Condition
Dry Eye
A chronic condition where the eyes do not produce enough tears or the tear film is of poor quality, causing discomfort, visual disturbance, and ocular surface damage.
Overview
Understanding Dry Eye
Dry eye disease is one of the most common eye conditions, affecting millions of people in the UK. It occurs when the eyes either do not produce enough tears, or the tears evaporate too quickly due to poor quality of the tear film. This leads to inflammation and damage to the ocular surface.
The tear film has three layers — an outer oily (lipid) layer, a middle watery (aqueous) layer, and an inner mucus (mucin) layer. Dysfunction of any of these layers can cause dry eye symptoms. The most common form is evaporative dry eye, caused by meibomian gland dysfunction (MGD), where the oil-producing glands in the eyelids become blocked or dysfunctional.
Symptoms range from mild irritation to severe discomfort that significantly impacts quality of life. Paradoxically, watery eyes can be a symptom of dry eye — the eyes produce reflex tears in response to surface irritation, but these emergency tears lack the proper composition to lubricate effectively.
Miss Tina Khanam takes a thorough approach to dry eye assessment and management. Identifying and treating dry eye is particularly important before any eye surgery, as it directly affects surgical measurements and outcomes. She offers comprehensive dry eye evaluation including tear film analysis and meibomian gland imaging.
Symptoms
Signs You May Notice
If you are experiencing any of these signs, a consultation can help determine the cause and appropriate treatment.
- Gritty or sandy sensation
Feeling of something in the eye, particularly in the morning
- Burning or stinging
Uncomfortable sensation that may worsen throughout the day
- Watering eyes (paradoxical)
Excessive tearing as a reflex response to dryness
- Blurred vision
Fluctuating vision that temporarily clears with blinking
- Red, irritated eyes
Persistent redness, especially after screen use or in dry environments
- Tired, heavy eyelids
Eyes feel fatigued, particularly by the end of the day
Causes
What Causes This
- Meibomian gland dysfunction (MGD) — the most common cause of evaporative dry eye
- Ageing — tear production decreases with age
- Prolonged screen use — reduced blink rate leads to increased tear evaporation
- Hormonal changes — menopause, pregnancy, oral contraceptives
- Systemic medications — antihistamines, antidepressants, blood pressure medications
- Autoimmune conditions — Sjögren's syndrome, rheumatoid arthritis, lupus
Risk Factors
Who Is at Risk
- Contact lens wear
- Prolonged screen use (reduced blink rate)
- Dry or air-conditioned environments
- Autoimmune conditions
- Age over 50
- Female sex (hormonal factors)
- Previous eye surgery (LASIK, cataract)
Important
When to Seek Help
Consider booking a consultation if you notice any of the following:
- Over-the-counter drops are not providing adequate relief
- Your symptoms are affecting your work or daily activities
- You have persistent redness, pain, or changes in vision
- You are considering eye surgery and want your dry eye optimised first
Common Questions
Frequently Asked Questions
Dry eye is typically a chronic condition that is managed rather than cured. However, with the right treatment plan, symptoms can be significantly reduced and quality of life greatly improved. Identifying and addressing the underlying cause is key.
This is called reflex tearing. When the ocular surface becomes dry and irritated, the lacrimal gland produces emergency watery tears. However, these reflex tears lack the oils needed to stay on the eye surface, so they run down the cheeks rather than lubricating the eye.
Prolonged screen use significantly contributes to dry eye. Studies show that blink rate drops by up to 60% during screen use, meaning tears evaporate faster. The 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) can help.
Concerned About Your Eyes?
Miss Khanam provides thorough, unhurried consultations to assess your condition and discuss the best treatment options for your situation.
Take the First Step
Understanding your condition is the first step toward clear vision. Your consultant is here to provide expert guidance, honest advice, and compassionate care.