The connection between dry eyes and blepharitis

Watery eyes? Tired eyes? Red eyes? Itchy eyes? Blurry eyes? Dry eye can present with many different symptoms but is one of the most common conditions that Opticians see in practice. Is it a simple one to solve? No, but it is one that our Opticians will do their best to help you with, often by recommending one of a range of specialist treatments available in practice.



The first thing to understand is that not all dry eye is the same and so it can’t all be treated in the same way. Eyes are dry because they’re either ‘aqueous deficient’ (this means that there aren’t enough tears to begin with) or ‘evaporative’ (when the tears evaporate too quickly from the front of the eye).


So, what will the Optician do?


Your Optician may want to ask some extra questions about your lifestyle and any symptoms you’re experiencing. They’ll also spend some time looking at the front of your eyes; the glands along the lid margins and eyelashes, the tear film on the front of the eye, the cornea and possibly under the eyelids. This may mean using some special equipment and dye in your eyes too.


They also need to rule out any underlying cause of dry eye as sometimes it can be linked with other health and skin conditions, certain medications or changes to the cornea.


How is dry eye treated?


For most people ocular lubricant drops which help replenish the tear film are a good starting point but there are many different options depending upon the sort of dry eye you have and things that you can change in your day to day life which might help too. Staying well hydrated, taking regular VDU breaks and getting outdoors can all make a difference to treating dry eye. Smoke, pollution and dust can also negatively affect the tear film.


So, your Optician has recommended some expensive drops. At this point many patients ask if they can just use an eyewash instead? A good comparison is that of washing your dry skin in water- eyewash will make the eye wet but it won’t add lasting moisture and replenish the tear film. Using a good lubricant drop is therefore essential. Often these will contain Sodium Hyalurontate (found in many cosmetics) and sometimes additional ingredients to soothe the eye or help heal the ocular surface. Preservatives found in some eyedrops can be damaging if used long term so ideally any lubricant drop recommended should be preservative free.


If your Optician thinks that the meibomian glands aren’t working properly around your eyelids they may also suggest using an Eyebag each day to stimulate the glands, followed by gentle massaging of the lid margins.


No blog about dry eye would be complete without a brief mention of Blepharitis, which is very commonly linked with dry eye. This means inflammation of the eyelids with crusting of the eyelid margins and/ or blocked meibomian glands. The eyelids are often sore and irritated, and a daily lid cleansing regime may be recommended in addition to using an Eyebag or ocular lubricants for any coexisting dry eye. This topic could take up a whole blog on its own but if you think you may be suffering with blepharitis ask your optician for more information.


Strangest of all, someone with a watery eye could be getting this because the eye is dry! Once the surface is dry, the brain stimulates the lacrimal gland to produce more tears to help. These “crying tears” flood the eye and hence the watering is caused by an underlying driness.


Remember, dry eye can have a massive effect on quality of life so if you think you might be suffering don’t hesitate to get in touch with your Optician to see how they can help!

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