Dry Eye Disease can cause much more than a feeling of dryness. It can lead to burning, grittiness, watering, eye fatigue and vision that fluctuates throughout the day.
At The Retina Clinic London, our dry-eye service combines specialist clinical assessment, objective tear-film analysis and targeted treatment to identify the factors contributing to each patient’s symptoms.
Dry eye often has more than one cause. By examining the tear film, eyelids, meibomian glands and surface of the eye in detail, we can build a clearer picture of what is happening and discuss a treatment plan based on those findings.
What is Dry Eye Disease?
The surface of the eye is protected by a thin layer of tears known as the tear film. A healthy tear film helps keep the eyes comfortable and supports clear, stable vision.
The tear film has several important components. These include an oily layer that helps reduce evaporation, a watery component that provides moisture and a mucous component that helps the tears spread evenly across the eye.
Dry Eye Disease develops when this system becomes disrupted. The eyes may not produce enough tears, tears may evaporate too quickly, or the tear film may become unstable. Inflammation can also become part of the condition.
For many patients, several of these factors occur together.
What causes Dry Eye Disease?
There is no single cause of dry eye. Understanding what is contributing to the problem is an important part of deciding how it should be managed.
Factors may include:
- Meibomian gland dysfunction, where the small oil-producing glands within the eyelids do not function normally, allowing tears to evaporate too quickly
- Reduced tear production
- Inflammation of the surface of the eye or eyelids
- Blepharitis, which is inflammation affecting the eyelid margins
- Rosacea and associated eyelid inflammation
- Long periods of screen use and reduced blinking
- Contact lens wear
- Air conditioning, heating, wind and dry environments
- Hormonal and general health factors
- Certain medicines and long-term eye drops
- Previous eye procedures, including cataract or laser eye surgery
Many patients have a combination of contributing factors rather than one isolated cause.
What are the symptoms of Dry Eye Disease?
Dry eye can affect people differently. Symptoms may include:
- Dryness or a gritty sensation
- Burning or stinging
- Redness
- Watery eyes
- Blurred or fluctuating vision
- Sensitivity to light
- Eye fatigue
- Discomfort during reading or prolonged screen use
- Difficulty wearing contact lenses comfortably
Watery eyes can seem surprising in someone with dry eye. This can happen because irritation of the surface of the eye triggers reflex tearing. These tears do not necessarily provide the stable, protective tear film the eye needs.
How we assess Dry Eye Disease
Our aim is not simply to establish that the eyes are dry. We want to understand why.
Our dedicated dry-eye assessment examines the different parts of the tear system and the surface of the eye to establish an objective baseline.
Depending on the individual assessment, this may include:
- A detailed discussion of your symptoms and how they affect daily life
- Review of your medical history, medicines and current eye drops
- Examination of the surface of the eye and eyelid margins
- Objective measurement of tear-film quality and stability
- Assessment of the oily component of the tear film
- Assessment of tear volume
- Analysis of blinking and incomplete blinking
- Examination of the structure and function of the meibomian glands
- Assessment for associated conditions such as blepharitis or rosacea
- Fluorescein assessment, using a diagnostic dye to highlight areas of dryness or disruption on the surface of the eye
Where appropriate, we can use advanced imaging and artificial intelligence-assisted analysis to help quantify findings and compare objective measurements over time.
This measurement-led approach allows us to consider your symptoms alongside what we can see and measure clinically.
Understanding the meibomian glands
The meibomian glands are small glands located within the eyelids. They produce oils that form an important part of the tear film and help prevent tears from evaporating too quickly.
When these glands become blocked or do not produce healthy oil, the tear film may become unstable. This is known as meibomian gland dysfunction and is an important cause of evaporative dry eye.
Assessing these glands directly can help us determine whether they are contributing to a patient’s symptoms and whether targeted treatment may be appropriate.
Treatment for Dry Eye Disease
There is no single treatment that is right for every patient.
Treatment depends on the pattern and severity of dry eye, the findings from the clinical examination and the factors contributing to the condition.
Our approach is to address these factors in a structured way rather than relying on a generic treatment pathway.
Intense Pulsed Light (IPL)
Intense Pulsed Light, usually referred to as IPL, delivers controlled pulses of light to the skin around the eyelids.
For selected patients with evaporative dry eye and meibomian gland dysfunction, IPL may form part of treatment aimed at improving the environment around the eyelids and supporting healthier meibomian gland function.
At The Retina Clinic London, IPL can be combined with manual treatment of the meibomian glands where clinically appropriate.
Treatment is recommended only after assessment has established whether this approach is suitable.
Manual meibomian gland treatment
Where the meibomian glands are blocked or their secretions have become altered, targeted treatment may be used to help improve gland function.
This can form part of a broader treatment programme alongside IPL and appropriate home eyelid care.
Anti-inflammatory treatment
Inflammation can play an important role in persistent Dry Eye Disease.
For selected patients, treatment may include anti-inflammatory eye drops. Short courses of topical steroid drops may sometimes be considered, with appropriate clinical monitoring.
Topical ciclosporin may also be considered where longer-term control of inflammation on the surface of the eye is required.
The choice of medication depends on the individual clinical assessment.
Punctal occlusion
Tears naturally drain away through very small openings at the inner corners of the eyelids called the puncta.
For some patients with reduced tear production, slowing this drainage can allow tears to remain on the surface of the eye for longer. This is known as punctal occlusion.
Options may include punctal plugs or other treatments designed to temporarily reduce tear drainage.
Lacrifill®
Lacrifill® is a preservative-free option for selected adults with Dry Eye Disease.
It is placed within the tear-drainage system to temporarily reduce tear drainage, allowing the patient’s own tears to remain on the surface of the eye for longer.
It may be considered for selected patients where reduced tear volume is an important part of their dry eye. Suitability is established during clinical assessment.
Lubricating eye drops
Lubricating drops, sometimes called artificial tears, remain an important part of dry-eye management for many patients.
Different formulations have different properties, which is why we consider the pattern of dry eye rather than simply recommending a generic lubricant.
Depending on the individual patient, drops may be used to:
- Improve hydration of the surface of the eye
- Reduce irritation
- Support tear-film stability
Preservative-free formulations may be preferred where drops need to be used frequently or where the ocular surface is particularly sensitive.
Eyelid care and heated eye masks
Home treatment can also play an important role, particularly when meibomian gland dysfunction or blepharitis is present.
This may include:
- Warm compresses or an appropriate heated eye mask
- Regular eyelid hygiene
- A structured eyelid-care routine
- Advice on blinking and screen habits
We will explain which measures are appropriate according to the findings from your assessment.
A treatment plan built around the cause
Dry eye management is often most effective when the different contributing factors are considered together.
Depending on the individual patient, this may mean combining treatment for the meibomian glands with management of inflammation, lubrication, tear retention or changes to everyday habits.
We may also review factors such as:
- Current eye drops or medicines
- Contact lens wear
- Screen use
- Environmental exposure
- Blepharitis
- Rosacea
- Previous eye surgery
Treatment recommendations are based on clinical assessment, and not every treatment will be suitable for every patient.
Monitoring your progress
Dry Eye Disease can require ongoing management rather than a single treatment.
Objective measurements allow us to establish a baseline and, where appropriate, compare changes over time. Follow-up assessment can help us understand how the tear film and ocular surface are responding and whether the treatment plan needs to be adjusted.
Our aim is to give patients a clear understanding of what is contributing to their symptoms and a structured plan for managing it.
Why choose The Retina Clinic London for dry-eye care?
Our dry-eye service combines specialist clinical assessment, objective tear-film analysis and targeted treatment to identify the factors contributing to each patient’s symptoms.
We take a measurement-led approach. Rather than treating dry eye as a single condition with a standard solution, we examine the tear film, eyelids, meibomian glands and ocular surface in detail.
Our technology allows us to assess features such as tear-film stability, tear volume, blinking and meibomian gland structure, giving us objective information alongside the patient’s symptoms.
Where appropriate, this can be complemented by artificial intelligence-assisted analysis to quantify findings and support comparison over time.
Most importantly, these measurements are interpreted within a specialist clinical consultation. Technology supports our decision-making, but it does not replace clinical judgement.
The result is a personalised pathway that begins with careful assessment, followed by a clear explanation of the findings and treatment options selected according to the individual patient’s needs.
Frequently asked questions about Dry Eye Disease
What is the main cause of dry eye?
There is no single cause. Dry eye may result from reduced tear production, excessive evaporation, meibomian gland dysfunction, inflammation or a combination of factors.
A detailed assessment can help establish which factors are most relevant.
Why are my eyes watery if they are dry?
Dryness and irritation can trigger reflex tearing. This can make the eyes water even though the underlying tear film is unstable or insufficient.
Is dry eye a long-term condition?
It can be. Some cases are temporary, while others require ongoing management. This depends on the underlying causes and associated factors.
How is dry eye diagnosed?
Assessment usually involves examining the tear film, surface of the eye, eyelids and meibomian glands. Objective measurements can provide additional information about tear-film stability, tear production and gland function.
What is the best treatment for dry eye?
There is no single best treatment for everyone. Treatment should be guided by the cause and clinical findings.
Options may include lubricating drops, eyelid care, Intense Pulsed Light (IPL), treatment of the meibomian glands, anti-inflammatory medication or punctal occlusion.
Does screen use make dry eye worse?
Long periods of concentrated screen use can reduce the frequency and completeness of blinking. For some patients, this can make dry-eye symptoms more noticeable.
Is IPL a laser?
No. Intense Pulsed Light (IPL) is not a laser. It uses controlled pulses of broad-spectrum light and should be described as Intense Pulsed Light or IPL.
How many IPL treatments will I need?
Treatment schedules vary. If IPL is considered appropriate, the recommended course will be discussed following assessment and will depend on the individual findings and response to treatment.
When should I see a specialist?
A specialist assessment may be helpful when symptoms are persistent or worsening, when they affect vision or everyday comfort, when contact lenses have become difficult to tolerate, or when symptoms continue despite the use of over-the-counter drops.
Book a Dry Eye consultation
If dry, uncomfortable or watery eyes are affecting your vision or quality of life, a detailed assessment can help establish the factors contributing to your symptoms and provide a clearer basis for treatment.
All new patients begin with a private specialist consultation and assessment. Our team will explain the findings clearly and guide you through the appropriate next steps.
To book your consultation, please call +44 (0)20 4548 5310 or use the form below.
We’ll be glad to guide you through the next steps.