Burning, irritation, blurred vision, reduced tolerance for contact lenses, or symptoms that keep returning despite the use of artificial tears may be signs of dry eye. These symptoms should be evaluated, particularly when they begin to interfere with daily activities.

At the Bumrungrad Dry Eye Clinic, patients are cared for by a team of ophthalmologists comprised of specialists with expertise in various subspecialties. They work together to assess, plan, and monitor treatment. Clinical examination findings via the IDRA dry eye analyzer are used to evaluate the tear film and meibomian glands, helping physicians select the most appropriate treatment approach.
 

Dry eye has many causes; one treatment approach may not be suitable for everyone.

It is not caused solely by insufficient tears and may involve abnormalities of the tear film, including the lipid, aqueous, and mucin layers.
By identifying the contributing factors more clearly, physicians can develop a treatment plan tailored to each patient.
 

What is assessed:

• Lipid layer, helps reduce tear evaporation and maintain tear-film stability.
• Aqueous layer, provides moisture to the ocular surface.
• Mucin layer, helps tears spread evenly and adhere to the surface of the eye.

 

Screen Use and Dry Eye

Normally, we blink approximately 15–20 times per minute. As we are looking at a screen, blinking frequency can decrease to around one-third of the normal rate.
Reduced blinking can cause the tear film to evaporate more quickly, leading to dryness and irritation. Many people may mistake these symptoms for eye fatigue.
 

Dry Eye Evaluation with a Slit Lamp

An ophthalmologist uses a slit lamp, which is a specialized microscope for examining the eye, to assess the:

• Corneal surface
• Conjunctiva
• Eyelids
• Eyelid margins
• Tear film

The examination can help identify abnormalities associated with dry eye, including:

• Inflammation or abnormalities of the cornea and conjunctiva
• Blepharitis and abnormalities of the eyelid margins
• Appearance of the meibomian gland openings and gland secretions
• Abnormalities of the tear film on the ocular surface
• Signs of ocular surface damage, which may be further assessed with diagnostic staining when appropriate

 
Slit-lamp findings are considered together with the patient’s symptoms, medical history, and other test results to support diagnosis and treatment planning.
 

In-Depth Tear Film Analysis with IDRA

The Bumrungrad Dry Eye Clinic uses IDRA (Ocular Surface Analyzer) to provide detailed information about the tear film and meibomian glands.
These findings help physicians better understand the patient’s tear-film composition and stability and supports individualized treatment planning.

IDRA can help assess:

• Lipid layer thickness — Evaluates the oily layer covering the tear film, which plays an important role in reducing tear evaporation.
• Meibomian gland structure — Provides images of the meibomian glands and helps assess abnormalities such as gland loss or atrophy, which may be associated with evaporative dry eye.
• Tear film stability — Assesses how long the tear film remains stable on the ocular surface. Rapid tear-film breakup may indicate tear-film instability.
• Tear volume — Helps assess the amount of tears on the ocular surface and whether dry eye may be associated with reduced tear production, increased evaporation, or both.
• Blinking pattern — Evaluates blinking frequency and completeness, particularly in people who spend long periods using digital screens. Reduced or incomplete blinking may prevent the tear film from spreading evenly and may increase tear evaporation.

Evaluation by an ophthalmologist using a slit lamp, together with IDRA findings, provides a more detailed view of both the ocular surface and the tear-film system. This information helps support diagnosis and selection of an appropriate treatment plan for each patient.
 

Dry eye may result from several contributing factors, including excessive tear evaporation, meibomian gland dysfunction, or eyelid inflammation.
Once the contributing factors have been identified, the ophthalmologist develops a treatment plan according to the patient’s underlying cause, severity, and lifestyle.

Treatment may include:

• Lifestyle and environmental adjustments — Patients may be advised to adjust their behaviors and avoid environmental factors that can trigger or worsen symptoms.
• Artificial tears — Artificial tears are commonly used as an initial treatment to increase lubrication, relieve burning and irritation and support the balance of the ocular surface

  There are different types of artificial tears. The ophthalmologist may recommend a formulation according to the patient’s type of dry eye, such as:

  • Moisturizing formulations
  • Lipid-enhancing formulations
  • Formulations designed to reduce tear evaporation


• Treatment for Meibomian Gland Dysfunction
  In many patients, dry eye is associated with dysfunction of the meibomian glands in the eyelids. When these glands do not function properly, the lipid layer of the tear film may become inadequate, causing tears to evaporate more quickly, contributing to chronic dry-eye symptoms.
  Treatment options may include:
  • Eyelid spa — A comprehensive eyelid-care treatment that may include:
    • Warm compresses
    • Meibomian gland massage or expression
    • Cleansing of the eyelid margins
  • IPL (Intense pulsed light) — IPL uses controlled pulses of light energy to help reduce eyelid inflammation, support meibomian gland function, and improve gland obstruction in appropriate patients.
  • LLLT (low-level light therapy) — LLLT uses low-level light energy to help stimulate cellular activity in the meibomian glands, reduce inflammation, and improve tear-film quality.

   

Our team consists of ophthalmologists who are experts in multiple subspecialties.

Each specialist is able to diagnose and manage dry eye and can assess contributing factors, develop an appropriate treatment plan, and monitor treatment.
Our team includes ophthalmologists specializing in:

• Cornea and corneal transplantation
• Oculoplastic, lacrimal, and orbital surgery
• Glaucoma
• Laser vision correction

Expertise across these subspecialties allows physicians to evaluate dry eye from multiple clinical perspectives.
 
Cornea specialists — Can assess abnormalities of the ocular surface, tear film, and meibomian glands, all of which may play an important role in dry eye.

Oculoplastic, lacrimal, and orbital specialists — Can assess abnormalities of the eyelids, blinking, meibomian glands, and tear-drainage system that may contribute to dry-eye symptoms in some patients.

Glaucoma specialists — Can manage dry eye in patients with glaucoma, including those who use long-term glaucoma eye drops and experience dryness or irritation.

Laser vision correction specialists — Can assess and manage dry eye in patients who are considering or have previously undergone laser vision correction, including evaluation of the ocular surface and tear film as part of their care.
 
Dry-eye management combines diagnostic findings, technology, and the clinical expertise of ophthalmologists to select treatment according to the cause, severity, and individual characteristics of each patient.
 
 
To schedule an appointment, please contact
Bumrungrad Dry Eye Clinic
Building A, 18th floor
Tel. 061 408 9622