Orr and Simpson Eye Care - Ayr
Orr and Simpson Eye Care - Ayrshire
Ayr: 01292 265 493
5 Killoch Place, Ayr KA7 2EA

Dry Eye Clinic

Dry eye and Blepharitis are common conditions which can cause a wide range of symptoms from dry, itchy, uncomfortable eyes to the opposite – blurry and watery eyes.  It is common to experience these symptoms in winter or dry, air conditioned environments and is more common in women than men and those over 40. Computer users and contact lens wearers can also commonly experience dry eye. Blepharitis is an inflammation of the eyelids which can lead to red, crusty uncomfortable eyelids and often is present alongside dry eye.

If you have had these symptoms for a while you will probably realise that there are a wide range of eye drops, gels and ointments available as well as oral supplements, lid cleaning products, heat packs and treatments on the market for both blepharitis and dry eye – knowing which will work best for you without expert guidance can be difficult.  Sometimes the wrong treatment or drop can make your symptoms worse.

Understanding what is causing your symptoms and how best to treat them is the key aim of our dry eye clinic.   Using the latest in dry eye diagnostic technology we can analyse different aspects of your tear film, ocular surface and eyelids to produce a personalised treatment plan.

What does it involve?

Your Optometrist will take a detailed history from you and ask you to complete a dry eye questionnaire.   

Oculus Keratograph K5M

This instrument allows us to capture digital imaging of your tear film and perform a number of different tests including :

  • NIKBUT – Non Invasive Tear Break Up Time – This can assess the stability of your tear film and how quickly your eyes are drying out.
  • R-Scan – This digital image quickly analyses how red the surface of your eyes are enabling comparisons between visits.
  • Tear Meniscus Height – This measurement is a good way of assessing your tear volume. Low tear volumes can indicate aqueous deficient dry eye.
  • Meibo-Scan – This infrared examination produces digital images of the Meibomian glands in your upper and lower eyelids. These glands are crucial to a healthy tear film.
  • Lipid Analysis - Imaging of the lipid layer (which is the outermost, protective layer of the three-layered tear film) can indicate the quantity of lipid present in the tear film.  Absent or reduced lipid layer can cause an increase in tear film instability and evaporation.


Assesses the tear film osmolarity which is an important marker of the severity of dry eye.  Using TearLab your Optometrist takes a tiny sample of tears which it then analyses and produces a value which we can use to monitor any change between visits.


This test detects elevated levels of MMP-9 protein which can indicate ocular surface inflammation. Inflammation and dry eye often go together and treating the inflammation can often lead to significant improvements in the dry eye symptoms.

Digital Slit Lamp Examination

Digital Slit Lamp Examination of your eyes, eyelids and tear film.  The high resolution camera within the microscope allows us to store images and videos for future comparison.  We will also use Fluorescein and Lissamine Green dyes to assess your tears and ocular surface.

None of these examinations are painful and your Optometrist will talk you through each one and when they instill some eyedrops there may be some mild stinging for a few seconds.

BlephEx treatment is also available for patients with significant blepharitis.  This uses a sterile surgical microsponge to gently lift debris from the eyelid and eyelashes. It is not painful or unpleasant but can tickle.

Why visit our dry eye clinic?

Both of our Optometrists have a wealth of experience in assessing, managing and treating dry eye in both contact lens wearers and contact lens non-wearers.  Douglas Orr is one of the few qualified independent prescribers in Ayrshire enabling him to treat a wide range of conditions.

We are also the only practice in the West of Scotland with the Oculus Keratograph K5M, InflammaDry and TearLab as well as digital slit lamp biomicroscopes.  This level of technology is far more accurate and provides us with greater information than the traditional method of looking through a microscope at the eye.  

What about contact lenses?

Dry eye commonly affects contact lens wearers.  Sometimes some simple steps, treatments or a change to your lenses (or solution) can make a significant difference to reducing your symptoms and increasing your lens comfort. Treating dry eye may also allow you to wear contact lenses if you have not been able to before. If you are visiting for a dry eye examination please do not wear your contact lenses for at least 2 hours beforehand. 

How much does it cost?

A private dry eye examination costs £125 and can take between 40 and 60minutes.  This includes the cost of the diagnostic tests, examination from our Optometrists and an individual dry eye report.  The fee for Clarity members if £60.

A follow up examination costs £70 (Clarity members £60) and usually takes between 20 and 30minutes.

Should your Optometrist determine BlephEx treatment is needed the fee is £45 or £20 for Clarity members. BlephEx treatment is not available without a prior clinical assessment or diagnosis from one of our Optometrists.

Why is this not free on the NHS?

The NHS is almost unique in the level of free eye care available to everyone in Scotland.  However, there are limits to what the NHS will fund and they do not fund the diagnostic tests available in our dry eye clinic.

Want to find out more?

Contact us using the links above, email info@orrandsimpson.co.uk or telephone 01292 265493.


We happily accept referrals for dry eye examination and management, BlephEx treatment or other investigations such as OCT, Fundus Autofluorescence, digital imaging, automated visual field testing . Full reports are provided to the referring clinician. Please contact us using the contact details above for our secure NHS email address. 

Orr and Simpson