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Do you suffer from sore, itchy, watery, red eyes?

Mrs Leah Khan - Simon Falk Eyecare

If you answer yes to any of those symptoms it is likely you have some dry eye disease. Dry eye disease (DED) also known as dry eye syndrome or keratoconjunctivitis sicca is a prevalent condition characterized by insufficient lubrication for your eyes. This can lead to discomfort, visual disturbances, and, if left untreated potential damage to the surface of the eye.

Aetiology: The tear film is made up of three layers, an outer oily layer to keep prevent tears evaporating, a middle watery layer to keep the eye lubricated and a mucous layer fasten the tears to the eye. There are two types of dry eye evaporative and aqueous deficient. Evaporative dry eye occurs when the meibomian glands in the eyelids aren’t functioning properly. The meibomian glands are responsible for secreting oils which prevent the tears from evaporating too quickly.

Meibomian gland dysfunction (MGD) is when these glands become blocked and inflamed reducing the quality and effectiveness of the oils causing rapid tear evaporation.

Aqueous deficient dry eye occurs when there is an insufficiency in the Aqueous layer of the tear film produced by the lacrimal glands.

Causes: Dry eye disease is multifactorial and unfortunately does not have one cause.

The most common causes include aging as the amount of tears we naturally produce declines over time. The environment we surround ourselves in such as those that are dry, dusty or exposed to air conditioning. Certain medications can reduce tear production. Heavy makeup can block the oil glands. Lasik or cataract surgery can also cause dry eye.

Unfortunately women are more likely to have dry eyes than compared to men due to hormonal changes in oestrogen, progesterone and testosterone which occur throughout their lives. These hormonal changes affect the quality and quantity of the tear film.

Symptoms: The symptoms of dry eye disease can vary in intensity and may include:

• Burning

• Red eyes

• Contact lens intolerance

• Excessive tearing

• Gritty sensation

• Itching

• Blurred vision

• Light sensitivity.

Diagnosis: Most people are prescribed artificial tears to treat dry eye symptoms without determining which type of dry eye disease a person has. Most artificial tears are designed to help enhance the watery layer of the tear film, however 86% of people suffer from the evaporative type. Therefore if you have been recommended a type of artificial tear that isn’t helping, it may be the wrong type. Our diagnostic equipment includes: Osmolarity

Patient History: We go through a thorough assessment of lifestyle including environment, sleep, medications and health history.

Osmolarity: Osmolarity is the measurement of the saltiness of the tear film. This allows us to score the severity of the dryness. An increased osmolarity indicates a decreased production of the water and oil layers of the tear film.

Tear film assessment: Using the IDRA diagnostic device to measure of the volume of the oily layer of the tear film and the height of the watery layer. The IDRA uses the gold standard method of measuring tear evaporation rate.

Meibomian gland evaluation: Using infrared technology to image the Meibomian glands allowing us to view the quantity and quality of the glands. We also assess the expressibility of the glands to check the quality of the oil. Examination of the ocular surface: Using special dyes to evaluate the health of the cornea and conjunctiva.

Treatment: The management of dry eye disease aims to alleviate symptoms, improve tear production and enhance tear film stability. At the end of the dry eye assessment a unique treatment plan is designed including a lifestyle guide. Our treatment options include:

Artificial Tears: Selecting the correct type of over the counter lubricating drops for the individuals needs to provide temporary relief and supplementing the deficient part of the tear film.

At home therapies: Such as at home heat therapy using a heated eye mask with massage this can help to keep the glands functioning better.

Meibomian Gland Expression: This treatment is used for meibomian gland dysfunction, to unblock the glands and remove the stagnant oil. We gently heat the lids using Activa Mask to soften the oil making it easier to express. We then gently squeeze each gland to express the blocked material.

Tixel®: Tixel® is a new device that is used for dry eye treatment. It uses Thermo-Mechanical Ablation (TMA), a non-laser treatment technology, to transfer thermal energy to the skin around the eyes quickly and safely to correct dry eyes by increasing lubrication and reducing tear evaporation. Tixel® treatment takes less than one minute and involves only a little discomfort with little to no pain. It is non-invasive and there is no downtime. The effects of Tixel® are longer lasting than the use of eye drops.

ACTIVA: is a painless and relaxing treatment to give immediate relief for evaporative dry eye. A clinically proven mechanical method to de-cap and stimulate Meibomian glands unclogging the glands and stimulating the natural production of oils. Patients typically notice a distinct improvement in comfort and a significant reduction in their dry eye symptoms often in the first month of use. We suggest using Activa once a week for four weeks. At the end of this first period, a session every two months is recommended to keep the benefits of the relief. This would reduce the need for at home heat mask and lid massage.

AB MAX™:  is a treatment for blepharitis which is inflammation of the outer eyelids. It is a professional cleaning procedure to remove bacteria, eyelash dandruff and demodex mite infestation. Treatments are usually repeated at regular intervals depending on the severity of your case. After a few treatments patients start producing more of their own tears and the chronic and irritating symptoms caused by Blepharitis will be reduced or alleviated.

Supplements: may also be recommended, especially omega 3 and vitamin D. Omega 3 has been shown to improve the quality of the tear film and reduce inflammation.

Specialty Contact lenses: Scleral contact lenses may be prescribed for those that can’t tolerate regular contact lenses due to dry eyes. They can also help those individuals who have dry eyes due conditions like Bell’s Palsy where the lids can’t close or those who have a deficiency with the watery layer of the tear film.

The reason I wanted to start a dry eye clinic is that I see so many patients in my regular eye examination clinics who are suffering with dry eyes and knew there had to be more options than artificial tears. I too have dry eyes and I am always researching and testing out new treatments and devices to try and help my patients. I would be delighted to see anyone one in the dry eye clinic to help determine the right treatments to help manage symptoms to provide relief and improved comfort and vision.

The clinics are run from the practice in Oakwood. You can contact Leah directly at

456 Roundhay Road,

Leeds LS8 2HU

Tel. 03309 002020

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