Dry Eyes
Dry eyes: symptoms, causes, and the treatments that work
Dry eye is one of the most common conditions we see at Rose Optometry in Frankton, Hamilton, and one of the most under-treated. Most people with dry eyes have tried drops from the supermarket, found they help for ten minutes, and concluded that dry eyes are something you live with. They are not. Dry eye is a real, measurable disease of the tear film and the eye's surface, it has identifiable causes, and the causes can be treated. This page explains what it is, how to tell which kind you have, and what actually helps — written by the team that runs the region's dry eye clinic.
Book a Dry Eye Evaluation online: open our online booking — the Dry Eye Evaluation is preselected; just choose a time. It is a paid, focused assessment and the fee is confirmed when you book. Prefer to talk? Call 07 847 3195.
Dry eye symptoms
Dry eyes rarely feel simply "dry". More often people describe:
- Gritty, sandy or scratchy eyes, as though there is something in them.
- Burning or stinging, especially first thing in the morning or late at night.
- Tired, heavy eyes by the end of the day, worse at a screen or in air conditioning.
- Blurred vision that clears when you blink.
- Watery eyes — yes, really. See why watery eyes are usually dry eyes.
- Redness, light sensitivity, and stringy mucus in the corner of the eye.
- Contact lenses that are no longer comfortable by afternoon.
- Drops that help briefly and then stop helping.
The two kinds of dry eye — and why it matters which one you have
Your tear film has a watery layer, made by the lacrimal gland, and an oil layer on top of it, made by the meibomian glands in your eyelids, which stops the water evaporating. Dry eye happens when either fails.
Evaporative dry eye (the common one)
The oil layer is thin or missing because the meibomian glands are blocked or damaged — meibomian gland dysfunction (MGD). Tears evaporate between blinks, the surface dries, and the eye becomes inflamed. In a clinic-based study, 86% of people with dry eye had signs of MGD. Ordinary lubricating drops do not fix this, because the problem is oil, not water. This is the kind that blepharitis feeds, and the kind that responds to gland treatment.
Aqueous-deficient dry eye
The lacrimal gland does not make enough of the watery layer. This is the kind associated with Sjögren's syndrome and other autoimmune conditions, with some medicines, and with age. It is less common on its own, and many people have a mix of both.
The two look identical from the outside and feel much the same. Telling them apart takes measurement, and it decides the treatment — which is why we measure before we treat.
What causes dry eyes
- Screens. You blink about a third as often at a screen, and each blink is less complete, so the tear film breaks up and the glands are not squeezed.
- Age and hormones. Dry eye becomes more common from the forties on, and menopause is a common trigger.
- Eyelid disease. Blepharitis, Demodex mites and rosacea all block and inflame the meibomian glands.
- Medicines. Antihistamines, some antidepressants and blood-pressure tablets, isotretinoin for acne, and hormone treatments all reduce tears or thicken meibum.
- Contact lenses, particularly long-term soft lens wear.
- Environment. Air conditioning, heat pumps, wind, dust, low humidity, and long-haul flights.
- Eye surgery. Laser vision correction and cataract surgery can reduce corneal sensation and tear production for months.
- Autoimmune and general conditions. Sjögren's syndrome, rheumatoid arthritis, thyroid eye disease, diabetes.
- Eye makeup worn along the waterline, and incomplete removal, block gland openings.
- CPAP masks that leak air across the eyes overnight.
How dry eye is diagnosed
Guessing from symptoms is how people end up on the fifth bottle of drops. At a Dry Eye Evaluation at Rose Optometry we measure the tear film with TearCheck (how quickly it breaks up, how much tear there is, how well you blink), photograph the meibomian glands with meibography to see how many are blocked or lost, measure tear osmolarity with ScoutPro — the saltiness of the tears, a core marker of dry eye disease — stain the surface with dyes to show damage, and examine the lid margins for blepharitis and Demodex. Fifteen minutes, nothing uncomfortable, and at the end you know which kind of dry eye you have and how severe it is. Every measurement is repeated at review so you can see whether treatment is working.
Dry eye treatment
Eye drops — the right kind
Drops help, when they are the right drops. For evaporative dry eye you need a lipid-containing or oil-based drop that supports the oil layer, not a thin watery one. For aqueous deficiency, a hyaluronate-based drop that holds water on the surface. Preservative-free is better for anyone using drops more than four times a day or wearing contact lenses. Decongestant "red eye" drops make dry eye worse. We stock the drops we prescribe in our online store and will tell you which one, not just "use drops".
Eyelid care
A warm compress that is warm enough and long enough (ten minutes — a heated eye mask beats a flannel), daily lid cleansing from our lid hygiene range, and treating blepharitis or Demodex if they are present. Devices open the glands; this keeps them open.
Treating the glands
Where meibography shows blocked glands, we treat them directly, in clinic: IPL (intense pulsed light) to reduce the lid inflammation that blocks them; LipiFlow to warm and clear them in a single twelve-minute treatment; Blephasteam as a gentle first-line or maintenance therapy; low level light therapy; and BlephEx lid cleaning where blepharitis is part of it. All are available at 38 Lake Road, so you are not sent to Auckland.
Prescription treatment
Our optometrists are therapeutically qualified and can prescribe short courses of anti-inflammatory drops to calm an inflamed surface, and other prescription treatments where the assessment calls for them.
Severe and stubborn dry eye
For an eye surface that has broken down and will not heal, we offer amniotic membrane treatment in clinic. For severe dryness that ordinary measures cannot control, a scleral contact lens that holds a reservoir of fluid over the cornea can transform comfort. And where the cause sits outside the eye — an autoimmune condition, a medicine that could be changed — we work with your GP or specialist.
What to expect
Dry eye is a chronic condition, managed rather than cured, but managed well most people reach the point where their eyes stop being something they think about. A typical plan is an assessment, a home routine and the right drop, a device treatment if the glands need it, and a review at three months with the same measurements so you can see the difference in numbers as well as in comfort. We see dry eye patients from Hamilton, Cambridge, Te Awamutu, Morrinsville, Huntly, Raglan and across the Waikato, and accept referrals from GPs and other optometrists. Rose Optometry is a founding member of the Dry Eye Specialist Group, a network of independent, optometrist-owned dry eye clinics across New Zealand.
Optometrists for dry eye at Rose Optometry
You will be seen by one of seven therapeutically qualified optometrists — all University of Auckland graduates, all able to prescribe eye medication where it is needed, and all of whom examine patients from six weeks of age.
- Jagrut Lallu — Partner Optometrist · BOptom (Hons), MSc Specialty Lenses (Hons), FIAOMC. Diagnoses and treats dry eye; dry eye is one of Jagrut's special interests. All special interests: children's vision, myopia management, orthokeratology, keratoconus and scleral lenses, dry eye.
- Jacqueline Rowe — Partner Optometrist · BSc, BOptom. Diagnoses and treats dry eye; dry eye is one of Jacqueline's special interests. All special interests: dry eye and meibomian gland dysfunction, orthokeratology, keratoconus, children's vision.
- Emilie Lawson — BOptom (Hons) · Accredited Glaucoma Prescriber · ACO Certificate in Advanced Contact Lenses. Diagnoses and treats dry eye; dry eye is one of Emilie's special interests. All special interests: children's vision, myopia management, orthokeratology, glaucoma, keratoconus, dry eye.
- Jason Shen — BOptom (Hons). Diagnoses and treats dry eye. Special interests: keratoconus and specialty contact lenses, children's vision.
- Jessica Wood — BOptom (Hons) · Clinical Research Optometrist, New Zealand Eye Research Centre. Diagnoses and treats dry eye; dry eye is one of Jessica's special interests. All special interests: orthokeratology, keratoconus, dry eye, children's vision, clinical research.
- Stella Wong — BOptom (Hons). Diagnoses and treats dry eye; dry eye is one of Stella's special interests. All special interests: myopia management, orthokeratology, keratoconus and specialty contact lenses, binocular vision, dry eye, children's vision.
- Anjali Hira — BOptom (Hons). Diagnoses and treats dry eye; dry eye is one of Anjali's special interests. All special interests: children's vision, orthokeratology, keratoconus, dry eye.
Frequently asked questions
Can dry eyes be cured permanently?
No — and be wary of anyone who says otherwise. Dry eye is chronic. But the cause can be treated so that symptoms largely disappear and the glands you have are protected, and that is a very different outcome from a lifetime of drops.
What are the best eye drops for dry eyes in NZ?
It depends on which kind of dry eye you have. Lipid-based drops for evaporative dry eye; hyaluronate drops for aqueous deficiency; preservative-free for frequent use. A drop that suits one person is useless for another, which is why we measure first. Our article on choosing the right eye drops goes through the options.
Is dry eye syndrome serious?
Usually not sight-threatening, but it is not trivial either. Untreated, the surface of the eye becomes chronically inflamed, meibomian glands are lost permanently, and severe cases can damage the cornea. It also makes contact lens wear and eye surgery outcomes worse. Early treatment is easier and cheaper than late treatment.
Why are my eyes so dry in the morning?
Usually because the lids do not close fully overnight, or because blepharitis and blocked glands leave the surface unprotected while you sleep. A thicker night-time gel or ointment and a lid routine help; the assessment tells us which.
Can I wear contact lenses with dry eyes?
Often yes, once the dry eye is under control. Daily disposable lenses in modern materials are kinder to a dry eye, and for severe cases a scleral lens can actually protect the surface. Treat the dry eye first; the lens then has a chance.
Do screens cause dry eyes?
They make it worse rather than cause it outright. You blink less and less completely at a screen, so the tear film breaks up and the glands are not expressed. Blink deliberately, take breaks, and treat the glands.
Do I need a referral?
No. Book a Dry Eye Evaluation online — the appointment is preselected; just choose a time.
Rose Optometry, 38 Lake Road, Frankton, Hamilton. 07 847 3195
More dry eye questions
What are the most common causes of dry eyes?
By some distance, meibomian gland dysfunction — blocked oil glands in the eyelids, so tears evaporate too fast. That is evaporative dry eye and it accounts for most cases. Less commonly the eye does not produce enough tear volume at all. Contributing factors: age, screen use and the halved blink rate that comes with it, hormonal change, medications including antihistamines and some antidepressants, contact lens wear, autoimmune conditions, air conditioning and heat pumps, and previous eye surgery. Most people have a mix.
Does dry eye ever go away?
Dry eye from a temporary cause — a course of medication, a dry office, a spell of heavy screen work — settles when the cause does. Dry eye from gland dysfunction does not go away by itself, because the underlying obstruction progresses if nothing is done, and glands lost to atrophy do not regrow. It is manageable rather than curable: treated properly, most people become comfortable and stay that way, but it is maintained rather than finished. That is the honest answer, and it is why we measure the glands rather than just handing over drops.
References
- Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283. PMID 28736335.
- Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II Epidemiology Report. Ocul Surf. 2017;15(3):334-365. PMID 28736337.
- Wolffsohn JS, Arita R, Chalmers R, et al. TFOS DEWS II Diagnostic Methodology Report. Ocul Surf. 2017;15(3):539-574. PMID 28736342.
- Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012;31(5):472-478. PMID 22378109.
- Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: Management and Therapy. Am J Ophthalmol. 2025;279:289-386. PMID 40467022.
Rose Optometry's dry eye clinic is led by Jacqueline Rowe — BSc Chemistry, BOptom. Partner Optometrist, Rose Optometry; New Zealand Eye Research Centre. Last reviewed August 2026.
Frequently asked questions
At Rose, a standard adult eye examination is $129. A new patient appointment takes 45 minutes, and imaging and a full pre-examination workup are included in that price rather than added afterwards. Children and school students are $79, tertiary students $99, and an acute appointment for a sudden problem — a red eye, a foreign body, a sudden change in vision — is $69. Where further testing is needed it is quoted before it is done: visual fields $69, macular OCT $69, full OCT $194, anterior segment OCT $39, corneal topography $59, optical biometry $49, cycloplegic refraction $59. Specialist appointments are priced separately. A keratoconus consultation is $139 for 30 minutes or $169 for 45. An ortho-k consultation is $129. A full dry eye evaluation, which produces a written treatment plan, is $247 — it assumes a current full eye examination, either with us ($129) or a full examination record from another practice within the last six months. Fees elsewhere in New Zealand vary widely, and a lower advertised price usually means a shorter appointment with imaging charged as an extra or not offered at all. It is worth comparing what is included rather than the headline number. Ring us on 07 847 3195 if you want the fee for your situation confirmed before you book.
No practice can honestly claim that, and you should be wary of any that does — "best" depends entirely on what your eyes need. If your eyes are straightforward, several good practices in Hamilton will look after you well, and we would rather say that than pretend otherwise. What separates practices is what they can measure, and what they can treat when things are not straightforward. Rose was built around the complicated end. The Rose K lens for keratoconus was designed in this practice, and lenses of that family are, on the manufacturer's figures, among the most widely prescribed in the world for the irregular cornea. We hold swept-source OCT, corneal tomography, epithelial thickness mapping, two independent optical biometers for monitoring a child's short-sightedness, and objective tear film assessment. For dry eye we hold intense regulated pulsed light, LipiFlow, Blephasteam, Tixel and Rexon-Eye — to the best of our knowledge no other practice in New Zealand has all of these under one roof. A better question than "who is best" is "who is set up for what I have". Ask any practice you are considering how long the appointment is, what they can measure, and whether imaging is included or extra. Those answers will tell you more than a ranking would.
Not usually as a full examination, but there are genuinely free and subsidised pathways worth knowing about. Pre-school children are screened free through the B4 School Check, and there is vision screening in schools. Both are screenings rather than eye examinations — they are designed to catch obvious reduced vision and they miss a great deal, including focusing problems and early short-sightedness. A child who passes a screening can still need glasses. Children under 16 whose family holds a Community Services Card, or who hold a current High Use Health Card, may be eligible for the government spectacle subsidy towards an examination and glasses. MSD criteria apply, and we accept MSD and WINZ payment cards. Southern Cross members can use their optical benefits with us, and we offer Afterpay, Genoapay, QCard and GoCardless. We also run two free 15-minute chats. The myopia chat is for parents of a short-sighted child who want the options explained and want help deciding what is actually right for their family, with our experience behind that decision rather than a brochure. The ortho-k chat is for anyone considering overnight lenses who wants to understand what is involved before committing. Neither is an eye examination, but both are a proper conversation with someone who does this work. If cost is the reason you have been putting off having your eyes checked, ring us on 07 847 3195 and say so. We would rather find a way than have you not come.
While payment is generally required on the day of appointment, we do offer a number of payment options including Afterpay, Genoapay, QCard, and GoCardless.
No. We are closed on public holidays and long weekends as we believe our staff should have the chance to enjoy this time with friends and family.
If your eyes are straightforward, almost any good optometrist can look after you well, and we would rather say that than pretend otherwise. Come to us when something is not straightforward: a prescription that will not settle, a cornea that has changed shape, a child whose short-sightedness is moving faster than it should, an eye surface that has stopped being comfortable, or a diagnosis you have been given but do not understand. Those problems are decided by measurement, and measuring them properly needs instruments most practices do not have.
Yes, and you do not need to justify it. A second opinion is not a criticism of whoever saw you first — very often they were right, and what you actually needed was the finding explained and the numbers put in front of you. What we can add is measurement. We can image the layers of your cornea and retina, map the epithelium, quantify how far your cornea sits from normal, measure the length of your eye and check your tear film objectively. That turns “something is not right” into a number, and a number either explains the problem or rules it out. Bring any previous scans, prescriptions and letters. Comparison against your own past results is often the most valuable thing in the room.
Usually. Complex is what this practice was built around — keratoconus, corneal grafts, irregular corneas after surgery or injury, severe dry eye, high prescriptions, and eyes that have been told they are not fittable with contact lenses. The Rose K lens for keratoconus was designed in this practice, and lenses of that family are, on the manufacturer's figures, among the most widely prescribed in the world for the irregular cornea. If we cannot help, we will tell you at the first appointment and tell you who can, rather than taking you through a course of treatment that was never going to work.
Waiting is the one thing that cannot be undone. Short-sightedness is axial — the eye is physically growing too long — and that length does not come back. What treatment does is slow the rate of growth, so the earlier it starts the more length is saved. We measure axial length directly on two independent biometers and plot it against normal growth curves, which means we can see a child drifting off their expected curve before the prescription changes. There is a free 15-minute myopia chat if you want to understand the options before committing to anything. It is worth being precise about what we are all trying to achieve. Myopia control does not stop a child's eyes changing and no practice should tell a parent it will. What it does, reliably and across many published trials, is slow the rate at which the eye lengthens — and because the risk of retinal detachment, myopic maculopathy and glaucoma in later life rises with every extra millimetre, slowing that growth is how a child is kept out of the range where sight is genuinely at risk. After seventeen years of focusing on this, we are now seeing children on customised plans whose axial length is not progressing at all over a monitoring period, and in some cases measurements that come back slightly shorter than the ones before them. That is our own clinical observation in our own patients rather than a trial result, and it has to be read carefully, because the choroid thickens when treatment is working and part of an apparent reduction can be that thickening rather than the eye itself shortening. That is precisely why we measure both. We are not yet able to tell a parent that we can stop myopia in its tracks, and we will not say it until we can.
Two things: we measure it before treating it, and we hold every current treatment technology in one building. Most dry eye is treated on the basis of symptoms, which is why drops so often fail. A tear film can be failing because the oil layer is blocked, because the water layer is short, because the surface is inflamed, or because the lids are the problem, and those need different treatments. We assess the tear film objectively with TearCheck — tear film stability, the oil layer, lid and gland imaging, and an inflammation measure — and measure tear osmolarity, the saltiness of the tears, which is the closest thing to a laboratory number for dry eye. Then we treat the cause. Rose holds intense regulated pulsed light for inflammation and gland function, LipiFlow thermal pulsation to clear blocked meibomian glands from the inner lid surface, Blephasteam controlled-humidity warming, Tixel thermomechanical treatment for the lids, and Rexon-Eye quantum molecular resonance for the more severe and treatment-resistant cases. At the time of writing, and to the best of our knowledge, no other optometrist or ophthalmologist in New Zealand has all of these available under one roof. We say that as a statement of fact rather than a boast, and we would be glad for it to stop being true. Dry eye is one of the most common and most under-treated conditions we see, and there are far more people living with it than one practice can look after. Any practice wanting to build this kind of service has our encouragement and our help — please contact us for co-management, and send us the cases you are not yet set up for. Why holding all of them matters is simple. A practice with one dry eye machine will offer you that machine. Holding all of them means the assessment decides the treatment, rather than the equipment deciding it — and when the first approach does not work, the next one is in the next room rather than in another city.
Yes — from around six weeks of age. Babies and toddlers are tested with Cardiff acuity cards and retinoscopy, neither of which needs the child to read a letter, name a picture or say a word. Most of the findings that matter in a young child cause no symptoms and are invisible to a parent, which is exactly why they need looking for.
In NZ an optometrist can calculate the prescription for glasses, fit contact lenses, diagnose and treat eye conditions and infections with medication. They can also manage ocular injuries including removing foreign objects. If surgery or specialist treatment is required they can refer to an ophthalmologist (eye surgeon), hospital, or other health care specialist. NZ-trained optometrists must complete a 5-year degree at the University of Auckland before becoming registered.
A dispensing optician has formal training in optical dispensing. They are qualified to help a client choose frames, read a prescription, discuss lens options, take measurements, order and fit glasses.
An ophthalmologist is a medical doctor who has specialised in the treatment of serious eye disease and ocular surgery such as cataract removal. They do not typically prescribe glasses or contact lenses.
Not always, and the difference is usually time and instruments rather than the optometrist. A low advertised fee generally buys a shorter appointment aimed at producing a spectacle prescription. That is a legitimate service and for many people it is enough. What it often does not include is retinal imaging, OCT scanning of the optic nerve and macula, measurement of eye length, or objective assessment of the tear film — the tests that find glaucoma before you notice it, detect macular change early, monitor a child's short-sightedness properly, or explain why your eyes feel gritty. At Rose a new patient appointment is 45 minutes, and imaging and the full pre-examination workup sit inside the $129 rather than on top of it. We are not the cheapest and do not try to be. Whichever practice you choose, three questions are worth asking: how long is the appointment, is imaging included or charged separately, and what happens to the images afterwards. A scan that is taken and kept becomes the baseline every future scan is compared against, and that comparison is frequently worth more than any single result.
Start with an optometrist in almost every case. An optometrist is your first point of contact for eye health and vision — examining the eyes, prescribing glasses and contact lenses, diagnosing eye disease, and in New Zealand treating many conditions with prescription medicines. An ophthalmologist is a medical doctor and eye surgeon who treats serious disease and performs surgery such as cataract removal, and who does not usually prescribe glasses or contact lenses. Neither is better than the other; they do different jobs. Most eye problems are diagnosed and managed by an optometrist, and where surgery or specialist medical treatment is needed we refer you promptly and stay involved in your care. The exception is anything sudden and severe: sudden loss of vision, a curtain across your vision, severe eye pain with a red eye, or a shower of new floaters and flashes. Phone us on 07 847 3195 rather than booking online — a person, not a calendar, decides how quickly you are seen — or go to hospital.
We are at 38 Lake Road in Frankton, with parking on site, a few minutes from the city centre and straightforward to reach from the western side of Hamilton. Our patients come from right across the city — Frankton, Dinsdale, Nawton, Te Rapa, Glenview, Hamilton East, Hillcrest, Chartwell, Rototuna and the central city — and from across the wider Waikato, including Cambridge, Te Awamutu, Morrinsville, Matamata, Huntly, Ngaruawahia, Otorohanga and Raglan. Because much of what we do is specialist work, a good number travel considerably further. We regularly see patients from Auckland, Tauranga, Rotorua, Taupo, Taranaki and the lower North Island for keratoconus, scleral and custom contact lens fitting, and complex dry eye — and we see patients from overseas who combine treatment with a trip. If you are travelling a distance, tell us when you book and we will group your appointments so the journey is worth making.
Forty-five minutes for a new patient, and the appointment is built so the measuring is done before you sit down with the optometrist. A full pre-examination workup and imaging are included in the fee rather than charged on top: assessment of your vision and prescription, examination of the front and back of the eye, eye pressure, and retinal imaging that becomes your permanent baseline. You will leave knowing what we found, what it means, and what — if anything — needs doing. If the honest answer is that nothing needs doing, that is what you will hear. If something needs watching or treating, you get a clear plan and a review date. Where a specific problem needs a specific test — visual fields, OCT, corneal topography, eye length measurement — those are quoted to you before they are done, never added afterwards without your agreement. Existing patients returning for a routine examination are booked for 30 minutes. Please arrive ten minutes early, and bring your current glasses or contact lenses, any recent prescription or referral letter, and a note of the medications you take, because some affect the eyes.
Yes. We keep acute appointments for sudden problems — a red or painful eye, something in the eye, a sudden change in vision, new flashes or floaters — and we see you the same day wherever we can. An acute appointment is $69. Phone first, on 07 847 3195, rather than booking online. A two-minute call establishes whether you need us or the hospital, and a person, not a calendar, decides how quickly you are seen. Any Hamilton optometrist can be phoned for a same-day problem. If we cannot fit you in, we will tell you straight away so you can try the next nearest practice rather than wait. Some things should not wait for an appointment at all. For a chemical splash, rinse the eye with clean water straight away and keep rinsing, then go to the hospital emergency department. For sudden loss of vision, a curtain or shadow across your vision, a penetrating injury, or severe eye pain with a red eye, phone us immediately during opening hours; outside our hours, go to the Waikato Hospital emergency department or call Healthline on 0800 611 116 for advice. You do not need to be an existing patient, and you do not need a referral.
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