Dry Eye

Dry eye can have a massive impact on quality to life and seems to be worsened by working from home, so many are coming to us looking for advice. Here Ian Cameron provides helpful advice for those who suffer from the condition.

Welcome to the Tear Clinic. We hope you are already enjoying the benefits of the treatment and advice you have received to date. Here we have uploaded a number of videos which we hope will be beneficial. Using an eye bag Inserting eye drops

Ocular surface disease (dry eye disease) Our tears, and the film they form over our eyes, serve a very important function in keeping our eyes comfortable, healthy and able to see well. It’s only when we don’t have enough tears or they are of poor quality that the surface of our eye becomes exposed and become uncomfortable. Tear film problems are often referred to as ‘dry eye disease’. This is sometimes a confusing name as ‘dry’ eyes can often be quite watery, so a more appropriate name is ocular surface disease. Ocular surface disease occurs when we either have too few tears or, more commonly, when we have enough tears but they are of poor quality. Ocular surface disease is often linked to blepharitis, an inflammation of the eyelids and the glands that produce the lipid layer of the tear film. How would I know if I had ocular surface (dry eye) disease? This can feel different for everyone but the common symptoms are: dry, tired feeling eyes stinging, burning or gritty sensation red eyes blurry vision that can be variable through the day and when we blink not producing enough tears or having excessively watery eyes. What are the causes of ocular surface (dry eye) disease? There are many causes which include: advancing age hormone changes laser eye surgery medications including antihistamines and beta blockers smoking contact lens wear spending time in a dry environment allergies blepharitis of which there are a variety of types including demodex blepharitis general health conditions such as thyroid eye disease, arthritis and Sjӧgren’s syndrome. How is ocular surface disease managed? The route to managing dry eyes properly is to have consultation that diagnoses the type of dry eye you have. Understanding this allows us to develop a tailored management plan for you. This diagnosis requires expertise and specialist equipment that GPs and pharmacists don’t have and can only be done properly at an optometrist or hospital eye service. Find out more about how we manage the condition at our Tear Clinic.

Lacrimal syringing for excessive tears The lacrimal gland, within the eyelid, produces tears. Tears are vital for day-to-day lubrication of the eye and to wash away potentially harmful substances or allergens.When natural tear production is disrupted it can cause excessively watery eyes (epiphora). If watering becomes excessive, particularly if the eye is red, uncomfortable or producing discharge then it would be advisable to make an appointment with one of our optometrists. How are lacrimal duct blockages treated? A common cause is poor quality tears due to dysfunction of the glands of the eyelid. When other possibilities have been exhausted it is important to investigate whether there are any blockages in the lacrimal ducts. Lacrimal syringing can be used to probe the lacrimal duct. Sterile saline is gently pushed through the syringe, where it may in some cases dislodge debris out through the nose thus removing the blockage causing the watery eyes. If a more permanent blockage is found then further referral to an eye hospital may be required for a surgical procedure to remove the blockage. For patient comfort, a drop of local anesthetic will be applied to the lacrimal duct opening (puncta), prior to the syringing process. Probing and irrigation does carry a small risk of injury to the lacrimal passage, which could aggravate any initial symptoms. It is however a very safe, and effective procedure. The procedure is both an investigation (to see whether the drainage channels are operating normally) and a treatment (to try to remove any blockage). We have found around two out of three people with symptoms find an improvement after syringing. What does lacrimal syringing cost? Lacrimal syringing is one of the many treatments covered by Vision+ membership. For non-Vision+ members, the price for the optometrist consultation and the syringing procedure is £99.

Punctal plugs for dry eyes Anyone who suffers from dry eyes will know just how uncomfortable the condition can be. Symptoms such as burning, gritty, red eyes are common and vision can be reduced in severe cases. The primary reason for dry eyes is either poor quality tears, or too few tears being produced.The use of lubricating drops and ointments play an important role in soothing dry eyes. However these do not cure the cause of dry eyes and even frequent use may not resolve the discomfort fully. How can punctal plugs help? When there is a lack of tears, a longer-term solution could be punctual plugs.Punctal plugs are inserted into the drainage channel (puncta) on the eyelid, preventing the escape of tears from the surface of the eye. At Cameron Optometry we use absorbable, extended duration punctal plugs. These plugs are composed of materials that gradually dissolve in the drainage channels of the eye, and last up to three months. Some causes of dry eyes are not permanent and one benefit of absorbable punctal plugs is that they need only be replaced as required. If the temporary plugs are effective, you may, in consultation with the optometrist, wish to try a permanent punctal plug which stays in place indefinitely but can be removed if required. We recommend this type of plug for people who have successfully worn the dissolvable type first.The insertion procedure is quick and comfortable and is performed in the practice. Once the plugs are fitted you are unable to feel them in your eye. What do punctal plugs cost? Punctal plugs are one of the many treatments covered by Vision+ membership from £30 per month. For non-Vision+ members, prices start at £105 which includes the optometrists consultation and insertion of three-month absorbable plugs. Please contact us at the practice if you wish to discuss your suitability for the procedure.

The huge increase in individuals working from home has resulted in an increase in patients getting in touch to ask for advice on dry eyes. It might be that people are spending more time on their devices, or that their working environment isn’t set up as well as in the office. The important thing is not to suffer in silence. Make an appointment with your optometrist and we can go through the options with you, which include: Lifestyle advice Dietary modifications Eyelid treatments, including using heat packs Artificial tear drops Prescription only medications Moisture chamber goggles Punctal occlusion (plugs) Lacrimal syringing Treatment for demodex blepharitis Specialist contact lenses We can advise on the best options for you. Visit our Tear Clinic page for further information.

We have vast experience in treating ocular surface disease, known as ‘dry eye’ disease or ‘watery eyes’ and have now created a specialist clinic for those suffering with the condition. So many people visit us having hit a brick wall, fearing that they must just live with the discomfort associated with the condition. We do not believe this should be the case. At our Tear Clinic we use the many treatments at our disposal, working to find the most suitable management plan for each individual who seeks our advice. Few optometrists in the area provide the comprehensive approach you will find at the Tear Clinic, so please do spread the word to anyone you know who may be suffering from the discomfort associated with the condition. Visit dedicated section on the site to find out exactly what you can expect at the Tear Clinic.

As part of National Eye Health Week, we are highlighting key eye care advice for various groups. Today we're sharing Vision Matters' advice on the ageing eye, sight after sixty. Our visual acuity steadily declines and our risk of developing a sight threatening eye condition increases as we age. This is due to a number of factors including: The natural ageing process – the lens inside our eye actually begins to stiffen from about the age of ten but it isn’t until we reach our mid- to late-forties that we start noticing problems trying to focus when reading or doing close work. Environmental factors – the cumulative effect of exposure to UV light can impact on the quality of our vision. Lifestyle factors – over time a poor diet, smoking and lack of exercise can all have a negative impact on our vision. Genetic factors – the quality of our parents’ vision can be a good indicator of how well, or not, our eyes and vision will age. And regular sight tests are vital ensure we maintain healthy vision. By the time we reach our 60s over 96 per cent of us will require some form of vision correction. In addition to conditions such as long- and short-sightedness there are a number of eye conditions that are age-related. These include: Age-related Macular Degeneration (AMD). This impairs your central field of vision and is Britain’s leading cause of blindness affecting an estimated 600,000 people across the UK. Glaucoma is a condition that a ects the optic nerve and disturbs your peripheral vision. If left untreated it can lead to total loss of sight. Twenty six per cent of all cases of sight loss in people aged 75 and over is due to untreated cataracts. This is despite the fact that vision can usually be restored with a routine surgical procedure. Dry Eye (Keraconjunctivitis Sicca) a condition where the tear glands are not creating enough, or creating poor quality, liquid to keep the eyes lubricated and comfortable. Dry eye is the most common cause of eye irritation in people aged 65 plus. Presbyopia is a natural part of the ageing process. It occurs when the crystalline lens in the eye loses its exibility and makes it more and more difficult to focus on close objects. Floaters re little dots or tadpole-like shapes which appear in our vision. These are caused by age and the general wear and tear of our eyes. Occasionally this can be an early warning of a detached retina so be sure to visit your optometrist straight away if you notice a sudden onset or rapid increase in the number of flashes or floaters in your vision. Poor uncorrected vision can have a significant impact on our social and physical well-being however, more than four million OAPs miss out on vital eye tests every year*. A simple eye test could help improve the quality of life for millions of pensioners. It’s ecommended that over 60s have their eyes checked every two years and over 70s should have theirs checked annually, unless recommended otherwise by their optometrist. For more advice about looking after your eyes visit www.visionmatters.org.uk *Figure calculated using ONS population data, Sight Test Volume and Workforce Survey and GOS:Ophthalmic Statistics

We're thrilled to learn Ian Cameron has been shortlisted for the BCLA's (British Contact Lens Association) Dry Eye Award. For those who have experienced dry eye (ocular surface disease), you will know just how debilitating it can be and it is for this reason that Ian has dedicated much of his time to the condition. For those who suffer, or know someone who suffers, from dry eye you may be interested in reading more about the treatments available at Cameron Optometry. After extensive research into dry eye and the impact it has on quality of life scores, Ian made the conscious decision to focus his attention on this area of optometry to ensure the practice provides the most effective management of the condition. He has since worked tirelessly to build on existing expertise, recognising the link between ocular surface disease and contact lens wear. Through the Cameron Optometry Dry Eye Clinic, our team now offer a full suite options for patients to ensure dry eye is effectively managed to reduce, and ideally eradicate, the discomfort they experience. Experience in independent prescribing, has been invaluable in expanding the practice's expertise, where he works alongside Gillian Bruce and Claire Keith who have also gained the IP diploma. He is often considered the go-to in Scotland, when it comes to complex eye conditions which require specialist management through the use of therapeutic treatments. Recently, he has found new drugs to be hugely beneficial for the treatment of severe dry eye disease in patients. Patients are often also recommended punctal plugs, something that are not commonly prescribed but that have good results. Ian is also often called upon to share his expertise in lid hygiene where he discusses the benefits of the specialist techniques employed at the practice. With the relatively recent resurgence of interest in Demodex, Ian has been at leading edge writing articles on new treatments methods for trade press and working with other practitioners to pool knowledge and promote best practice in a new area of treatment. More specifically, Ian has worked to raise awareness of blepharitis and the treatments available. Another area that we have discussed in the blog before, is the benefits supplements can have for numerous eye conditions. The practice now stocks a range of what we believes to be the most effective supplements such as Omega 3 fish oils which are proven to help alleviate the symptoms of dry eye. This is just a brief summary of the expertise in dry eye and treatments available at Cameron Optometry. If you are experiencing dry eye, please do get in touch by calling 0131 225 2235 or emailing vision@cameronoptom.com. And we'll let you know how he gets on at the awards.