When your tears are not enough

Dry eye is a common condition that affects millions of people worldwide. It occurs when the eyes don’t produce enough tears or the tears evaporate too quickly, leading to discomfort, redness, and eye irritation. There are many treatment options available to help manage dry eyes, including both medical and surgical interventions.

Causes of dry eyes

As people age, hormonal changes can result in decreased tear production, leading to dry eye.

While both men and women can experience dry eye, it is more common in women, particularly those who have gone through menopause.

Other potential causes of dry eye include underlying medical conditions such as rheumatoid arthritis, Sjögren’s syndrome, thyroid disease, and lupus. Eye-related conditions such as blepharitis, entropion, or ectropion can also cause dry eye.

Environmental factors like smoke, wind, or dry climates can exacerbate dry eye symptoms. Activities that reduce blinking, such as prolonged computer use or reading, can also contribute to dry eye.

Long-term use of contact lenses, as well as certain medications like diuretics, beta-blockers, antihistamines, sleeping pills, and anxiety or antidepressant medications, can cause dry eye.

Refractive eye surgeries like LASIK can also result in dry eye symptoms.

Assessment of dry eyes

Before embarking on a treatment plan, Dr Parker will perform a comprehensive assessment of your eyes, focussing on the quantity and quality of tears produced by your eyes and whether your vision is affected. He’ll also check your corneas for any damage that may have occurred due to having dry eyes.

Medical treatment of dry eyes

Over-the-counter medications

The first line of treatment for dry eyes is usually medical therapy. This includes using over-the-counter or prescription eye drops, such as artificial tears, to help lubricate the eyes and reduce inflammation.

Prescription medications

Prescription medications, such as anti-inflammatory drugs or antibiotics, may be prescribed to address underlying causes of dry eye, such as inflammation or infection.

Lifestyle changes

Lifestyle changes can also be helpful in managing dry eyes. This includes avoiding environmental triggers such as wind or dry air, taking breaks from prolonged computer use, and blinking regularly to help spread tears across the surface of the eye. A diet rich in omega-3 fatty acids may also help improve the quality of tears.

Eyelid hygiene techniques for dry eyes

Hot compresses and massage can both help with dry eyes.

  • Make a hot compress by placing a warm, moist towel over closed eyes for several minutes. This can help to soothe dryness and relieve discomfort. The heat from the compress can also help stimulate production of natural oils in the eyes, helping to lubricate the eyes and prevent further dryness. It's important to be careful when using hot compresses as water that’s too hot can cause injury.
  • Massage can also be helpful in relieving dry eyes by helping to stimulate the flow of tears and natural oils. Gently massage the eyelids and the area around the eyes, using gentle circular motions.

Intense pulsed light (IPL)

Intense pulsed light (IPL) therapy can be effective in treating dry eyes caused by ‘meibomian gland dysfunction’, a condition where the meibomian (oil-producing) glands in the eyelids don't produce enough oil, leading to dryness and irritation. IPL opens up these glands, helping to keep the eyes lubricated.


Another option for dry eyes caused by blocked meibomian glands is Lipiflow. This is a medical device which helps to open up these glands.

Surgical treatment of dry eyes

Punctal plugs

Insertion of punctal plugs is a common surgical treatment for dry eyes. It involves the plugging the tear ducts in your eyelids to prevent tears from draining too quickly. This can help keep tears on the surface of the eye for longer periods, reducing dryness and irritation.

First, Dr Parker will examine your eyes to figure out the best type and size plug for your eyes.
He will then numb your tear ducts with anaesthetic eye drops. You may feel some pressure as the punctal plug is placed in your eyelid.

After he has placed the plugs , you can return to your normal activities right away.

Risks of punctal plug surgery for dry eyes

The most common side effect of punctal plug surgery is having a scratchy or irritating feeling in the corner of your eye. Many people find this feeling goes away or they simply get used to it. Sometimes punctal plugs make your eyes too watery, in which case they may need to be removed and possibly replaced with a different type of plug.

You should discuss the options for dry eye treatment thoroughly with Dr Parker to decide whether medical treatment or surgical intervention is the best course of action for you.

You should discuss the options for dry eye treatment thoroughly with Dr Parker to decide whether medical treatment or surgical intervention is the best course of action for you.