Dry Eye and Ocular Surface Disease

Ocular surface disease covers disorders of the tear film, eyelid margins, conjunctiva and corneal surface, which work as one unit to keep the eye comfortable and the vision clear. Dry eye disease and meibomian gland dysfunction are by far the most common, affecting a large share of adults, especially women after the menopause and heavy screen users.

These are usually chronic conditions that are controlled rather than cured. Treatment is stepwise and works best when the specific type is identified: too little tear production, tears that evaporate too quickly because of poor eyelid oil, inflammation, allergy or a lid problem.

Conditions this service looks after

• Dry eye disease, aqueous deficient and evaporative
• Meibomian gland dysfunction and blepharitis
• Ocular rosacea
• Allergic eye disease, including vernal and atopic keratoconjunctivitis
• Sjogren syndrome and dry eye from other autoimmune disease
• Exposure from incomplete lid closure
• Neurotrophic keratitis
• Conjunctival scarring from Stevens-Johnson syndrome or mucous membrane pemphigoid
• Dry eye after laser eye surgery or from contact lens wear
• Demodex lid infestation

Tests you may be offered

• Symptom questionnaire: Scores such as OSDI record severity and track response.
• Tear break-up time: Shows how quickly the tear film becomes unstable after a blink.
• Fluorescein and lissamine green staining: Reveals damaged cells on the cornea and conjunctiva.
• Schirmer test: Filter paper strips measure tear production over 5 minutes.
• Tear osmolarity and inflammatory markers: Point-of-care tests that support the diagnosis.
• Meibography: Infrared imaging of the oil glands in the lids, showing dropout.
• Blood tests: Autoantibodies when Sjogren syndrome is suspected.

Treatments available

• Lubricants: Preservative-free drops, gels and night ointments, matched to the type of dry eye.
• Warm compresses and lid hygiene: Daily treatment for meibomian gland dysfunction.
• Anti-inflammatory drops: Ciclosporin or lifitegrast long term; short steroid courses under supervision.
• Punctal plugs: Tiny plugs in the tear drainage openings to keep tears on the eye.
• In-clinic gland treatments: Thermal pulsation and intense pulsed light. They help some people with oil gland disease; evidence is moderate and repeat sessions are needed.
• Oral doxycycline or azithromycin: For rosacea and stubborn lid margin disease.
• Autologous serum drops and scleral lenses: For severe disease that does not respond to other measures.
• Treatment of lid position and closure: Surgery when the lids do not protect the eye.

When to ask for a specialist opinion

• Burning, grittiness or fluctuating blur most days despite lubricant drops
• Eyes that water paradoxically in wind or when reading
• Dry eye together with dry mouth or joint pain
• Planned cataract or laser eye surgery, since untreated dry eye worsens results
• Intolerance of contact lenses
• Pain out of proportion to what is seen on examination

Travelling to Türkiye for this care

A visit can provide a detailed dry eye work-up in 1 to 2 hours, a specific diagnosis and a written stepwise plan, which many people have never had. Punctal plugs or an initial gland treatment can be done on the same trip. Improvement takes weeks to months and relies on daily care at home, and treatments such as intense pulsed light are usually given as 3 to 4 sessions a few weeks apart, which does not suit a single short stay. Review and prescriptions for long-term drops should continue with a local doctor.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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