Eye Care
Dry Eye Care
Chronic dry eye assessment and personalised therapy to restore comfort and surface health.
Dry Eye Disease (DED) is one of the most prevalent eye conditions globally and is rapidly increasing with growing screen time, air conditioning exposure, and contact lens wear. Yet it remains persistently under-diagnosed and under-treated because patients and their doctors often attribute symptoms to 'tiredness' or 'strain'. At Zala Clinic, Dr. Mala R. Zala takes a structured, subtype-specific approach to dry eye — distinguishing evaporative disease from aqueous-deficient disease and prescribing targeted therapy for each.
Symptoms of Dry Eye Disease
DED presents with a wide and sometimes confusing range of symptoms:
- Burning, stinging or scratching sensation — often worse in the afternoon and evening
- Paradoxical excessive watering — reflex tearing in response to ocular surface irritation
- Blurred or fluctuating vision that clears temporarily with blinking
- Redness, particularly in air-conditioned or low-humidity environments
- Difficulty wearing contact lenses comfortably
- Eye fatigue or heaviness after screen use or reading
- Sensitivity to light (photophobia)
Diagnostic Evaluation
Sub-typing dry eye disease is essential for targeted therapy:
- OSDI / DEQ-5 questionnaire — standardised symptom scoring
- Tear meniscus height and quality — slit-lamp assessment
- TBUT (Tear Break-Up Time) — fluorescein dye instillation to measure tear film stability
- Schirmer's test — quantifies aqueous tear production
- Meibomian gland expression and evaluation (meibography where available)
- Ocular surface staining (fluorescein + lissamine green) to map epithelial damage
- Lid margin assessment for blepharitis, rosacea, meibomian gland dysfunction (MGD)
Treatment Strategies
Treatment is tailored to the patient's dry eye subtype and severity:
- Preservative-free artificial tears — cornerstone of mild-moderate DED
- Warm compresses and lid hygiene — essential for evaporative / MGD-dominant disease
- Omega-3 fatty acid supplementation — reduces meibomian gland dysfunction
- Topical cyclosporine (0.05–0.1%) — anti-inflammatory therapy for moderate-severe DED
- Serum eye drops — autologous serum or umbilical cord serum for refractory cases
- Punctal plugs — collagen or silicone inserts to conserve natural and artificial tears
- In-office procedures: meibomian gland expression, lid scrubs for blepharitis
- Scleral contact lenses for severe surface disease
Practical Screen-Time Guidance
In the modern digital environment, the 20-20-20 rule is essential: every 20 minutes, look at something 20 feet away for at least 20 seconds. Blink consciously and fully during screen use. Optimise screen height (below eye level), reduce glare with anti-reflective coatings, and maintain indoor humidity above 40%. Dr. Mala provides a customised environmental and lifestyle guide alongside every dry eye treatment plan.
Dr. Mala R. Zala
MBBS, MS · Ophthalmologist