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Eye health centre

Self-help advice for dry eye syndrome

NHS Choices Medical Reference

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There are a number of things you can do to ease your symptoms or prevent dry eye syndrome.

Environmental factors

Certain environments can irritate your eyes. Keep your eyes protected from:

  • wind
  • hot air
  • smoke

Wrap-around glasses may provide good protection. Avoid smoky environments and if you smoke you should try to stop.

Do not use eye make-up. Eyeliner and mascara will block the special glands in the eyelids and can cause a toxic inflammatory reaction.

Specialised eyeware

Some cases of dry eye disease can be treated using specialised eyeware. These include specially made glasses called moisture chamber spectacles. These wrap around your eyes like goggles, helping to retain moisture and protecting your eyes from irritants.

If your previous contact lenses were causing dry eye disease, special contact lenses are also available. You should discuss various options with your high street optometrist.

Adjust your computer

Make sure that your computer workstation is positioned correctly to minimise eye strain. If you are using a computer at work, most employers have a health and safety officer or an occupational health representative who can advise you about this. Your monitor (screen) should stand at eye level or just below it.

If you use a computer, make sure that you take enough breaks away from your computer screen and blink your eyes regularly. Taking breaks every hour to "rest" your eyes may help reduce your symptoms.

Read more information about workplace health and  how to sit correctly.

Use a humidifier

A humidifier at work and home will moisten the surrounding air. Opening windows for a few minutes on cold days and longer in spring and summer will also help keep air moist and prevent build-up of mould.

Keep your eyes clean

Good hygiene will help improve dry eye syndrome, particularly if you have  blepharitis (inflammation of the eyelids).

There are three main steps to eyelid hygiene that should be performed once or twice a day:

  • warm compresses
  • gentle eyelid massage
  • lid margin hygiene

Warm compresses

  • boil water and cool it to a warm temperature
  • soak a clean flannel or eye pad in the warm water and gently place this over the eyes for around 10 minutes
  • reheat the compress periodically by soaking it in warm water so that the flannel is not allowed to cool - the warmth melts the oils in the stagnated meibomian glands
  • some people find a microwavable "eyebag" useful - make sure you clean the eyebag before and after use

Eyelid massage

  • Gently massage your closed eyes by rolling your little finger in a circular motion - this will help to push the melted oil out of the glands. You cannot see the oil come out, as the droplets are tiny.
  • Next, take a cotton-tipped applicator (cotton wool bud). With your eyes shut, gently roll the cotton bud downwards on the upper eyelid towards the lashes and eyelid margins, then repeat along the whole length of the upper eyelid. This will help express the residual oil out of all the glands.
  • Repeat expression for the lower eyelid glands by rolling a clean cotton-tipped applicator upwards towards the lashes and the eyelid margin.
  • If the oils have been stagnant in the glands for quite some time, they might have changed their chemical structure. It is possible that when the oil drains onto the surface of the eye after gentle expression, it might cause irritation, a bit like getting soap in your eyes. This is normal and should get better with time as the blepharitis comes under control.

Lid margin hygiene

  • The expressed oils should be wiped away from the eyelid margin. This also helps to reduce bacteria, dust or grime that might have accumulated along the eyelids while blinking, and also any remaining crusts.
  • There are many recipes for cleaning solutions. Boil a pint of water in a kettle and pour into a clean bowl. Add one teaspoon of bicarbonate of soda or a few drops of tea tree oil. Do not use baby shampoo, as this is fragranced and can make things worse.
  • Soak clean cotton wool in the warm solution and remove crustiness from around the eyelids, paying special attention to the eye lashes. Throw the cotton wool away. If necessary, repeat with clean cotton wool.
  • Dip a clean cotton-tipped applicator into the solution and gently clean the eyelid margins by wiping the cotton bud along the rims behind the roots of the lashes, the bases of the lashes and the lengths of the lashes.
  • Alternatively, commercially available cleaning solutions or sterile lid wipes can be tried.

Sometimes your doctor might prescribe an antibiotic ointment to rub along the eyelid margins after the three-step lid hygiene regime. This is usually used only for a short period of time. If there is inflammation, anti-inflammatory eye drops or tablets may be required.

Diet

There is increasing evidence that suggests a diet high in omega-3 fats can help improve ocular surface health, meibomian gland function and dry eye disease.

This also has a wide range of health benefits, including reducing the risk of heart disease, joint problems and macular degeneration.

The most important omega-3s are:

  • eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) - both found in wild fish
  • alpha-linolenic acid (ALA) - found in green leafy vegetables, flaxseed, soya beans, canola oil and walnuts

However, it is important to maintain a balance with omega-6 fatty acids, found primarily in vegetable oils, red meat-derived saturated fats, fast foods, evening primrose oil and borage oil.

The best way to redress the omega-3 versus omega-6 balance is to increase oily fish intake, such as:

  • mackerel
  • salmon
  • sardines
  • herring
  • fresh tuna (not canned, as the canning process removes the beneficial oils)

Aim to eat at least two portions of fish a week, one of which should be oily fish. Omega-3 supplements are also effective.

Read more information about eating a healthy diet.

Medical Review: May 02, 2012

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