Dry Eye Syndrome

Dry eye syndrome or dry eye disease, is a very common condition that occurs when the eyes do not produce enough tears or the tears evaporate too quickly. This leads to the surface of the eyes drying out and becoming irritated and possibly inflamed. Although there is no cure for dry eye syndrome, targeted treatments are available to help control the symptoms. These depend on whether the symptoms are caused by the decreased production of tears, tears that evaporate too quickly, or an underlying condition. We have invested in the Oculus Keratograph 5M, which incorporates the latest technology for tear film assessment. This allows us to investigate the cause and provide an individualised treatment plan.


  • "I have just completed my follow-up consultation with Graham Coates of Morgan-Owen & Coates and wanted to express my gratitude to him for helping to manage my ‘runny watery eyes’… Since my consultation and diligently sticking to my day-to-day management of the condition (which is not onerous at all) my eyes have felt hugely more comfortable almost to the point that I am not ‘conscious’ of my eyes and it’s all thanks to Graham and his interest and research into ‘Dry eye Syndrome’. I would recommend anyone travel a distance to visit him if it meant getting relief for this tiring and annoying eye condition."
    Sue Sheppard
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The Tear Film

Tears help form a layer on the very front of the eye. Called the tear film, this layer has a number of important functions. The tear film has a role in the focusing of light into the eye and is crucial in lubricating the eye, keeping the surface moist and smooth. The tear film is actually made up of three layers each with a different function.


1. The outer layer is called the lipid layer. This is an oily film which seals the tear film to the eye and helps to prevent any evaporation.

2. The middle layer is called the aqueous layer. This is the watery layer that most people think of when they think of tears. This layer is produced by the lacrimal gland which is underneath the upper eyelid. This layer provides moisture and supplies oxygen and other important nutrients to the cornea. This layer is mainly water.

3. The layer closest to the eye is called the mucin layer. It coats the cornea which is the clear window at the front of the eye; it forms a foundation for the other layers of the tear film.


The mucin and lipid layers are produced by small glands around the eye. Each time we blink the tears are spread onto the front of the eye. Excess tears are drained away by tiny drainage holes on the inner margin of the eyelids, these holes channel the excess tears into the nose. This is why crying sometimes makes your nose run.

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Symptoms of Dry Eye

  • feel irritated

  • feel scratchy

  • feel dry and uncomfortable

  • feel a burning sensation

  • feel gritty

  • are red

  • experience periods of blurred vision

  • have periods of watering too much

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Causes of Dry Eye

Dry eye has a number of causes. It happens mostly as a part of the natural ageing process but can also be caused by problems with blinking or problems with the glands which produce the tears. Some drugs can cause dry eye, like antihistamines and oral contraceptives. Contact lenses carry an increased risk if you have dry eye.
Sometimes dry eye is also a symptom of other conditions affecting other parts of the body particularly arthritis or a condition called Sjogrens syndrome. This is where, as well as dry eyes, people can also have a dry mouth and may involve a type of arthritis.

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Tear Substitutes

Eye drops are the mainstay of treatment for many forms of dry eye.  A drop of normal saline immediately soothes the dry eye, but its relief is fleeting. Attempts have therefore been made to improve the composition of artificial tears and prolong their duration of action. As a general rule, tear substitutes of very low viscosity, such as Tears Naturale, are now rarely prescribed. 
Others, such as Systane Ultra, are slightly more viscous and enhance the stability of tears. These products can generally be used as often as required. Many of the formulations are now available in single use, preservative–free options, for convenience and for those requiring long term use. The latest formulations, such as Systane Balance, include lipid enhancing components for those with evaporative dry eye.

The more viscous products, including gel formulations such as Viscotears, may be more suitable for those with severe dry eye and for night time use. They are not recommended for use when driving as they can blur the vision.

Eye logic is an eye spray which restores deficiencies in the tear film’s lipid layer and hence protects the tears from evaporation. It is easy to use as it is simply sprayed onto the closed eyelid.

The Eye Bag

Convenient, simple and extremely easy to use, the EyeBag is a re-usable warm compress which treats a variety of eyelid and eye problems. It provides an effective alternative  to the use of hot wet face flannels.

The EyeBag was devised in 2004 by Mr Teifi James, a Consultant Ophthalmic Surgeon who works in West Yorkshire. We have had very positive feedback from those who have tried it.

Simply microwave for 30 seconds and lay the warm EyeBag across the closed eyes. The warmth softens and releases the natural oils in the eyelid glands which are then able to ‘lubricate the blink’. Use the EyeBag for ten minutes twice every day for a fortnight to rapidly relieve the symptoms of dry eye syndrome, blepharitis, stye and eyelid cysts.

Watch the video to find out more.

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37 Lavant Street, Petersfield, Hampshire, GU32 3EL, 01730 264258