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DR MARTIN SCURR: Why massaging the eyelids helps relieve dry eyes

I have been diagnosed with dry eyes and have been using warm eye drops and pads for two weeks. But it’s still very uncomfortable. Can you suggest any other remedy?

Jayne Cole, Southampton.

As many as one in four of us have dry eyes, but many may not realize it, as the symptoms that cause it can be confusing: largely because, paradoxically, dry eyes sometimes water.

These tears are the eye’s way of compensating for dryness.

Normally, there is a tear film that spreads across the surface of the eye every time we blink. This provides a protective covering that allows the eyelids to open and close comfortably. It also has healing properties.

The tear film is made up of a mucoid inner layer, a watery middle layer, and an oily outer layer that prevents the watery layer from evaporating too quickly.

However, for a variety of reasons, such as age or menopause-related hormonal changes, for example, the meibomian glands that line the eyelid and produce the oily secretions become less productive, and any oil they do produce becomes less cash.

Up to one in four of us have dry eyes, but many may not realize it

This means that the aqueous layer is left unprotected, so it evaporates or spills out like tears, leaving your eye dry, gritty and sore.

Using lubricating eye drops will help. You say in your longer letter that you are using sodium hyaluronate, but this treats the symptom and is not a cure.

The best results come from meticulous and regular hygiene of the eyelids. This involves applying heat to the eyelids to soften any sticky oil secretions that may be clogging the meibomian gland outlets. Do this for four or five minutes.

You will also need to apply a little pressure to the area, massaging along the eyelid margin with a cotton swab. Wipe along the outer edge of each eyelid after heat treatment: three to four strokes along each lower lid. It works even better if you dip the cotton swab in baby shampoo.

The best way to apply heat is with a warm compress, for example flannel that is wrung out after soaking in hot water. You can also buy an eye compress that contains wheat, which is heated in a microwave (be careful to follow the instructions).

I also experimented with an ocular wand, a vibrating device to heat the eyelids. These are available online, although they can cost around £60.

If you get into the habit of using compresses and massaging daily, lubricating eye drops may only be needed occasionally.

Another consideration is that prolonged use of laptops and other screens appears to lead to reduced blinking, and this interferes with the normal spread of the tear film in the eyes. So make sure you get a screen break every hour if this applies to you.

I hope this regimen will lead to improvement in a few weeks.

During an ER visit with a broken rib, I was told my heart rate was a little high. Since then I have been checking my resting pulse and it is 80 beats per minute (bpm) which amazes me. I do a 30 minute brisk walk every day and a 30 minute hill walk weekly with no discomfort. Do I need medication to reduce my pulse?

Paul Jones, via email.

I think there is no need to worry about this. You say in your longer letter that you take doxazosin, prescribed for high blood pressure.

This is a medicine called an alpha adrenoceptor antagonist. A known and harmless side effect of these medications is reflex tachycardia, in which the heart beats faster.

There’s nothing wrong with having a slightly elevated heart rate: you’re still within the normal range of 60 to 100 bpm.

What matters is that your blood pressure is normal and you have no symptoms or shortness of breath when you exercise, which indicates that your heart function is good.

Rest assured, you don’t need to worry.

Write to Dr. Scurr

Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London W8 5HY or email: drmartin@dailymail.co.uk, include contact details. Dr. Scurr is not allowed into personal correspondence. Answers should be taken in a general context. Consult your own GP if you have any health problems.