Why lubricating drops so often fail, what a proper dry eye assessment measures, the treatment ladder from lid hygiene to IPL, and every Hamilton practice that runs a dry eye clinic.
Dry eye is one of the most common reasons people see an optometrist with symptoms — grittiness, burning, watering (yes, watering), tired eyes by afternoon, blurred vision that clears with a blink — and the most common mistake is to treat all of it with lubricating drops. In most adults the underlying problem is not too little tear fluid but tears that evaporate too fast because the oil glands in the eyelids (the meibomian glands) are blocked or inflamed. Drops help for minutes; they do nothing for the glands. If you have been using drops several times a day for months and are no better, the drop is not the problem — the diagnosis is.
A dedicated dry eye assessment is longer than a standard examination and measures the things drops cannot fix: tear break-up time, tear volume, the state of the meibomian glands (often with gland imaging), the surface of the eye with dyes, lid margin and lash health (demodex mites are a frequent, treatable culprit), and your environment and medications. The result is a graded diagnosis — evaporative, aqueous-deficient or mixed; mild to severe — and a treatment plan in stages.
A growing number of Hamilton practices run a dedicated dry eye clinic rather than fitting dry eye into a routine examination. Rose Optometry's dry eye clinic in Frankton offers a full assessment ($247, assuming a current eye examination) and in-clinic treatments, and is part of the Dry Eye Specialist Group network (a site also run by Rose Optometry); Rototuna Optometrists runs a Dry Eye Clinic with IPL; Specsavers Te Rapa lists IPL and low-level light therapy; Paterson Burn, Bell Neuhauser & Matthews and OPSM list dry eye treatment. Ask what the assessment measures and which in-clinic treatments are available on site.
A practice is included when its own website lists this service; it is not a rating. Ask the practice how often it provides the service and who will see you.
Frankton · Independent
Watering is a reflex to an irritated surface. When the tear film evaporates too quickly the eye responds with a flood of watery tears that lack the oily layer needed to stay put, so the eye is both wet and dry. Treating the oil glands usually settles the watering.
Rose Optometry publishes $247 for a full dry eye assessment, which assumes a current comprehensive eye examination. Other practices quote when you book; in-clinic treatments such as IPL are usually a course of three or four sessions priced separately.
For evaporative dry eye due to meibomian gland dysfunction, intense pulsed light has reasonable trial evidence for reducing inflammation and improving gland function, usually as a course of several sessions combined with lid hygiene. It is not the first step for everyone, and a good clinic will assess before recommending it.
It depends on the type of dry eye. Preservative-free drops are preferable if you use them more than four times a day; lipid-containing drops suit evaporative dry eye; thicker gels help overnight. If drops several times a day aren't working after a few weeks, have an assessment rather than trying another brand.
Mild dry eye is a comfort problem. Moderate to severe disease can damage the surface of the cornea, blur vision and make contact lens wear impossible, and chronic blepharitis causes recurrent styes and lid problems. It is worth treating properly rather than tolerating.
Book a dedicated dry eye assessment rather than another bottle. Rose Optometry's dry eye clinic and Rototuna Optometrists' Dry Eye Clinic both run dedicated clinics; others are listed above.