Dry eye treatment

Dry eye disease has two main forms, and they need different treatments. In evaporative dry eye — by far the more common — the meibomian glands in the eyelids stop releasing enough oil, so the tear film breaks up too quickly. In aqueous-deficient dry eye the eye simply does not make enough tears. Many people have both. Identifying which you have is what decides whether drops, eyelid treatment, or something that keeps tears on the eye for longer is the right answer.

What causes dry eye

• Meibomian gland dysfunction (MGD). The oil glands along the lid margin block or thicken, so the tear film evaporates within seconds. This is the underlying cause in most dry eye, and it is why lubricating drops give relief that only lasts minutes.
• Blepharitis. Inflammation and debris along the lash line, often alongside MGD. It tends to recur, so treatment is about ongoing control rather than a one-off cure.
• Reduced tear production. Age, some medications and autoimmune conditions such as Sjögren’s syndrome reduce the watery layer of the tear film.
• Screens, contact lenses and environment. Blink rate falls sharply when concentrating, and air conditioning, heating and wind all accelerate evaporation. These make symptoms worse rather than causing the disease outright.

How dry eye is assessed

Symptoms alone do not tell you which type you have — the eye can feel gritty and watery at the same time. Assessment looks at how fast the tear film breaks up, the quality of the oil being produced, and the state of the glands themselves. Meibomian gland imaging (LipiScan) photographs the glands directly, which shows whether they are simply blocked or have already been lost, and that distinction changes what is worth treating.

In-clinic treatments

These target the eyelids and glands rather than adding fluid to the surface, and are used when drops alone are not holding symptoms.

• Intense pulsed light (IPL). Light applied to the skin around the lids reduces inflammation and helps the glands express normally, usually as a short course of sessions — see OptiLight IPL and IPL for dry eye and blepharitis.
• Thermal treatments. LipiFlow and iLux warm and express the blocked glands in clinic, which is far more effective than a warm compress at home.
• Thermo-mechanical treatment. Tixel treats the lid skin and margin where inflammation is driving symptoms.
• Eyelid debridement. BlephEx cleans the lid margin and lash line, and is typically repeated periodically for blepharitis.
• Punctal plugs. Tiny inserts that block the tear drainage ducts so your own tears stay on the eye for longer — used for aqueous-deficient dry eye. See punctal plug costs.
• Scleral lenses. These vault the cornea and hold a reservoir of fluid against the eye all day, and can transform comfort in severe ocular surface disease — scleral lens fitting.
• Amniotic membrane. Reserved for severe surface damage that has not healed with other treatment — amniotic membrane graft costs.

Prescription drops

Over-the-counter lubricants relieve symptoms; prescription drops treat the underlying inflammation or replace what the tear film is missing.

• Ciclosporin drops. Ikervis (ciclosporin 0.1%) is licensed in the UK for severe keratitis in adults with dry eye disease that has not improved despite tear substitutes. It damps the inflammation driving the disease, and takes weeks rather than days to show its effect.
• Perfluorohexyloctane. EvoTears (perfluorohexyloctane) forms a barrier that slows evaporation, aimed specifically at the evaporative, MGD-driven form of dry eye.
• Autologous serum drops. Made from your own blood serum, these supply growth factors that manufactured tears cannot, and are used for severe or persistent surface disease — autologous serum eye drops.
• Ciclosporin for allergic disease. Verkazia is licensed for vernal keratoconjunctivitis, a severe allergic eye condition in children and young people. It is a different indication from ordinary dry eye, though the symptoms can overlap.

Any prescription treatment needs a consultant assessment first, because the right drop depends on whether inflammation, evaporation or tear volume is the dominant problem.

What dry eye treatment costs

Most dry eye care is delivered in clinic rather than in theatre, so costs are closer to a course of treatment than to surgery. Each page below gives an indicative UK 2026 self-pay price, and your written quotation is confirmed after your assessment.