My Dry Eyes

Treat Dry Eye

Before your in-person consultation, please complete two quick forms to help us better understand your symptoms and medical history. These forms are essential for a personalised and comprehensive dry eye evaluation. Your input allows our specialists to tailor the in-person assessment to your needs, ensuring we can offer the most effective treatment options.

Please take a few moments to fill out the forms below, and we’ll be ready to create a treatment plan.

SPEED Questionaire

Name(Required)

Email(Required)

DOB

Gender

Male

Female

Prefer not to say

Practice(Required)

Yorkshire - Airedale Opticians

Wiltshire - Jacqueline Burns Opticians

Report the type of SYMPTOMS you experience and when they occur:

Today?

Dryness, Grittiness or Scratchiness

Soreness or Irritation

Burning or Watering

Eye Fatigue

In the past 72 hrs?

Dryness, Grittiness or Scratchiness

Soreness or Irritation

Burning or Watering

Eye Fatigue

Within the past 3 mths?

Dryness, Grittiness or Scratchiness

Soreness or Irritation

Burning or Watering

Eye Fatigue

Report the type of SYMPTOMS you experience and when they occur:

Report the SEVERITY of your symptoms using the rating list below

Report the SEVERITY of your symptoms using the rating list below

Do you use eye drops for lubrication?

Yes

No

If yes, how often?

Ocular Surface Disease Index

Name(Required)

Email(Required)

DOB

Practice(Required)

Yorkshire - Airedale Opticians

Wiltshire - Jacqueline Burns Opticians

Have you experienced any of the following during the last week?

Have problems with your eyes limited you in performing any of the following during the last week?

Have your eyes felt uncomfotable in any of the following sitautions during the last week?

Blephex
Treatment

Blephex
Treatment

Intense
Pulsed Light

Intense
Pulsed Light

Artificial
Tears

Artificial
Tears

Lacrifill
Gel

Lacrifill
Gel

Zest
Ocular

Zest
Ocular

Punctal
Plugs

Punctal
Plugs

Medical
Contact Lenses

Medical
Contact Lenses

Nasolacrimal
Irrigation

Nasolacrimal
Irrigation

Meibomian
Gland Probing

Meibomian
Gland Probing

Amniotic
Membrane

Amniotic
Membrane

Low Level
Light Therapy

Low Level
Light Therapy

Styes &
Chalazions

Styes &
Chalazions

Blephex
Treatment

We Specialise in Blepharitis treatment, diagnosis and management.

Blephex
Treatment

Intense
Pulsed Light

Treats Meibomian Gland Dysfunction, the cause of up to 80% of dry eye cases.

Intense
Pulsed Light

Punctal
Plugs

Block tear drainage, retaining moisture on the eye’s surface and reduce dryness.

Punctal
Plugs

Lacrifill
Gel

Lacrifill is a simple in-clinic treatment that helps your eyes retain natural surface tears.

Lacrifill
Gel

Meibomian Gland Probing

Unblocks oil-producing glands in the eyelids, restoring tear film stability and relieving dry eye

Meibomian Gland Probing

Amniotic
Membrane

Promotes healing of the ocular surface in severe cases of dry eye and corneal damage.

Amniotic
Membrane

Styes &
Chalazions

The different ways to treat swollen eyelid bumps caused by blocked oil glands

Styes &
Chalazions

Artificial
Tears

Provides immediate lubrication to relieve dryness by supplementing the natural tear film.

Artificial
Tears

Low Level
Light

Treats Meibomian Gland Dysfunction, the cause of up to 80% of dry eye cases.

Low Level
Light

Nasolacrimal
Irrigation

Clears blocked tear ducts, restoring tear flow and alleviating dry eye symptoms.

Nasolacrimal
Irrigation

Zest
Ocular

A cleansing treatment for dry eye, meibomian gland dysfunction, demodex and inflammation.

Zest
Ocular

Medical
Contact Lenses

Creates a moisture barrier over the eyes, providing continuous hydration for severe dry eyes.

Medical
Contact Lenses

Blephex
Treatment

We Specialise in Blepharitis treatment, diagnosis and management.

Blephex
Treatment

Intense
Pulsed Light

Treats Meibomian Gland Dysfunction, the cause of up to 80% of dry eye cases.

Intense
Pulsed Light

Punctal
Plugs

Block tear drainage, retaining moisture on the eye’s surface and reduce dryness.

Punctal
Plugs

Lacrifill
Gel

Lacrifill is a simple in-clinic treatment that helps your eyes retain natural surface tears.

Lacrifill
Gel

Meibomian Gland Probing

Unblocks oil-producing glands in the eyelids, restoring tear film stability and relieving dry eye

Meibomian Gland Probing

Amniotic
Membrane

Promotes healing of the ocular surface in severe cases of dry eye and corneal damage.

Amniotic
Membrane

Styes &
Chalazions

The different ways to treat swollen eyelid bumps caused by blocked oil glands

Styes &
Chalazions

Artificial
Tears

Provides immediate lubrication to relieve dryness by supplementing the natural tear film.

Artificial
Tears

Low Level
Light

Treats Meibomian Gland Dysfunction, the cause of up to 80% of dry eye cases.

Low Level
Light

Nasolacrimal
Irrigation

Clears blocked tear ducts, restoring tear flow and alleviating dry eye symptoms.

Nasolacrimal
Irrigation

Zest
Ocular

A cleansing treatment for dry eye, meibomian gland dysfunction, demodex and inflammation.

Zest
Ocular

Medical
Contact Lenses

Creates a moisture barrier over the eyes, providing continuous hydration for severe dry eyes.

Medical
Contact Lenses