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Ophthalmology · UK

Dry eye clinic, IPL, LipiFlow and the whole stepladder.

A proper diagnosis with meibography, tear osmolarity and inflammatory testing, then the right treatment: lid hygiene and lubricants, LipiFlow thermal pulsation, IPL, BlephEx, punctal plugs, ciclosporin or amniotic membrane, in that order.

A stethoscope on a clinical desk

Indicative pricing

What private dry eye treatment costs in the UK.

Treatment Indicative range
Initial dry eye consultation and full workup £220–£380
LipiFlow thermal pulsation (both eyes) £850–£1,600
IPL (Lumenis M22 or E-Eye) per session £250–£450
IPL course of 4 sessions £1,000–£1,800
BlephEx microblepharoexfoliation £180–£280
Amniotic membrane (Prokera self-retained) £550–£950

The journey

From first appointment to a stable ocular surface.

Diagnosis first, then the stepladder. No device is booked before the workup confirms the subtype.

  1. 01

    Before

    Send your OSDI score and current drops

    A short confidential form. Symptoms, screen hours, contact lens wear, current lubricants and any autoimmune history.

  2. 03

    In clinic

    Full dry eye workup

    OSDI questionnaire, Schirmer, TBUT, corneal fluorescein and lissamine staining, meibography (LipiScan or LipiView), tear osmolarity (TearLab) and MMP-9 (InflammaDry).

  3. 04

    In clinic

    Stepladder treatment plan

    Lid hygiene and preservative-free lubricants first, then in-office IPL, LipiFlow, BlephEx or RF as clinically indicated.

  4. 05

    After

    Review at 6 to 12 weeks

    Repeat OSDI and objective tests. Adjust the plan, add ciclosporin or punctal plugs if needed, and refer for Sjögren s serology if suspected.

When it helps

The dry eye presentations we see most.

Symptoms overlap; treatment does not. TFOS DEWS II staging plus meibography and osmolarity narrow it down.

  • Evaporative dry eye (MGD)

    The commonest subtype. Blocked meibomian glands, unstable tear film, worse late in the day. Responds well to LipiFlow, IPL and warm compresses.

  • Aqueous-deficient dry eye

    Reduced tear production from age, medication or Sjögren s syndrome. Needs lubricants, ciclosporin, punctal plugs and autoimmune workup.

  • Mixed disease

    Both mechanisms together, which is what most established patients actually have. Treated across the stepladder rather than one device.

  • Anterior blepharitis and Demodex

    Crusting, cylindrical dandruff and itchy lid margins. BlephEx microblepharoexfoliation clears the biofilm; tea tree formulations for Demodex.

  • Post-refractive dry eye

    Symptoms after LASIK, LASEK, PRK or SMILE. Usually settles by 6 months with lubricants, ciclosporin and short-term punctal plugs.

  • Contact lens intolerance

    Reduced wearing time and end-of-day discomfort. Treating underlying MGD often restores tolerance without abandoning lenses.

  • Screen-related dry eye

    Reduced blink rate at screens amplifies evaporative disease. Behavioural changes, blink training and lubricants alongside device therapy.

  • Red flag: severe pain or photophobia

    Sudden severe pain, marked photophobia or visual loss needs same-day ophthalmology, not a routine dry eye slot.

Treatment options

The full dry eye stepladder in one place.

Step 1 lid hygiene and preservative-free lubricants (Systane, Hylo-Forte, Thealoz Duo, Cationorm). Step 2 warm compresses (Bruder mask), omega-3, expression. Step 3 in-office devices. Step 4 punctal plugs, ciclosporin, serum drops, amniotic membrane. Step 5 scleral lenses (PROSE), tarsorrhaphy, rebamipide.

  • LipiFlow thermal pulsation

    A 12-minute activator vector applies 42.5°C heat to the inner lid with gentle outer massage, liquefying and expressing meibum. Best for confirmed MGD on meibography.

  • IPL (Lumenis M22, E-Eye)

    Intense pulsed light across the cheekbones and lower lids, typically 4 sessions 2 to 4 weeks apart. Reduces inflammation, telangiectasia and MGD, especially in rosacea patients.

  • BlephEx microblepharoexfoliation

    A medical grade micro-sponge cleans the lid margins under magnification, removing biofilm, scurf and Demodex debris. Repeated 4 to 6 monthly.

  • RF radiofrequency and iLux / TearCare

    Alternative in-office thermal expression platforms. Handpieces heat and express the glands under direct visualisation, useful when LipiFlow is not tolerated.

  • Punctal plugs

    Silicone plugs (temporary collagen or permanent) occlude the tear drainage puncta to conserve tears in aqueous-deficient disease.

  • Amniotic membrane (Prokera)

    A self-retained cryopreserved amniotic membrane worn for 3 to 5 days to heal persistent epithelial defects and severe surface disease.

  • Ciclosporin and secretagogues

    Ciclosporin 0.05% (Ikervis in the UK, Restasis in the US) reduces T-cell inflammation. Rebamipide 2% and, where available, lifitegrast and varenicline nasal spray broaden the options.

  • Autologous serum drops 20%

    Drops made from your own centrifuged serum, rich in growth factors, for severe or Sjögren s-related surface disease unresponsive to standard drops.

Our vetted UK network

Dedicated dry eye services in London and beyond.

Introductions to the right unit for your subtype. Sjögren s workup and rheumatology referral built in where indicated.

  • Consultant ophthalmologists or specialist optometrists running a dedicated dry eye clinic

  • On-site meibography, tear osmolarity and MMP-9 testing, not just symptom scores

  • Access to LipiFlow, IPL, BlephEx and RF platforms under one roof

  • Clear pathways for Sjögren s serology, rheumatology referral and scleral lens fitting

Clinics

  • Moorfields Private Dry Eye Clinic
  • Cadogan Clinic Dry Eye Service
  • London Medical
  • One Welbeck Eye Care
  • HCA The Wellington Ophthalmology
  • Focus Clinics
  • Optegra London

Safety and expectations

What to expect, honestly.

Dry eye is chronic. Devices buy back gland function; daily home care keeps you comfortable.

  • IPL: skin type and eye shielding

    IPL is calibrated to Fitzpatrick I to IV skin. Metal ocular shields protect the globe. Not suitable in pregnancy, active herpes zoster or photosensitising medication.

  • LipiFlow: transient tenderness

    Mild lid tenderness for 24 hours is common. Rare corneal abrasion or lid swelling settles within days. Not used with active ocular infection or recent lid surgery.

  • Ciclosporin: initial stinging

    Ikervis stings on instillation for the first weeks. Perseverance for 3 months is needed before judging effect. Preservative-free lubricants used alongside.

  • Punctal plugs can extrude or cause epiphora

    Plugs occasionally cause watery eyes or fall out. Permanent thermal cautery is reserved for severe disease.

  • Amniotic membrane discomfort

    Prokera is bulky and blurs vision while worn. Removed in clinic at 3 to 5 days. Used for persistent epithelial defects, not routine dry eye.

  • Home care matters more than devices

    Twice daily warm compresses (Bruder mask), lid hygiene, omega-3 supplementation and screen breaks do more long term than any single in-office session.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Insurers vary on dry eye cover. Consultations and Sjögren s workup are often covered; IPL and LipiFlow are usually self-pay.

Frequently asked

Everything patients ask about dry eye.

IPL vs LipiFlow, cost, Sjögren s, drops and whether treatment is forever.

  • What actually causes dry eye disease?

    Dry eye is a multifactorial disease of the ocular surface. Around 85% of cases are evaporative, driven by meibomian gland dysfunction (MGD) where the oil layer of the tear film is deficient. The rest is aqueous-deficient (age, medication, Sjögren s syndrome) or, most often, a mix of both. TFOS DEWS II is the international framework used to diagnose and stage it.

  • IPL or LipiFlow, which one do I need?

    They treat the same underlying problem (MGD) by different mechanisms. LipiFlow is a one-off 12-minute in-office thermal pulsation that expresses the glands directly. IPL is a course of 4 sessions 2 to 4 weeks apart that reduces inflammation, telangiectasia and Demodex around the lids, and is particularly good for rosacea-associated MGD. Some patients have both. The decision follows the meibography and osmolarity, not the marketing.

  • How much does private dry eye treatment cost in the UK?

    Expect £220 to £380 for a full initial consultation with meibography and osmolarity. LipiFlow both eyes is £850 to £1,600. IPL is £250 to £450 per session or £1,000 to £1,800 for a course of 4. BlephEx is £180 to £280. Amniotic membrane (Prokera) is £550 to £950. Ciclosporin (Ikervis) is a private prescription on top.

  • Do I need to be tested for Sjögren s syndrome?

    If you have significant aqueous-deficient disease, dry mouth, joint pain, unexplained fatigue or a positive family history, yes. A dry eye clinic will arrange anti-Ro, anti-La, ANA and rheumatoid factor and refer to rheumatology if positive. Missed Sjögren s means missed systemic disease, not just dry eyes.

  • Are the drops on the market really different?

    Yes. Preservative-free lubricants such as Systane, Hylo-Forte, Thealoz Duo and Cationorm target different layers of the tear film. Ciclosporin 0.05% (Ikervis) is anti-inflammatory rather than lubricating. Autologous serum drops at 20% are used for severe surface disease. Varenicline nasal spray (Tyrvaya) and lifitegrast (Xiidra) are not currently licensed in the UK.

  • Will I need this treatment forever?

    Dry eye disease is chronic. In-office treatments (LipiFlow, IPL, BlephEx) buy back gland function and reduce inflammation, but daily lid hygiene, preservative-free lubricants, warm compresses and omega-3s are lifelong. Most patients repeat IPL or LipiFlow every 12 to 18 months rather than continuously.

Related

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