Synopsis
Assess tear-film and lid-margin disease together, provide practical sustained treatment, and identify patients whose pain, corneal damage or systemic features require specialist assessment.
- Dry eye reflects unstable tear-film function and surface inflammation; reflex watering can occur despite inadequate lubrication.
- Meibomian gland dysfunction promotes evaporation and often links posterior blepharitis with dry-eye symptoms.
- Burning, grittiness and fluctuating blur that clears after blinking fit surface disease, but sustained visual loss requires further assessment.
Key red flags
Persistent visual loss, a corneal white spot or severe unilateral pain requires urgent corneal assessment.
Investigation priorities
Determine whether symptoms accompany a sustained functional deficit.
Management branches
Symptoms and examination support dry eye without urgent corneal or visual findings.
- Choose a lubricant suitable for symptom severity and practical administration, explaining dose, expiry and storage.
- Encourage screen breaks, a screen slightly below eye level and avoidance of direct airflow or smoke where feasible.
Lash debris, lid irritation or meibomian gland dysfunction accompanies the ocular discomfort.
Key medicines
Carmellose sodium eye dropsInstil one to two drops into the affected eye or eyes as needed. The NHS describes 0.5% for mild symptoms and 1% for moderate to severe symptoms; treatment can continue for as long as needed.