Dry eyes

What are dry eyes?

Having dry eyes is a very common condition that occurs when the eyes don’t make enough tears, or the tears evaporate too quickly. This leads to the eyes drying out and becoming red, swollen and irritated. Dry eye can also be called keratoconjunctivitis sicca or simply dry eye syndrome.

What are the causes of dry eyes?

Some possible causes of dry eyes include:

Hormonal changes
Ageing: as you get older the body produces less tears and eyelids can’t spread tears over the surface of your eyes as well as before
Exposure to the sun, wind or a dry climate may cause tears to evaporate
Activities such as reading, writing or working on a computer may mean you blink less often
Side-effects of some medication
Laser eye surgery
Wearing contact lenses
Medical conditions such as blepharitis, Sjögren’s syndrome, contact dermatitis or arthritis

How can I take care of my eyes?

Taking care of your eyes is a personal responsibility. Dry eyes are usually a chronic condition and although there is no cure there are things that you can do yourself to help your eyes feel more comfortable and ease symptoms. In mild cases self-care may be all you need.

Things you can do include:

Keeping your eyes clean and maintaining good eyelid hygiene, particularly if you have blepharitis. You can do this using boiled and cooled water and a clean cotton pad or eyelid wipes available over the counter
Keeping your eyes protected from wind, dust or other air which can irritate your eyes
Avoid using eye make-up which can block glands that naturally lubricate your eyes
Limiting contact lens use to shorter periods, especially if these cause irritation
Avoiding smoky environments and stopping if you smoke
Using a humidifier to moisten the surrounding air and avoiding too much time in places with air-conditioning
Drinking plenty of water
If you use a computer for long periods, place your monitor at or below eye level, avoid staring at the screen, and take frequent breaks

And don’t forget to blink, as this helps prevent your eyes drying out.

What are the treatments for dry eyes?

Treatments for treating dry eyes include artificial tears, tear replacement and ocular lubricants, usually in the form of eye drops or gels. If, after trying the self-help methods, you still have symptoms of dry eyes then you can try any of the following treatments.

You can buy these treatments from your pharmacy over the counter (OTC) or at the supermarket. Your pharmacist can advise you on which type of eye product is best for you.

Below are the options of the lubricants that can be used in ranking order based on severity of dry eyes from less to more severe.

Please note that the generic / trade names mentioned are for examples only. There are several brands of manufacturing drops with the same ingredients. We recommend that you request the drops from the pharmacist based on ingredients and not brand names (Pharmacy at Brighton and Sussex Eye hospital NHS Trust and the Sussex Eye Hospital do not have any conflicts of interest in any brand name mentioned below).

How to administer eye drops and eye gels

Always wash your hands before and after using eye products

Tilt your head back a little and pull the lower lid of your eye out to form a ‘pocket’
Administer eye drops into the pocket of the eye
For gels, apply a thin line of gel along the inside of the lower eyelid
Close your eyes for a moment and blink to spread the gel. Try not to rub your eyes. Repeat on the other eye
To reduce contamination of the bottle, avoid touching the surface of your eye with the nozzle

List of treatments for dry eyes

Ingredients	Example brands and prices*	Other useful information
Hypromellose eye drops 0.3% or 0.5%	Generic £1.49-£3.49 Isopto Plain® £1.50	Most people can use hypromellose. Use every hour for the first day until your symptoms improve and reduce the number of times you take to 4 times a day
Carbomer 0.2% gel	Clinitas® carbomer gel £3.65Viscotears® £5.49	Use 30 minutes before putting in contact lenses. Can be used in the daytime up to 3 times a day (though you might not need it that often) and at night before bed. Can be used for before bed alongside eye drops if eye drops are preferred in the day
Carmellose 1% PF eye drops	Celluvisc® £4.99	Apply as often as required (up to 6 times a day).
Sodium hyaluronate 0.15% drops	Blink comfort drops for contact lens wearers 10ml bottle £3.99 20x 0.35ml £6.49	Apply as often as required (up to 6 times a day).
Sodium hyaluronate 0.4%	Clinitas soothe 20x 0.5ml £6.59	Apply as often as required30 x re-sealable 0.5ml unit dose. Re-use vial for 12 hours. Preservative-free. Appropriate for contact lens wearers
Hydroxypropyl guar eye drops	Systane® £7.99	Apply as often as required (up to 6 times a day).
Paraffin-based ointments	VitA-POS/HyloNight 5g (preservative free) £4.95 Xailin Ointment 5g £4.49	For night-time application due to blurred vision. Can be administered with other drops in the daytime for any severity of dry eyes.

*Price from reputable retail and online pharmacies, correct as of January 2020.

Finding an effective treatment can vary between people. If one doesn’t work then others can be tried until you find the right one for you. A proper trial of one product would be for at least 6 to 8 weeks. If your symptoms change or worsen then you should see your GP.