Dry Eye

Dry Eye Treatments

There are a number of treatments for dry eye listed below. We are able to examine and determine the severity of the dry eye. Dry eye is not a curable condition acquired over the years for many different reasons and we’re here to help and guide you.

Artificial Supplements: 

Eye lubricant drops usually are the first step in dry eye treatment. There are many brands of eye drops that are available over the counter without a prescription with a wide variety of ingredients and viscosities, some of which are unsuitable or ineffective. Pretty much like choosing your toothpaste or skin moisturiser.

Prescription Eye Drops:

Medications that your GP could prescribe may reduce inflammation and improve tear production.

Punctal Plugs: 

Tiny silicone plugs inserted into tear ducts help retain natural tears.

Meibomian Gland Treatments:

Warm compresses, eyelid scrubs, or newer therapies like Meibo drops target meibomian gland dysfunction.

Intense Pulsed Light (IPL) Therapy:

IPL (Intense Pulsed Light) treatment for dry eye although not everyone is suitable for this treatment. Here are some groups of people who may need to avoid or exercise caution with this therapy:

  • Darker Skin Types: Individuals with higher Fitzpatrick skin types (IV and above) may be at risk of hyperpigmentation, hypopigmentation, burns, or scarring due to the higher melanin content in their skin.
  • Pregnant or Breastfeeding Women: IPL is generally not recommended during pregnancy or breastfeeding due to potential risks.
  • Certain Medical Conditions: People with autoimmune diseases, skin conditions, or severe dry eye syndrome may not be suitable candidates.
  • Medications: Those taking medications that exacerbate dry eye symptoms should consult their healthcare provider before considering IPL.
  • Sensitive or Allergic Skin: Individuals with highly sensitive or allergic skin should approach IPL with caution.

Possible complications with IPL Therapy:

  • Skin Reactions: Temporary redness, swelling, or a mild sunburn-like sensation around the treated area. In rare cases, burns or scarring may occur.
  • Pigmentation Changes: Changes in skin pigmentation, such as hyperpigmentation (dark spots) or hypopigmentation (light spots), particularly in individuals with darker skin tones.
  • Increased Sensitivity: The skin around the eyes may become more sensitive to sunlight, requiring extra protection like sunglasses or sunscreen.
  • Ocular Symptoms: Temporary light sensitivity or visual disturbances may occur post-treatment.
  • Infection Risks: Though rare, any procedure involving the skin carries a slight risk of infection if not performed under sterile conditions.

Although, it is reported that LLT reduces inflammation, reverses aging of the cell mitochondria  and improves tear film stability, recent studies in the last few years have yet to prove its cost effectiveness and safety; their conclusions were inconclusive recommending that more studies are required. It is for these reasons that currently we are not offering this type of treatment until more research has been done.

Lifestyle Adjustments:

Using humidifiers, taking regular screen breaks, and staying hydrated can help manage symptoms; even eye sprays may prove helpful.

Dry Eye Disease

Information on Dry Eye Disease available when viewed on a laptop or desk top computer.

Dry eyes or gritty eyes are typically caused by a mix of aqueous tear-deficiency and evaporative drying. Aqueous tear-deficiency occurs when the lacrimal gland is not producing enough water-based tears to keep the corneae hydrated. Evaporative drying happens if the oil- (meibum) producing meibomian glands in the eyelid/eyelash margin are blocked from enhancing the watery tears and hence allowing the watery tears to evaporate. In advanced cases of dry eye this leads to inflammation and infection of the eyelids.

Dry eyes can affect clarity of vision. It could be intermittent, temporary or chronic and temporary can develop into chronic. Chronic dry eye may require long term care. Eye rubbing is to be avoided because it is a possible cause of Keratoconus, a condition where the cornea thins and does not regenerate and in advanced stages would lead to corneal transplant. Prolonged wearing of ill-fitting contact lenses with untreated dry eye could scar the cornea and affect the clarity of vision annoyingly to the wearer and over time permanently.  

Some people may have minimal clinical signs of dry eye but still suffer from dry eye pain. Here the brain amplifies the dry eye nerve impulses, and this is called neuropathic dry eye. Then there is an opposite presentation, with evidence of eyes being dry under examination, but these people do not feel dryness at all. This is known as neurotrophic dry eye. Typically, most cases do not fall in the extremes of neurotrophic or neuropathic categories but somewhere in between.

Causes of Dry Eye

Dry eye syndrome can occur due to various factors that disrupt the tear film, which keeps the eyes lubricated and healthy. Some common factors include:

  • Aging: Tear production tends to decrease with age, especially after 50’s.
  • Hormonal Changes: These can affect tear production particularly in women during menopause or pregnancy.
  • Medical Conditions: Autoimmune diseases like Sjögren’s syndrome, rheumatoid arthritis, or thyroid disorders can contribute.
  • Medications: Certain drugs, such as antihistamines, antidepressants, and beta-blockers, may reduce tear production.
  • Environmental Factors: Wind, smoke, dry climates, air-conditioning, heating or prolonged near focus with digital devices can lead to faster tear evaporation.
  • Contact Lenses: Over-wearing contact lenses can irritate the eyes and reduce tear quality.
  • Eye Surgeries: Laser eye surgery such as LASIK may temporarily reduce tear production even as long as a couple years however this tends to settle down.

  • Demodex mites live on eyelashes and eyelids alongside the hair follicles and can contribute to dry eye symptoms when there is demodex overpopulation and result in particularly meibomian gland dysfunction, a key factor in evaporative dry eye. These mites and their waste products can cause inflammation, irritation, and clogging of the meibomian glands, reducing the production and flow of meibum that lubricates the eyes by preventing evaporation of the aqueous tear layer. Tea Tree Oil is a good medium for reducing the overpopulation of demodex however this can prove to be harsh on the skin and tear layer when used longterm. Here at Expressive Eyes we offer professional eyelid scrubs that have a gentle longlasting effect on demodex and enhanced with regular at-home dermatologist approved maintenance.

  • Remote Working: Remote working from home with a greater tendency to be near focussed. During this screen time our blink rate would have decreased and our focus would have been predominantly at near to intermediate distances unless you had an outdoor office/media setup. Some of us would have experienced dry eyes and some eye strain or even both. To combat dry eyes regular conscious  blinking or use of an eye lubricant or moisturiser widely available would bring some relief. For eye strain relief you should change your focus to far for every twenty minutes spent on your close-up work/hobby. Eye strain or headaches are good indicators that you may need optometric help.