Condition
Persistent dry eye disease
Treatment aimed at the blocked oil glands behind persistent dry eye, so you can work in comfort, drive at night and wear contact lenses.
Dry eye disease happens when the tear film does not work properly. Tears are not just water. They contain a careful mix of oil, water, mucus, proteins and immune factors that protect the eye surface and keep vision clear between blinks.
- Treatment
- Four steps in one appointment
- Duration
- About an hour
- Targets
- Blocked oil glands and their cause
- Assessment
- In clinic, before treatment
Is this you?
The symptoms people with dry eye most often describe.
- Burning, stinging or grittiness
- Watery eyes from reflex tearing
- Vision that goes hazy between blinks
- Glare and halos around lights, especially at night
- Tired, heavy eyes by the end of the day
- Discomfort with contact lenses or screens
Why reading is where you notice it
Dry eye can develop when the eyes do not produce enough tears, when tears evaporate too quickly, or when inflammation disrupts the ocular surface. A common contributor is meibomian gland dysfunction. These glands sit in the eyelids and produce oils that slow tear evaporation.
When the oil is poor or the gland openings are blocked, the tear film breaks up within seconds of each blink. Vision goes hazy, the eye stings, and bright light starts to glare. Blinking clears it briefly, and then it starts again.
Looking after your eyes
Reading and comfort
A healthy tear film is rebuilt with every blink, spreading a thin layer of oil that keeps the front of the eye smooth enough to focus cleanly.
When that layer breaks up, print softens and bright lights spread. Blinking clears it briefly, and then it begins again.
Looking after your eyes
Reading and comfort
A healthy tear film is rebuilt with every blink, spreading a thin layer of oil that keeps the front of the eye smooth enough to focus cleanly.
When that layer breaks up, print softens and bright lights spread. Blinking clears it briefly, and then it begins again.
How we approach dry eye
Your assessment looks at the whole picture: tear film stability, eyelid and gland function, and how symptoms affect your day. That is what determines whether this treatment is likely to help you, or whether something else should come first.
Most persistent dry eye comes back to the oil glands in the eyelids. Drops alone replace the water but never fix the oil, so relief is short-lived. Our treatment works on the glands themselves and on the cause of the blockage, in four steps carried out in a single visit.
Is it suitable for me?
This treatment is for persistent dry eye whose cause is in the oil glands of the eyelids, which is where most of it starts. Your assessment checks that: the tear film, how the lids and glands are working, and what else might be going on, because sometimes something else should come first.
It is not suitable for anyone who would find it very hard to have their eyelids touched. We use an anaesthetic to make the eyes less sensitive, but if you are very squeamish about it, it would not be safe to carry out.
Common questions before treatment
The things people most want settled before they get in touch.
What improvements might I realistically expect?
Nobody can promise a result, and not everyone responds in the same way. We score your symptoms on a standard questionnaire before treatment and again afterwards, so any change is measured rather than guessed at. Most people need only one session. Dry eye tends to come back over time, so looking after your eyelids at home still matters afterwards.
What is the total cost?
From £150 for the treatment, which for most people is a single visit of about an hour. The price depends on where you live, because travel is the only thing that changes it; the costs page gives the figure for your area. Your assessment is included in the price shown. If a second session is needed about two weeks later, it is charged as a second session at the same price.
Does it hurt?
The light step is painless. The cleaning and gentle pressing of the eyelids can feel uncomfortable for some people, though not painful, and we use an anaesthetic to make the eyes less sensitive. If you would find it very hard to have your eyelids touched, the treatment is not suitable for you.
Is this available on the NHS?
NHS eye examinations are free in Scotland for anyone who usually lives in the UK, and your local optometrist can advise on drops and lid care. In-clinic treatments for blocked eyelid glands are only available privately: the NHS does not currently offer them.
What happens if it doesn't work?
If your symptom score has not moved, we will say so, and look again at the cause: dry eye has more than one, and not all of it comes from the glands. A second session is only suggested where we think it would help, and you are never committed to one. Your NHS eye examinations continue as normal.
What patients treated for dry eye say
The four‑step treatment
Each step prepares the eyelid for the next. Use the buttons to see what happens to the eyelid margin and the oil glands at each stage.
Before treatment
A blocked, inflamed eyelid
The oil glands are capped and full of thick, stale oil. Debris and crusting build up along the lash line, the lid is red and inflamed, and Demodex mites live at the base of the lashes.
Simplified diagram. Two glands are drawn short throughout because gland loss is permanent: treatment restores flow in the glands you still have, it does not regrow ones that are gone.
How the light step works
- 1
Selected wavelengths
Red and near-infrared light is delivered to the eyelids in controlled doses. It does not cut, burn or remove tissue.
- 2
Into the eyelid
The light passes through the skin of the lid and reaches the oil glands sitting inside it, which drops alone cannot reach.
- 3
Energy and inflammation
Absorbed by mitochondria in the gland cells, it is used to treat mitochondrial dysfunction and calm the inflammation around the lid margin.
- 4
Softer oil, better flow
The lid is gently warmed, loosening thickened oil so the glands can be expressed properly in the next step of the treatment.
More questions
When the surface of the eye dries out, its nerves trigger the tear glands to release a flood of watery tears. These are mostly water and do not protect the eye for long. There are too many to drain away, so they spill onto your cheek. Watery eyes are a common sign of dry eye, but they have other causes too, such as a blocked tear duct, so get them checked.
The meibomian glands are tiny oil glands along the edges of your eyelids. Their oil sits on top of the tears and slows evaporation. In meibomian gland dysfunction the oil thickens and the openings block, so the tears dry up too quickly between blinks. It is one of the most common causes of persistent dry eye.
Demodex are microscopic mites that live on the skin of most adults, including at the roots of the eyelashes. They become more common with age. In large numbers they are linked with blepharitis and blocked oil glands, and can leave a crusty collar at the base of the lashes. We look for signs of them at your assessment.
Lubricating drops add moisture to the surface of the eye, and many people find they ease symptoms for a while. They cannot unblock the oil glands, so if the cause is in the eyelids the dryness comes back. That is why our treatment is aimed at the glands themselves. Dry eye often returns, so lid care at home still matters.
Screens can make dry eye worse. They do not damage the eye, but we blink far less often while concentrating on them, and many blinks are incomplete. Every 20 minutes, look at something about 20 feet away for 20 seconds, and blink fully.
Hold a warm compress on closed eyelids for 5 to 10 minutes. It should feel comfortably warm, never hot. Then gently clean along the lid edges to help the oil flow. Take regular screen breaks, keep air from heaters and fans off your face, and avoid smoke. If it keeps coming back, see an optometrist rather than trying drop after drop. If your eye becomes red and painful, sensitive to light, or your sight blurs, see an optometrist the same day.
NHS eye examinations are free in Scotland for anyone who usually lives in the UK. Your local optometrist can check for dry eye and advise on drops and lid care. In-clinic treatments for blocked eyelid glands are only available privately: the NHS does not currently offer them.
Most people need only one session. If your dryness is more advanced, a second session about two weeks later may be needed. We decide that together once we see how you respond to the first.
The treatment involves cleaning and gently pressing on the eyelids. We use an anaesthetic to make the eyes less sensitive, but if you would find it very hard to have your eyelids touched, it would not be safe to carry out the treatment. Your assessment also checks that nothing else rules it out.
Leave contact lenses out and make-up off for the rest of the day. From the next day you can use both as normal.
Your first and final assessments take place in a clinical setting, where the diagnostic equipment lives. That is what allows us to take detailed macular scans and compare them properly at the end of your course.
Yes. Once your assessment is complete and treatment has been recommended, every treatment session is delivered at your home. That avoids repeated journeys during a three-week course.
For dry AMD, each home session takes around 12 minutes, and the course is nine sessions over three weeks. The dry eye treatment is a single appointment of around an hour, covering all four steps. Your clinician will confirm timings for your own plan.
No, and that is why every patient is assessed first. Suitability depends on your diagnosis, the stage of your condition, your general health and your medication. If PBM is not right for you, we will tell you.
We cover the central belt, from Tayside in the north to Ayrshire in the south west. The price per session depends on where you are treated, because travel is the only thing that changes it. It starts at £150 per session. The costs page lists every area and lets you check your postcode.
Ready to talk it through?
Every patient is assessed before treatment is discussed. If PBM is not right for you, we will tell you.
The information on this site is for general guidance only and is not medical advice. Diagnosis and treatment decisions should always be made with a qualified eye care professional. If your vision changes suddenly, seek urgent advice.