Managing dry eyes is an incredibly important subject. We’re seeing an epidemic of dry eye symptoms in the adult population. Primarily, it’s a function of lifestyle. It’s a function of the fact that we often work long hours, we work in air-conditioned offices, or centrally heated rooms, we stare at computer screens for long periods, and then we relax by staring at more screens or phones or tablets. These factors are why it is important to manage dry eyes.

There’s a reflex we have that reduces our blink rate when we’re engaged in intense, concentrated visual attention. You can’t help it. So when you’re concentrating on something, particularly up close, you accommodate and bring your focus, your eyes pulling together slightly, but also your blink rate lowers. We do it as surgeons, in particular when operating, pilots do when they’re coming into land or if people are concentrating on driving they’ll lower their blink rate, but we all do it. From these types of focused activities, you get increased evaporation of the front of the eye. Understanding your role is the key first component to managing dry eye.

Change behavior

The first thing is ‘C’ or ‘change’ behaviour. Being aware of the behaviours that can generate dry eye symptoms is key. Take little breaks from your work, blinking more often when you press the return key, just being aware you need to blink and have a think. That just allows little breaks from that evaporation of the front of the eye that can be contributing to dry eye symptoms.

Use an eye bag

The next thing you can do is use an eye bag or some other kind of warmth. So the eye bag contains linseeds it looks like those masks people wear on an aeroplane when they are trying to get to sleep. Just heat it up in the microwave for 30 seconds and then put on the closed eyes for five minutes. That warmth melts the oils in the apex of the glands in the eyelids improving the flow of oil at the front of the eye and the condition of the eyelids. You can achieve a similar effect with a clean face towel in the shower heated up in hot water and applying that on your eyes for 15 seconds four times.

I’m a realist. I know people are busy and finding time to get up and heat up an eye bag in the morning is not realistic but the face towel in the shower is practical for the morning and eye bag in the evening, and then you’ve done something to improve the condition of your eyelids. I ask people to think about it like cleaning the teeth for their eyes. As children, we get trained to clean our teeth, and we don’t think anything of it, and later in life, someone like me asks you to do some work looking at the front of the eyes.

Supplementation with Topical lubricants

Supplementation of the tear film with topical lubricants can help with dry eyes, which there are loads on the market. I’ve secret shopped in all of the main pharmacies, and the owned brands are very good. They contain the important molecules to provide really good lubrication to the front of the eye. There’s a range of lubricants important to work with your optometrist, with the GP or with your pharmacist to try different types to find one that suits you.

Diet with Omega-3

Supplementation of your diet with oral omega-3 has good evidence now from randomised controlled trials proving that a gram a day of Omega-3 is a supplement that will improve the quality of the tear film the eyes and look better on examination. Most importantly, they feel better for patients, and visual quality is better with a better tear film.

Maintain good Hydration

Finally, maintain good hydration. If you’re dehydrated, your body will pull in water from everywhere including your tear film.

So, if you follow that CUSTOM regime;

• change behaviour,
• use an eye bag,
• supplement the topical lubricants with the tear film,
• a diet with omega-3, and
• maintain good hydration

you’ve gone a long way to manage dry eye as a common problem.