Dry eye is very common, affecting approximately one in three to five Australians. Following a Dry Eye Assessment at our practice in Sippy Downs, we will recommend dry eye treatments tailored to treat your symptoms to provide lasting relief. We are dedicated to ensuring that you have clear and comfortable vision so you can enjoy life. Whether you have chronic dry eye or a recent dry eye issue, we aim to develop the right treatment plan for your eyes with or without contact lenses.

What is dry eye?

Dry eye starts with a reduction in the quality, quantity or stability of tears.  The tear film comprises three layers that work together to keep your eyes moist and protected, removing irritants from the eyes and providing lubrication between the surface of the eye and your eyelid. The top oily layer helps to prevent evaporation of tears and is produced in Meibomian glands in the upper and lower eyelids. The middle, watery layer is the thickest layer and keeps the eye moist and flushes irritants off the surface of the eye. It is produced in the lacrimal gland, under the upper outer eyelids. The sticky bottom layer helps the tear film to adhere to the eye, and is produced by the conjunctiva. If anything upsets the tear film it can become unstable and evaporate. This results in dryness and inflammation which can initiate a self-repeating cycle of increasing dryness and inflammation leading to further deterioration in tear function and worsening of symptoms.  Early dry eye management is important to break this cycle.

Dry eye is considered a multifactorial condition as it has numerous and complex causes and risks.  Treatment often involves multiple components to address each of an individual’s root causes and risks. It is not as simple as just putting in drops when your eyes feel sore and there is no “one size fits all” treatment.

Dry eye is a chronic condition that will require ongoing management.  You may need to adjust your treatment and management at times throughout your life as your body and lifestyle changes. Periodic reassessment of your dry eye management is advisable to minimise your symptoms.

Dry eye affects more than the comfort of your eyes. It can affect your ability to work, socialize and enjoy life and can take a toll on your emotions and mental health. You may feel isolated, but you’re not alone. It takes patience and perseverance as treatments take time to achieve full effect, but it’s definitely possible to find relief.

Figure: Tear film - AdOM Advanced Methods Optical
Common symptoms of dry eye include:
  • Blurred or fluctuating vision
  • Sore eyes
  • Stinging or burning eyes
  • Watery eyes – your body may produce “chopping onions” type tears in an attempt to compensate for the dryness. Unfortunately these are not stable and tend to run.
  • Tired eyes
  • Gritty or scratchy eyes
  • Itchy eyes
  • Red eyes
  • Foreign body sensation
  • Difficulty wearing contact lenses

Causes

External factors

  • Weather – dry air and wind
  • Air conditioning
  • Prolonged concentration e.g. when driving, using a computer, reading
  • Contact lens wear
  • Refractive laser surgery
  • Smoking

Internal factors

  • Female gender
  • Age
  • Hormonal changes including menopause, contraception and pregnancy
  • Asian ethnicity
  • Some medications
  • Autoimmune conditions
  • Skin conditions including Rosacea
  • Blepharitis
  • Demodex
  • Eyelid position

How is dry eye diagnosed?

H2 Vision Centres has a dedicated Dry Eye Clinic where our optometrist will thoroughly assess your tear film.  This may include measuring the quantity of tears produced, the stability of the tear film, instilling dyes to assess the tears and surface cells of the eye, assessing tear drainage, assessing your lids and blink dynamics, as well as infrared imaging of your meibomian glands (which produce the oil layer of your tears).  This allows development of a multipronged individualised treatment plan to manage your dry eye in the short and long term.

What do I need to bring to my Dry Eye Assessment?

  • Complete list of current medications, including supplements
  • Complete list of known allergies
  • All eyedrops and lid cleaning products you are currently using

Causes

External factors

  • Weather – dry air and wind
  • Air conditioning
  • Prolonged concentration e.g. when driving, using a computer, reading
  • Contact lens wear
  • Refractive laser surgery
  • Smoking

Internal factors

  • Female gender
  • Age
  • Hormonal changes including menopause, contraception and pregnancy
  • Asian ethnicity
  • Some medications
  • Autoimmune conditions
  • Skin conditions including Rosacea
  • Blepharitis
  • Demodex
  • Eyelid position

Management and Treatment

Aqueous (Watery) Layer Management
  • Artificial Tear Supplementation in preservative free form – following your Dry Eye Assessment our optometrist will advise on the most suitable product for you.
    • Systane Complete
    • Systane Hydration
    • Systane Ultra
    • Systane Gel
    • Hyloforte
    • Hylofresh
    • Cationorm
    • Viscotears
    • Tears Again (spray)
Lipid (Oil) Layer Management
Anti-Inflammatory Products
  • Optimel
    • Optimel Dry Eye Drops
    • Optimel Forte Gel
    • Optimel Manuka Eyelid Cream
  • Medicated Eye Drops (note these are prescription only products and have defined criteria that must be met prior to prescription)
  • Cequa
  • Ikervis
Dietary Changes
  • Mediterranean diet
  • Omega 3 supplementation Prebiotics – e.g. soy beans, onion, asparagus, garlic, bananas, artichoke, bread
  • Probiotics – e.g. aged cheese, kefir, yoghurt, dark chocolate, sour cream, pickles, probiotic milk
  • Drink plenty of water
Environmental Changes
  • Avoid excessive heating / cooling and direct air vents away from your eyes
  • Wear wrap-around sunglasses when outdoors
  • Take frequent breaks when using the computer or reading
  • Position your computer screen below eye level
  • Make an effort to blink more often
  • Blink training
  • Thoroughly remove all makeup nightly. Avoid applying makeup inside the lash line as this can clog the openings of the Meibomian glands