spend on electronic devices and having breaks from staring at screens.
Drinking more water — you should aim for at least eight to 10 glasses every day.
Having sufficient sleep (about seven to eight hours of sleep every night).

Punctal plugs

If your tears are rapidly draining from your eyes, your Consultant or GP may recommend placing special plugs, known as punctal plugs, in your tear ducts. These plugs are formed of silicone or collagen. They can treat dry eyes by reducing or prevent your tears from rapidly draining from the surface of your eyes.

Meimobian gland expression

Meibomian gland dysfunction (MGD) is a chronic abnormality of the Meibomian gland that can cause a change in your tear film and irritation in your eyes. Meibomian gland expression involves unblocking the small obstructions that are blocking your Meibomian glands. Prior to this procedure, you will also receive a local anaesthetic to minimise discomfort.

IPL treatment

Intense pulsed light (IPL) therapy is a light-based therapy that involves the treatment of the skin near your eyelids. It is a considered a potential treatment for Meibomian gland dysfunction. IPL therapy involves applying high-intensity light pulses with different wavelengths to encourage the secretion of oil in your Meimobian glands. IPL therapy can also target the abnormal blood vessels in your eyelids, which can lead to inflammation in your eyelids.

We have a broad range of specialist opthalmologst Consultants who can help diagnose your health issue and build a treatment plan tailored to your needs.

Book an appointment with one of them online today.