The Ultimate Guide to Treating Dry Eyes in Singapore (2025)

What are Dry Eyes? 

Dry eyes represent more than just temporary eye discomfort. This condition occurs when your tears aren't providing adequate lubrication for your eyes. There are 3 primary factors that cause dry eyes:

1. Insufficient tear production from your tear glands

2. Poor quality tears produced by your tear glands

3. Rapid tear evaporation from your eye surface You might encounter dry eyes while flying, spending time in air-conditioned spaces, or after extended periods of computer screen use, among other scenarios. Let's explore the causes of dry eyes and available treatments below! 

What are the symptoms of Dry Eyes? 

You might wonder, What do dry eyes feel like? As the name implies, you'll experience dryness and discomfort in your eyes. Common signs of dry eyes include:

• Burning or stinging sensations in your eyes

• Eye mucus formation in or around the eyes

• Eye redness

• Sensitivity to light

• Vision becoming blurry

• Problems with contact lens wear

These symptoms typically affect both eyes and suggest you may have dry eyes. Interestingly, another dry eye symptom is experiencing watery eyes occasionally.

Strange, right?

How can eyes be simultaneously dry and watery?

This seemingly contradictory symptom is called reflex tearing. It happens when eye dryness irritates your eyes, triggering your body to produce additional moisture. However, these reflexive tears consist mainly of water and don't function like regular tears.

They fail to provide the lubricating coat your eye surface needs and only serve to flush out irritants or dust from your eyes.

Why Do Dry Eyes Occur?

There are numerous causes of dry eyes - some unavoidable, while others can be prevented. You might experience dry eye symptoms at specific times during the day. In certain cases, underlying medical conditions contribute to developing dry eyes.

Understanding the specific cause of your dry eyes is crucial for proper treatment selection. That's why I suggest getting a comprehensive eye examination.

Here are the common causes of dry eyes:

Age-Related Changes

Dry eyes are often considered an age-related condition, becoming increasingly prevalent as you get older. Your eyes undergo various changes with age, including a decline in tear production capabilities.

Medication Effects

Tears consist of oil, water, and mucus. Certain medications can reduce any of these components. Key examples include:

• Isotretinoin

• Antidepressants

• Diuretics

• Beta-blockers for hypertension

For example, antihistamines used for nasal congestion decrease body mucus production. This affects tear formation and can lead to chronic dry eyes.

Extended Screen Time

In today's digital age, screen time has increased dramatically, especially among computer-based professionals.

Interestingly, people tend to blink 30% to 50% less frequently when viewing computer screens compared to reading printed materials. This reduced blink rate contributes significantly to eye dryness.

Smoke Exposure

Environmental smoke can cause eye dryness. It's advisable to avoid smoky environments or take protective measures when exposure is unavoidable.

For smokers, consult your doctor about cessation options, including nicotine replacement therapy or prescription medications.

Surgical Procedures

Eye surgeries like LASIK, ReLEX SMILE, and cataract surgies can potentially damage corneal nerves if not performed correctly. This reduces corneal sensitivity.

Consequently, your eyes might fail to detect the need for lubrication, interrupting the signal for tear production and resulting in inadequate eye moisture.

When Do Dry Eyes Typically Occur?

As previously noted, patients may experience dry eyes or symptom intensification at different times throughout the day.

These timing patterns aren't random - they often indicate specific underlying medical conditions.

Morning Dry Eyes

Ever wondered why your eyes feel particularly dry when you wake up? Here's a key reason for morning dry eye symptoms:

Nocturnal Lagophthalmos

This condition occurs when your eyelids don't close completely during sleep, leading to morning dryness. Approximately 20% of people have this benign condition.

The primary cause of nocturnal lagophthalmos is facial nerve weakness. The facial nerve (seventh cranial nerve) controls eyelid closure during sleep. This weakness can result from:

• Skull trauma

• Jaw trauma

• Cerebellar artery injury

• Bell's palsy (temporary facial muscle weakness)

While other factors can cause morning dry eyes, nocturnal lagophthalmos is typically the main culprit. General factors like tear quality and production volume can also contribute.

Nighttime Dry Eyes

Conversely, some people only experience dry eyes in the evening. One significant cause is your body's natural metabolic slowdown at night [3]. This decreased metabolism reduces tear production volume [4], resulting in nighttime dry eyes.

Medical Conditions Associated with Dry Eyes

Several existing medical conditions can trigger dry eye development. Some surprising connections include:

Hormonal Changes

Menopause can lead to dry eyes due to hormone imbalances affecting tear production. Interestingly, hormone replacement therapy hasn't shown effectiveness in improving this condition.

Vitamin Deficiencies

• Vitamin A deficiency: Well-known for supporting eye health, insufficient vitamin A can cause dry eyes

• Vitamin D deficiency: Recent research indicates a connection with dry eye development

Autoimmune Conditions

Sjögren's syndrome, an immune system disorder, affects eye moisture-secreting glands [5]. This reduces tear production. Other autoimmune conditions like diabetes may also impair tear production.

Eyelid Inflammation

Blepharitis involves bacterial-induced eyelid inflammation [6]. While incurable, treatment options include:

• Antibiotic eye drops

• Warm compress application

• Proper eye hygiene maintenance

Contact Lens Wear and Dry Eyes

Extended contact lens wear can contribute to chronic dry eyes.

If you experience persistent dryness with contacts, consider temporarily switching to glasses. Your lenses might be limiting corneal oxygen exposure.

Special moisture-retaining contact lenses are available for dry eye sufferers. Consult your eye doctor about these options.

For contact lens wearers experiencing significant dryness, extra caution is warranted. Severe dryness increases infection risk, which could potentially threaten vision.

Managing Post-Surgical Dry Eyes

Experiencing dry eyes after laser eye surgery is a common occurrence. During LASIK and laser cataract procedures, corneal nerve disruption reduces corneal sensitivity.

Consequently, your eyes might not detect the need for lubrication, resulting in decreased tear production.

Fortunately, this condition typically resolves within days or weeks. During recovery, regular use of lubricating eye drops is essential to maintain proper eye moisture.

Dry Eye Diagnosis Methods in Singapore

Eye care professionals use questionnaires and specific examinations for dry eye diagnosis. The standard examination includes applying fluorescent dye to evaluate tear films using a SlitLamp biomicroscope at eye clinics.

Additional Diagnostic Tests

While not mandatory, your eye doctor might recommend these supplementary tests:

Tear Volume Assessment

The Schirmer test measures tear production capacity using blotting paper strips placed under lower eyelids for 5 minutes. Results interpretation:

• Healthy: Over 10 millimeters moisture

• Dry eyes: Less than 10 millimeters

• Additional testing: Over 15 millimeters

Tear Quality Evaluation

Special dye-containing eyedrops reveal corneal staining patterns and tear evaporation rates, helping assess tear quality.

Advanced Testing Options

• Tear Osmolarity Test: Analyzes nanofilter volumes of tear fluid

• Meibomian Gland Imaging: Infrared scanning to detect chronic inflammation

• Blood Analysis: Checks thyroid function, vitamin D levels, and other relevant factors

Common Dry Eye Concerns

Permanence

Dry eye permanence varies by cause and severity. Most cases can be stabilized with treatment, leading to improved comfort, reduced symptoms, and potentially enhanced vision.

Contagion Risk

Unlike conjunctivitis (pink eye), dry eye syndrome isn't contagious. You can maintain normal eye contact without transmission concerns.

Health Risks

While rarely dangerous when properly managed, severe untreated dryness can increase infection risk, particularly for contact lens wearers.

Treatment Options for Mild Dry Eyes

Over-the-counter eye drops and gels typically suffice for occasional or mild symptoms. Three main categories include:

1. Artificial Tears

These synthetic tears provide moisture through:

• Lubricating agents

• Healing electrolytes

• Guar gum (for rapid tear evaporation)

• Preservatives (for bottle sterility)

Avoid preservative-containing drops if:

• They cause irritation

• Your condition is severe

• Usage exceeds 4-6 times daily

2. Allergy Drops

Designed for allergy-induced dry eyes, containing:

• Antihistamines for symptom relief

• Mast-cell stabilizers for preventive care

3. Anti-redness Drops

Also called decongestants, these contain:

• Vasoconstrictors to reduce visible blood vessels

• Sometimes combined with antihistamines

Note: Limit use to 72 hours to prevent rebound irritation unless otherwise directed by your doctor.

Preservative-Free Eye Drop Options

A popular prescription option is Optive Fusion, available over-the-counter for $20-$30 per month's supply.

Identifying Preservative-Free Products

Preservative-free drops feature distinctive packaging:

• Single-use vials or sticks

• 12-hour usage window

• Similar pricing to preserved drops ($30)

In contrast, preserved drops come in bottles lasting one month after opening. Both types risk contamination through contact with hands or eyes.

Advanced Treatment Options for Severe Dry Eyes

For persistent symptoms, targeted treatments addressing root causes include:

Home-Based Treatments

Regular warm compresses and lid scrubs benefit those with chronic eyelid margin inflammation or oil gland issues.

Professional Treatments

Clinic-based options include:

• Lid margin exfoliation

• Meibomian gland expression

• Prescription eye drops for concurrent allergies

• Specialized gels (Genteal, Vidisic) for conditions like Nocturnal Lagophthalmos

Medical Interventions

Punctal Plugs

Tiny devices inserted into tear ducts prevent drainage, available in:

• Temporary collagen

• Permanent silicone

Surgical Solutions

Rare cases may require conjunctival "face-lift," particularly beneficial for elderly patients with redundant conjunctiva.

Advanced Therapeutic Options

Thermo-Mechanical Ablation (TMA)

This non-laser treatment delivers thermal energy around eyes to:

• Enhance lubrication

• Reduce evaporation

• Improve meibomian gland function Features quick, low-pain pulses without skin pigmentation effects.

Lipiflow Treatment

Automated therapy combining:

• Warm compress benefits

• Meibomian gland expression

• 12-minute "eyelid spa" procedure Particularly effective pre-cataract surgery.

Prevention Through Eye Exercises

Dr. Donald Korb's blinking sequence:

1. Close your eyes normally (minimal corner movement)

2. Hold 2 seconds, open

3. Repeat closure for 2 seconds

4. Squeeze tightly for 2 seconds

5. Perform 5-7 times daily

Remember the 20-20-20 rule: Every 20 minutes, take 20 seconds to look at something 20 feet away.

Effective Home Remedies

Environmental Modifications

• Minimize direct air exposure

• Use wraparound sunglasses outdoors

• Install humidifiers in dry spaces

Dietary Improvements

• Increase omega-3 sources:

  • Salmon

  • Tuna

  • Sardines

  • Chia seeds [8]

• Maintain proper hydration

Supplement Options

Omega-3 fatty acid supplements can enhance eye oil film quality.

Cosmetic Considerations

• Practice thorough eye makeup removal

• Avoid eyelid adhesives

• Prefer daily disposable contacts

• Reduce contact lens wear when possible

• Source contacts from reliable vendors

Treatment Costs for Dry Eyes in Singapore

Cost Breakdown

• Eye evaluation: $200 - $380

• Eye drops (monthly): $20 - $30

• Punctual plugs (per pair): $188

• LipiFlow (both eyes): $800

• TMA (both eyes): $300 - $450

Medisave Coverage

Most dry eye treatments related to eye surgery, particularly cataract operations, qualify for Medisave coverage. Additional details are available on the Medisave website.

Treatment Philosophy

As the Chinese saying goes, "细节决定成败" (details dictate outcomes). Success in managing dry eyes requires:

• Close collaboration with patients

• Careful attention to detail

• Patient-centered approach

• Comprehensive health monitoring

I believe there's always room for improvement in treatment outcomes. By considering all aspects of patients' health, we can enhance both their quality of life and eye care specifically.

Surgical Considerations

Dry eye management is crucial for surgical success. Incorporating proper dry eye care into both pre-operative preparation and post-operative treatment can significantly enhance outcomes, from basic LASIK to complex cataract procedures.

Key Takeaways

Understanding the tear film's complex structure is essential for effective treatment:

• Mucous layer

• Aqueous (water) layer

• Lipid (oil) layer

Successful treatment requires addressing all components rather than focusing on a single layer.

Important Considerations

• Dry eyes can complicate post-surgical recovery

• Proper management is crucial for optimal results from elective procedures

• Early intervention is recommended

• Seek professional evaluation before planned procedures like LASIK

Don't dismiss persistent dry eye symptoms. Schedule an evaluation promptly to ensure proper diagnosis and treatment.