Are your Eyes......

Watery                   tired

               Gritty                                        heavy eyes

                                                     
Burning

           Sore                easily irritated

Fluctuating
vision                                  

                                                                  Eyelids stuck together            

You may have

DRY EYE SYNDROME

We offer a specialist Dry Eye Clinic where we ask questions about your specific symptoms then we have a closer look at your lids, lashes and the front surface, tear film of your eyes. After this assessment we will recommend treatments which you can use for a couple of weeks and then return for a follow up assessment.

Sadly this service is not NHS funded.

More information about dry eye:

Dry eye syndrome is a multifactorial disease of the
tears and ocular surface that results in a range of symptoms, including
discomfort, visual disturbance, tear film instability and potential damage to
the ocular surface.

The key features of dry eye syndrome are:

• Decreased tear production
• Increased tear evaporation
• Incorrect composition of tears

These result in inadequate lubrication of the eyes.

Dry eye is a catch-all term referring to abnormalities of the tear layer which normally
coats the surfaces of the eyes, providing clear vision and protecting sensitive
surface tissues

Patients will present with some or
all of the following symptoms

• Scratchy, gritty eyes
• Aching or sore eyes
• Smarting or burning eyes
• Eyes tire easily, particularly noticeable when reading, watching TV or
  using a computer
• Contact lens discomfort or intolerance
• Excessive mucus discharge
• Watery eyes
• Eyes easily irritated by smoke
• Eyelids feel 'heavy' Sensitivity to light (photophobia
• Fluctuating vision
• Blurred vision, particularly first thing in the morning and/or late in
  the day
• Eyelids 'stick shut' at night  

Mild dry eye conditions can usually be managed satisfactorily with
artificial tear supplements, lid therapy and other common treatments. Many millions of people may suffer from dry eyes from time to time and many will be unaware of the symptoms.

Moderate dry eye may affect vision more, and will probably affect quality of life a lot more because of chronic pain, eye sensitivity, light sensitivity and restricted activities.

Severe dry eye may lead to desiccation of the corneal epithelium, ulceration and perforation of the cornea, an increased incidence of infectious disease and, potentially, serious visual impairment and blindness.

Dry eye syndrome has a higher prevalence amongst women and those over 60 years old; however, it is an extremely common eye condition and has a wide range of causes, including:

Medical Conditions

• Systemic diseases (Sjogrens syndrome, RA (Rheumatoid Arthritis), Lupus
  erythematosus, Stevens Johnson, thyroid disease, Bell’s palsy)
• Eye conditions (ocular rosacea, corneal dystrophies)
• Rosacea
• Meibomian Gland Dysfunction (MGD)
• Eyelid conditions (lagophthalmos, ptosis)
• Eye injuries and burns
• Conditions of the eyelid, such as blepharitis
• Vitamin A deficiency
• Neurological lesions (e.g. Riley-Day syndrome)
• Absence/abnormality of lacrimal gland/ductules
• Blink disorders
• Blepharitis anterior or posterior
• Ocular surface disease/allergic conjunctivitus

  Medications

• Chemotherapy and radiation

• HRT

Surgery

• LASIK surgery
• Blepharoplasty-Eye Lid surgery
• Refractive surgery

Biological factors

• Age
• Gender
• Hormonal (e.g menopause)

Lifestyle factors

• Diet
• Lack of sleep
• Contact Lenses
• Prolonged computer use
• Botox

Environmental

• Air conditioning, car heaters, air currents
• Smoky and dusty environments
• Air pressure changes (e.g. on a plane)

How is Dry Eye treated?

In some cases patient's symptoms can be relieved simply by altering the external influences above. Environmental factors can be helped by making simple changes – for example avoidance of dehydrating environments such as air conditioning; if your job involves lots of computer work take regular breaks to rest your eyes. Protecting the eye from dehydrating influences such as a cold wind by wearing spectacles or sunglasses may also
help.

Tears must be distributed efficiently, replaced or
conserved in order to provide relief. As Dry Eye syndrome is caused by an imbalance of tears on the eye's surface the most logical way to treat the problem is to artificially replace the tears and by so doing improve both quantity and quality. Surprisingly, having a watery eye can actually be caused by a lack of tears. This results in dry patches which the eye tries to correct
by a flood of watery tears. Sometimes too much tear flow just needs better lubrication; think of a car engine with water in it, it will be wet but will not be well lubricated. There are a variety of artificial tears available and you will be advised the best option for your particular problem and how to use your treatment.

Lubricating Drops

It is recommended to use a thicker eye drop last thing at night and
first thing in the morning after doing a warm compress over the eyelids. A thinner drop or spray can be used throughout the day to maintain hydration levels.
  
What is Blepharitis?

Blepharitis refers to inflammation of the eyelids. Oils and other products normally secreted by the eye and eyelids
build up on the lid surface and eyelashes resulting in eye irritation and oftenredness. It’s a common disorder and occurs in two forms:

• Anterior Blepharitis - this is when the inflammation affects the outside front edge of your eyelids, where your eyelashes are connected. Two possible causes are bacterial infection and Seborrhoeic dermatitis.
• Posterior Blepharitis - this is when the inflammation affects the inside front edge of your eyelids, where they comeinto contact with your eye. This is caused when something affects the glands that are found at the rim of your eyelids, for example skin conditions such as seborrhoeic dermatitis or acne rosacea.

Signs & Symptoms

Regardless of which type of blepharitis you have, you will probably experience such symptoms as eye irritation, burning, tearing, foreign body sensations, crusty debris (in the lashes, in the corner of the eyes or on the lids), dryness and red eyelid margins.

How can eyelid hygiene help?

Developing a regular routine of eye hygiene is essential in the treatment of blepharitis as it tends to recur and rarely disappears completely. It is important that you clean your eyelids every day, whether or not you are experiencing any symptoms. You should consider it part of your daily routine, like showering or brushing your teeth. Daily eyelid care helps prevent the build up of oils and crusted matter around the eyelid and lash area.

Treatment

Treatment depends on the type of blepharitis you have. It may include applying warm compresses to the eyelids, cleansing them, using an antibiotic and massaging the lids. If your blepharitis makes your eyes feel dry (usually because your tears evaporate more quickly)you may be recommended to use artificial tears.

The warm compresses are designed to both loosen crusts on your eyes before you cleanse them and make the tear secretions more liquid and less greasy. Wash your hands then dampen a clean washcloth with warm water and place it over your closed eyes for a 5 to 10 minute period.

Cleansing the eyelids is essential to blepharitis treatment. You may be recommended to clean them with: warm water only, salt water or a special over-the-counter product specifically made for cleansing the eyelids. First wash your hands, and then dip a cotton wool bud or gauze pad into your cleaning solution. Gently wipe across your lashes and lid margin.
Rinse with cool water. Use a different cotton wool bud for your other eye and repeat the process. When you first begin treatment you may have to cleanse your lids several times a day. When the eyes feel better from the lid hygiene (usually after about 3 weeks) treatment can be done once a day. Remember, to
stop treatment altogether will probably result in a recurrence of problems. Only regular lid hygiene will keep the blepharitis under control.

When you first begin treatment you may have to
cleanse your lids several times a day. When the eyes feel better from the lid hygiene (usually after about 3 weeks) treatment can be done once a day. Remember, to stop treatment altogether will probably result in a recurrence of problems. Only regular lid hygiene will keep the blepharitis under control.