How to run a dry eye clinic

The TFOS DEWS II classification is: ‘Dry eye is a multifactorial disease characterised by loss of tear film homeostasis with tear film instability and hyperosmolarity as well as ocular inflammation and ocular surface damage, and neurosensory abnormality play etiological roles.’

Daily in practice we have patients, especially the elderly, who complain of dry eyes. For them the solution is to lubricate and all our instructions on lid hygiene, hot compresses and supplements usually fall on deaf ears. It can be frustrating for us practitioners as the patient will usually contact their GP and be prescribed eye drops that are not ideally suitable for their dry eyes. Drops with hyaluronic acid or carbomethyl cellulose with high molecular weight or cross-linked applied four to six times a day are most appropriate.