Dry eye in Montréal: exam and eye drops

Illustration of an eye seen from the side with its eyelids: the oily layer of the tear film is torn in two places and tears evaporate from the surface of the eye in rising wisps.
When the oily layer of the tears is lacking, tears evaporate too fast and the eye dries out.

Do your eyes burn, sting or feel gritty? PrimeVision, an optometry clinic and optical store at 9520 Boulevard de l'Acadie, Suite 222, in Montréal, assesses dry eye. The optometrist looks for the cause, checks your tears and eyelids, and tells you which drops to use. The drops are available at the clinic.

What is dry eye?

The surface of the eye is covered by a thin film of tears. Dry eye is when the eye does not make enough tears, makes tears without the right composition, or the tears dry out too quickly. The film has three layers: an oily layer on the outside, a watery layer in the middle and a mucus layer against the eye. The oil comes from the meibomian glands in the eyelids and keeps tears from drying up too fast.

An eye seen from the side with its eyelids. A thin blue layer of tears covers the cornea, with a fine orange layer of oil on the outside. In the eyelids, the meibomian glands, in orange, open at the lid margins.
The tear film, drawn much thicker than it really is, covers the surface of the eye. According to the American Academy of Ophthalmology, oil from the meibomian glands keeps tears from drying up too quickly.

The American Academy of Ophthalmology describes two main forms: evaporative dry eye, which most people have, when the oily layer is lacking and tears evaporate quickly, and aqueous-deficient dry eye, when the eye does not make enough tears. Many people have a mix of both.

Three magnified cross-sections of the tear film on the surface of the eye. Stable tear film: a blue layer of tears under a continuous layer of oil. Not enough tears: the layer of tears is very thin. Tears evaporate too quickly: the oil layer has gaps and tears evaporate in several places.
Two mechanisms, often combined: the eye doesn't make enough tears, or the tears evaporate too quickly because the eyelids secrete too little oil.

What are the symptoms of dry eye?

According to the Canadian Association of Optometrists and the American Academy of Ophthalmology, the most common signs are:

  • redness;
  • burning or stinging;
  • a gritty feeling, or the feeling that something is in your eye;
  • blurry vision, especially when reading;
  • contact lenses that have become uncomfortable;
  • watery eyes.

Watery eyes can be surprising. When dryness irritates the eye, it makes extra tears as a reflex to compensate.

Card: Signs to watch for. A red eye. Burning or stinging. A gritty feeling. Watery eyes.
The signs the Canadian Association of Optometrists lists: redness, burning or stinging, a gritty or foreign-body feeling, and sometimes watery eyes.

What causes dry eye or makes it worse?

Several factors play a part, often at the same time:

  • age and hormonal changes, for example after menopause;
  • dry air, wind, smoke and air pollution;
  • long periods at a screen or reading, because we blink less;
  • wearing contact lenses for a long time;
  • some medications, such as antihistamines, some antidepressants and oral contraceptives;
  • some diseases, such as rheumatoid arthritis, Sjögren's syndrome or thyroid disease;
  • laser refractive surgery such as LASIK.
Card: What makes dryness worse. Screens: we blink less. Dry air, wind, smoke. Some medications. Age and hormones.
The Canadian Association of Optometrists and the American Academy of Ophthalmology name age, hormones, dry air, wind, smoke, screens and some medications.

What does a dry eye exam check?

The optometrist starts with questions about your symptoms, your health, your medications and your environment at home and at work. According to the Canadian Association of Optometrists, the answers help decide which tests to do. The optometrist may then:

  • look at your eyelids, the surface of the eye and how you blink;
  • examine the eye with a slit lamp microscope and a dye, to see the amount, quality and spread of your tears;
  • time how long your tear film lasts after a blink;
  • measure how many tears you make with a small strip of paper placed on the edge of the eyelid (Schirmer's test).

These tests are described by the National Eye Institute. They are simple and quick, usually cause little or no discomfort, and the optometrist picks the ones that are useful in your case.

Card: What the exam can check. Your symptoms and medications. Eyelids and blinking. The tear film, with a dye. How many tears you make.
The dry eye exam, as described by the Canadian Association of Optometrists and the National Eye Institute: questions, eyelids, the tear film and tear volume.

Which dry eye drops do we carry?

For mild dry eye, the usual treatment is artificial tears, according to the National Eye Institute. At PrimeVision we carry three drops from I-MED Pharma. All three are preservative-free and come in a 10 mL bottle that can be used for up to 12 months after opening, according to the maker.

  • I-DROP PUR: 0.18% hyaluronic acid with glycerin. The maker recommends it for mild to moderate chronic dry eye and describes it as compatible with contact lenses (maker's product page).
  • I-DROP PUR GEL: 0.30% hyaluronic acid with glycerin, a more concentrated formula. The maker recommends it for moderate to severe chronic dry eye (maker's product page).
  • I-DROP MGD: 0.20% hyaluronic acid plus an ingredient that supports the oily layer of the tears. The maker recommends it for chronic evaporative dry eye, the kind often linked to meibomian gland dysfunction (maker's product page).

Which one fits depends on your type of dry eye. For evaporative dry eye, the American Academy of Ophthalmology suggests a drop with lipids or one made for evaporative dry eye. Your optometrist tells you which one to use after the exam.

Card: The drops we carry. I-DROP PUR: lens compatible. I-DROP PUR GEL: moderate to severe. I-DROP MGD: evaporative. All preservative-free.
The three I-MED Pharma drops carried at PrimeVision, from the maker's product pages.

How should you use eye drops?

  • Often? If you use drops more than four times a day over a long period, the American Academy of Ophthalmology advises a preservative-free drop.
  • With contact lenses: use only a preservative-free drop that says it is made for contact lens wear. For other drops, the American Academy of Ophthalmology advises taking the lenses out, waiting five minutes, putting in the drop, then waiting 10 to 15 minutes before putting the lenses back.
  • Skip red-eye relief drops: they often contain vasoconstrictors that can make symptoms and redness worse over time, according to the American Academy of Ophthalmology.
  • The technique: wash your hands, gently pull down the lower eyelid and let a single drop fall, as the maker's instructions describe.

If you wear contact lenses, read our article on contact lenses and dry eyes.

What helps dry eyes day to day?

  • Take breaks from the screen and remember to blink.
  • Use a humidifier in winter, when heating dries the air.
  • Wear wraparound sunglasses outside to block the wind.
  • Stay away from smoke and from fans or hair dryers blowing at your eyes.
  • Drink enough water and get enough sleep.

These tips come from the American Academy of Ophthalmology and the National Eye Institute.

Card: Every day. Blink often at the screen. A humidifier. Wraparound sunglasses. Enough sleep and water.
Habits suggested by the American Academy of Ophthalmology and the National Eye Institute: blink often at the screen, a humidifier, wraparound sunglasses outdoors, enough sleep and water.

When should you see an optometrist for dry eyes?

Book an appointment if:

  • you use artificial tears more than two or three times a day (the American Academy of Ophthalmology then recommends a comprehensive exam);
  • dryness or redness does not get better with treatment (Canadian Association of Optometrists);
  • your contact lenses have become uncomfortable;
  • your vision blurs at times, especially when reading or at a screen.

Call us right away at 514-827-7463 if your eye is very red, painful or sensitive to light, if your vision suddenly drops or gets blurry or if you notice discharge: the American Academy of Ophthalmology says these can be signs of an infection. For those cases, see also our urgent eye care page.

Dry eye is worth treating. According to the Canadian Association of Optometrists, severe and chronic dry eye can damage the cornea and affect vision.

Card: When to see us. Drops more than 2 or 3 times a day. Redness that does not settle. Contact lenses that feel bad. Pain or blurry vision: call.
Signs that call for an exam, according to the American Academy of Ophthalmology and the Canadian Association of Optometrists.

What if drops are not enough?

Other treatments exist for more severe dry eye, according to the American Academy of Ophthalmology and the National Eye Institute. At PrimeVision, our dry eye care is the exam and eye drops. If your optometrist thinks you need something more, they explain the options and, when needed, refer you to an ophthalmologist: the clinic prepares the referral, sends it directly and gives you a copy. The wait depends on the hospital or clinic that receives it.

Book a dry eye appointment in Montréal

PrimeVision is at 9520 Boulevard de l'Acadie, Suite 222, in Montréal, near Marché Central. We are open Monday to Friday from 10 a.m. to 6 p.m. and Saturday from 10 a.m. to 5 p.m. Book online or call 514-827-7463 and tell us you are coming in for dry eyes.

We see children from age 4. RAMQ covers eye exams for children under 18 and adults 65+. The details are on our page who pays for your eye exam.

Also see our eye exams in Montréal page, our contact lenses and the article dry eyes: causes and treatment.

Frequently asked questions

Where can I get dry eyes checked in Montréal?

At PrimeVision, 9520 Boulevard de l'Acadie, Suite 222, near Marché Central. An optometrist checks your eyelids, your tear film and how you blink, then tells you which drops suit you. Book online or call 514-827-7463.

Which dry eye drops do you carry?

Three preservative-free drops from I-MED Pharma: I-DROP PUR, I-DROP PUR GEL and I-DROP MGD. Your optometrist tells you which one fits your type of dry eye.

Can I use eye drops with contact lenses?

Only preservative-free drops labelled for contact lens wear, according to the American Academy of Ophthalmology. Its maker describes I-DROP PUR as compatible with contact lenses.

Is dry eye a long-term problem?

According to the Canadian Association of Optometrists, dry eye is usually a chronic condition that needs ongoing care, but symptoms can be relieved and the health of the eye can improve with the right treatment.

Is the exam covered by RAMQ?

RAMQ covers eye exams for children under 18 and adults 65+. We see children from age 4. For others, check with your private insurer whether the exam is reimbursed.

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