Thin Lenses for Strong Prescriptions: What You Are Actually Paying For
5 October 2026
12:20
Dry eye is on almost nobody’s list of menopause symptoms. Hot flushes, sleep and joints all get talked about. The gritty, tired, sometimes streaming eyes that arrive in the same years usually get put down to screens, age or needing new glasses.
They are often connected, and it is worth knowing, because dry eye at this stage of life is very common, very treatable, and regularly goes on for years without anyone looking at it properly.
Three things happen at once in your forties. Your close focus starts to go, so reading becomes harder. You are probably on a screen for much of the day, which cuts how often you blink, as I have covered in screen time and your eyes. And the tear film starts to change.
All three make your vision feel less reliable, and the obvious conclusion is that you need stronger glasses. Sometimes you do. But if the blur comes and goes, and blinking sharpens things up for a moment, that is the tear film and no pair of glasses will fix it.
Because the usual problem is the oil layer, treatment starts at the eyelids, not with a bottle of drops.
The full range is set out in my guide to dry eye in Glasgow.
Dry eye comes on gradually and affects both eyes. If one eye becomes red and painful, if light hurts, or if your vision drops suddenly, that is something else and it should be seen the same day. That is what our emergency eye care is for.
I ask about your symptoms, your general health and what you have already tried. I examine the eyelid edges and the oil glands under magnification, measure how quickly your tear film breaks up after a blink, and check the surface of the eye for dry patches. Then I write down a plan and see you again to check that it is working.
More about how I treat it is on the dry eye and blepharitis page. If you have been using drops from the chemist for months, bring them with you.
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The usual symptoms are gritty or sandy eyes, burning or stinging, watering in wind or cold, vision that blurs and clears on blinking, tired eyes by evening, and contact lenses that become uncomfortable sooner than they used to. Symptoms are typically worse later in the day and in heated or air-conditioned rooms.
A squint is where the eyes point in different directions. A lazy eye is reduced vision in one eye. A squint is one of the main causes of a lazy eye, but many children have a lazy eye with no squint, and both eyes look perfectly straight.
The evidence is mixed. Some studies report an improvement in dry eye with hormone replacement therapy, some report no change, and some report that symptoms get worse. HRT is not a treatment for dry eye. Whether to take it is a decision to make with your GP for other reasons.
When the surface of the eye dries out it becomes irritated, and the eye responds by producing a flood of watery tears. Those tears lack the oily layer that keeps them on the eye, so they run down the cheek and do not relieve the dryness. Watering in wind or cold is one of the most common signs of dry eye.
Treatment usually starts with the eyelids: a daily warm compress using a heat mask for about ten minutes, lid cleaning, and preservative-free lubricating drops used regularly. Where that is not enough, in-practice eyelid treatment or prescription medication may be recommended after an assessment.
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