Dry Eye and Blepharitis Clinic

We offer a personalised management and treatment plan for patients suffering from dry eyes and blepharitis.

What is dry eye syndrome?

Dry Eye Syndrome can cause symptoms such as grittiness, burning, stinging and may also blur your vision. The causes of dry eye are multifactorial. Your tears consist of three layers - a mucous layer, a watery aqueous layer and an oily layer. A deficiency in any of these layers or a combination of them can cause symptoms. Aqueous – deficient Dry Eye can occur in conditions such as rheumatoid arthritis. In fact, most cases of Dry Eye are evaporative where the oily layer is poor resulting in excessive tear evaporation. This can due to damage to the ocular surface or by inflammation of the lid margins or blepharitis.

Blepharitis

Blepharitis is a chronic inflammation of the lid margins. Common symptoms of blepharitis include the following:

Itching or scratchy eyes
Foreign body sensation
Tearing
Crusting
Redness/inflammation
Mattering
Dry eyes
Eye rubbing

Assessment and diagnostic tests

The dry eye examination normally includes the following procedures:

Dry eye pre-examination questionnaire – this helps us understand and track the improvement in your symptoms.
Detailed history and symptoms – we discuss with you about when your problem began, other examinations you may have had, your general health, your diet, your medications, your family history, previous treatments and current treatments to get a full understanding of your problem.
High definition, high resolution photographs of the front of the eye using our video/photo slit lamp biomicroscope.
Tear Osmolarity Testing – Tear osmolarity is a measure of the salt concentration of your tears. Increased tear film osmolarity (hyperosmolarity) whether due to an increased tear evaporation rate or a reduction of tear secretion, is indicative of reduced tear volume.
Tear volume assessment – by measuring the tear prism height and using Phenol red thread or Schirmer tests we can diagnose aqueous deficient dry eye.
Fluorescein and lissamine green diagnostic dyes – these are used to assess the health of the front of the eye using our video/photo slit lamp biomicroscopes.

We then produce a detailed personalised dry eye report and treatment plan to help you understand why you have dry eye and/or blepharitis and how we aim to manage your condition.

Management of Dry Eye and Blepharitis:

Home treatments

Heat Treatment

We often advise frequent use of heat treatment to the eyelids in conditions such as dry eye syndrome, meibomian gland dysfunction (MGD), and blepharitis, Heat has been shown to be both effective in easing the symptoms of such conditions but also helping the underlying cause. Heat treatment is followed by lid massage to express the Meibomian glands.

Lid hygiene

Depending on the type and severity of your dry eye and/or blepharitis we may suggest a lid hygiene product, often in conjunction with heat treatment. Such products are specially designed for cleansing the eyelid and eyelashes.

Lubrication

Artificial tears and ocular lubricants are an important aspect of treating dry eye symptoms.

Eye ointments or gels

Eye ointments or gels can also be used to help lubricate your eyes and help keep them moist overnight because your tears can evaporate while you sleep if your eyes are not fully closed.

Supplements

We may also advise the use of dietary supplements to aid in the treatment of dry eye. There have been numerous studies suggesting, in particular, high quality Omega III being beneficial to MGD and dry eye sufferers.

In - House Treatments

BlephEx

BlephEx is an in-practice procedure during which we can thoroughly and precisely eliminate the scurf and bacterial debris which are the main causes of inflammatory lid disease. This is achieved by spinning a medical grade micro-sponge soaked in a preservative free solution very precisely and carefully along the edge of your eyelids and lashes. This removes unwanted biofilm and exfoliates your eyelids.

Intense Pulsed Light (IPL)

Intense Pulsed Light (IPL) therapy is a quick and painless procedure that can provide immediate improvement in dry eye symptoms. It is used to treat meibomian gland dysfunction (MGD), the underlying cause of dry eye in the majority of sufferers.IPL treatment actively treats MGD, the root cause of evaporative dry eye and can also slow the progression of chronic dry eye as a result of damage to the meibomian glands.

How does IPL work?

Your tears contain three layers - a mucous layer, a watery aqueous layer and an oily layer. Each layer has its own unique function. The oily layer, produced by your meibomian glands, prevents the tears from evaporating too quickly between blinks. Quick evaporation can lead to symptoms of dry eye.

You have about 30 - 40 meibomian glands in the upper eyelid and around 25 in the lower eyelid. MGD occurs when the meibomian glands become inflamed or blocked. IPL treatment opens the meibomian glands and liquifies the thickened oil within the glands. Immediately after IPL treatment we express the meibomian glands to remove any blockages.

What happens in IPL?

The area around the eye is cleaned and small protective ceramic eye shields are place on like swimming goggles. A thin layer of a cooling gel is applied to the treatment area around the eyelid and cheek. We then use an IPL hand piece to target and administer short burst of intense light around the eyelids. Five treatments zones are covered in each eye. You will feel a slight heating sensation with each burst of light. The procedure is completely pain free.

Normally three sessions several weeks apart are recommended.

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Punctal Plugs

Punctal plugs stop tears from draining out of the eye by either permanently or temporarily blocking the tear ducts. This can be very useful in treating certain types of dry eye.

View Video

Why Punctal Plugs?

Punctal plugs can help alleviate the symptoms of dry eye in patients diagnosed with low tear volume (aqueous deficiency) if used in conjunction with other treatments such as artificial tears. Punctal plugs would be considered if other treatments have not sufficiently improved the symptoms of dry eye.

How do Punctal Plugs work?

Each eye has a punctum in the upper eyelid and the lower eyelid which allow tears to drain into your nose. Punctal plugs work by permanently or temporarily blocking or reducing the drainage of tears from the eye into the tear duct, thus maintaining the tears on the surface of the eye.

Book a Consultation

Fill out our enquiry form with details of which treatment you are interested in and one of our team will be in touch as soon as possible to discuss how we can help.

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