What to expect in our dry eye clinic
We offer a personalised management and treatment plan customised to your particular type and severity of dry eye utilising cutting edge, state-of-the-art diagnostic equipment and software combined with our clinical expertise and experience.
The aim of our specialist dry eye clinic is to evaluate your tear film with regards to quality and quantity, lid margin health and tear producing glands, to help us understand why you have dry eye and/or blepharitis and how best to alleviate your symptoms using the latest and most appropriate treatments available. Our treatment protocols are derived from the work of Tear Film and Ocular Surface Society (TFOS I and TFOS II) Dry Eye Workshop and Meibomian Gland Workshop, the landmark studies in the treatment of dry eye and blepharitis.
The dry eye examination normally includes the following procedures:
- Dry eye pre-examination questionnaire – this helps us understand and track the improvement in your symptoms
- Detailed history and symptoms – we chat long and hard about when your problem began, other examinations you may have had, your general healthy, your diet, your medications, your family history, previous treatments and current treatments to get a full understanding of your problem
- High definition, high resolution photographs of the anterior eye (front of the eye) using our video/photo slit lamp biomicroscopes
- InflammaDry Testing – this in-practice laboratory test allows us to measure inflammation in the tear film and treat the inflammation appropriately
- Meibography – we visualise and assess the meibomian glands (glands which produce complex oils to stabilise your tears) to ensure their optimum performance
- Anterior OCT – produces 3-dimensional cross sectional images of the cornea to monitor changes in the cornea and tear film thickness
- Corneal topography – maps the shape and irregularities in the cornea
- Non-invasive Tear break up assessment – using the Oculus Keratograph to measure the speed at which your tears evaporate
- Assessment of the lipid layer (oil layer) of your tear film using the Keratograph
- Use of fluorescein and lissamine green diagnostic dyes – these are used to assess the health of the front of the eye using our video/photo slit lamp biomicroscopes. This causes no discomfort or change in vision.
- We then produce a detailed personalised dry eye report and treatment plan to help you understand why you have dry eye and/or blepharitis and how we aim to manage your condition
The Oculus Keratograph 5m
We were the first practice in Scotland and amongst the first in the UK to offer the Oculus Keratograph K5. The Keratograph 5M technology is a revolution in corneal topography and dry eye analysis.
Non-invasive tear evaporation time – evaluation of tear quality
The Oculus K5 evaluates the tear film with the aid of white and infrared illumination. The new high definition colour camera makes the finest structures visible. NIKBUT (non-invasive Keratograph break-up time) allows for assessment of the quality of the tears important in the diagnosis of evaporative dry eye. We can then track improvements in tear evaporation over time.
Tear meniscus height - Evaluation of tear film quantity. With an integrated measuring guide and various magnification tools we can measure tear meniscus height and evaluate its characteristics along the lower lid margin. We can then track improvements in tear volume during your dry eye treatment plan.
Lipid Layer - Evaluation of lipid layer thickness
The colour and structure of the lipid layer are visualised and can be recorded. Measurements are taken of lipid layer thickness, which correlates with tear film evaporation and dry eye symptoms. If the lipid layer is too thin or absent, the tear evaporation rate and tear film instability increase.
TF dynamics - Evaluating the particle flow characteristics
A video recording with up to 32 images per second, permits observation of tear film particle flow characteristics and shows tear film viscosity.
Meibography - Meibo-Scan
Dry eye is most commonly caused by meibomian gland dysfunction (MGD). Meibo-Scan reveals morphological changes in the meibomian glands. The ability to assess and grade the quality of meibomian glands allows us to specifically target and treat dry eye with more accuracy.
How long does a dry eye assessment take?
Normally an initial assessment takes between 60 to 90 minutes. This allows plenty of time to discuss your history, conduct all of our examinations and then discuss our findings, diagnosis and treatment plan, leaving time for any questions you may have.
How many visits will I require?
This varies depending on the type and severity of your dry eye. In most cases we will review you 2-4 weeks after the initial examination to ensure the treatment is working well and make changes to the treatment plan if required. Again depending on the extent of your dry eye we may then re-exam your eyes on a 3-6 monthly basis.
Are the treatments available on the NHS?
In Scotland the NHS will pay for a full examination every 2 years (every 12 months in patients over 60 with eye disease, diabetic patients of any age every 12 months, patients with glaucoma or ocular hypertension every 12 months, and children aged 16 and under every 12 months). The NHS will also fund supplementary examinations to evaluate symptoms such as those of dry eye. The NHS funded eye examination does not cover all of the techniques used to fully exam the eye for dry eye such as corneal topography, meibography, anterior eye photography nor treatments such BlephEx eyelid cleaning or IPL.
How does it work if I am referred by another optician?
If you have had an up-to-date and recent eye examination you simply book in for a dry eye evaluation appointment. If you have not had a recent eye examination we will first perform a comprehensive eye examination followed by the dry eye evaluation.
Does it hurt?
No, none of the examinations or treatments causes pain or discomfort. We may instil drops into the eyes in some cases which can be mildly stingy for a few seconds. However, the majority of the examinations involve nothing touching the eye. The BlephEx lid cleaning session slightly tickles the eyelid but is not unpleasant. Our IPL treatment creates the sensation of warmth but again is pleasant rather than unpleasant.
How do I get started?
Simply call our reception team on 0141 943 3300 to make an appointment within our dry eye clinic or blepharitis clinic.