Dry eye clinic · Middleton, for north Manchester
Dry eye clinic in Middleton
Eyes that sting by teatime, stream in the wind, and never stay fixed for long on drops are usually telling you about the oil glands in your eyelids, not a lack of tears. On Long Street we measure what your eyes are doing, show you on the screen, and treat it here, IPL included.
Does this sound like your eyes?
If three of these are you, it is almost certainly your glands. And that is treatable.
- “My eyes are fine in the morning and gritty by four o’clock.”
- “They water for no reason, in the wind, in the car, in the supermarket.”
- “The screen goes blurry, then clears when I blink.”
- “Drops help for ten minutes and then it is back.”
- “I quietly gave up my contact lenses because they stopped being comfortable.”
- “They sting at night and I wake with them stuck.”
- “I have used a warm compress and a lid wipe for a year and nothing has really changed.”
- “I was told it is just age, or the menopause, or something I have to live with.”
None of this is in your head, and none of it is something you have to live with. It has a cause, the cause can be photographed, and once you have seen it, the rest makes sense.
“This is the first time anybody has mentioned the problems with dry eyes, which I have had for a number of years. I was given a course of action.”
What is actually happening
Most dry eye is not a shortage of tears. It is blocked oil glands.
Once you understand this, everything you have been through with drops and compresses makes sense, and so does what fixes it.
Your tears have three layers
Water in the middle, a sticky layer underneath that holds it to the eye, and a thin layer of oil on top. The oil is the seal. It stops the water evaporating between blinks.
The oil comes from glands in your eyelids
About thirty in the top lid and twenty-five in the bottom, running from the lash line back into the lid, called meibomian glands. Every blink squeezes a little oil onto the eye. They are the part almost nobody has ever been shown.
When they block, the seal fails
Screens halve your blink rate, so the oil sits in the gland and thickens. Hormones, age and some medicines thicken it too. Once a gland is blocked the tear film loses its seal and the water evaporates within seconds of each blink. The eye dries, stings, and then waters in protest. This is evaporative dry eye, and it is about eighty-five per cent of everything we see.
This is why drops never fixed it
A drop replaces the water for a few minutes. It cannot unblock a gland. A warm compress softens the oil but does not clear the gland. That is why a year of drops and wipes leaves you where you started, and why the treatment that works is the one that clears the glands and keeps them clear.
The other type: not enough water
About one in seven people has the opposite problem. The middle, watery layer is short, because the tear gland itself is under-producing. It goes with some autoimmune conditions, some medicines, the menopause and air-conditioned rooms. It is treated differently: keeping the tears you make on the eye for longer, with plugs or a gel, and the right drop. Many people have a little of both, which is exactly why we measure before we treat.
Blepharitis, the usual companion
Inflammation and debris along the lash line, which so often sits alongside blocked glands and makes the tear film worse still. It is treated here as part of the same programme. Blepharitis, explained →
Types of dry eye
The three types of dry eye, and what we do for each
Most people are told “you’ve got dry eyes” and handed drops. But there are three different causes, and each needs something different. Most people have a mix.
Blocked oil glands: meibomian gland dysfunction (MGD)
In one large study, 86% of people with dry eye had signs of this. Along the edge of your eyelids are tiny glands, about 30 in the top lid and 25 in the bottom, that put a thin layer of oil on your tears. When they block, your tears dry up in seconds, however much water your eyes make. It feels gritty, burning and tired, often worse on screens or by evening. Drops help for an hour, because they don’t unblock the glands.
What we do: photograph your glands so you can see them, warm and clear them in clinic, clean the lid edge, and use IPL or light therapy where it helps. Then we give you a simple routine for home.
Not enough tears
Your eyes don’t make enough of the watery part of tears. This is more common with age, some medicines, the menopause, and conditions like Sjögren’s.
What we do: measure your tear level, choose the right drops for you, and use tiny plugs to keep your own tears in where they help. We’ll write to your GP if something needs checking.
Inflamed eyelids: blepharitis, often with tiny mites called Demodex
Crusty, itchy, red lid edges, often worse in the morning.
What we do: deep-clean the lid edge in clinic, treat the mites, and show you how to keep the lids clean at home.
Not sure which one you have? That’s what the assessment is for. We look at your glands, tears and lids, and tell you which type, or which mix.
Three ways to start
Three ways to start. Pick the one that fits where you are.
Know the treatment you want? Book it. Want to know what is wrong first? Book the assessment. Have questions? Your optometrist rings you back. Nothing here commits you to anything.
Treatment available within the week. Have your assessment and start treatment the same day, where we can.
For anyone who has read this page, or had the assessment, and knows which course they want. We check your eyes at the first visit before anything starts.
- EyeClean, £480: three sessions, every gland cleared
- EyeRelief, £900: four IPL sessions and an EyeClean
- EyeRelief Max, £1,495: for inflamed lids and blepharitis
Pay in full, or half today and half at your next visit.
For anyone whose eyes have been a problem for a while and who wants a proper answer.
- A dry eye questionnaire
- Tear break-up time, with and without dye
- Tear volume
- Surface staining, including lissamine green
- An eyelash check
- Photos and videos as the optometrist needs them
- A written plan
£50 of this comes off any treatment you go on to have.
Not sure it is dry eye, or whether it is worth the trip? Leave your number. Your optometrist rings you, listens, and tells you honestly what to do next.
- You speak to the optometrist, not a call centre
- No fee, no commitment
- Book on the call if you want to
Inflamed lids or blepharitis? Book the Essential Dry Eye Assessment, £225. Started with the £145 assessment? It upgrades on the day.
Gland Scan: £15 with any eye examination (included in our Gold eye examination). Booked at Abra & Co — Middleton, 36 Long Street. Not sure it is dry eye? Take the 60-second check.
Arrange a call-back with your optometrist
Leave your number. Your optometrist rings you, usually the same day. No fee, no commitment.
Inside the assessment
The dry eye assessment, explained step by step
Three quarters of an hour with the optometrist, and nothing is done to you without being shown to you. These are the nine things we look at, in the order we look at them, and what each one tells us about your eyes.
Understanding you
The measurements come after the conversation
- 01
A score for how your eyes feel
Six short questions about the past month: bright light, blurred vision, driving at night, watching television, windy days, dry rooms. They add up to a score, and that score is how we prove to you, visit by visit, that things are improving.
- 02
What your days do to your eyes
Hours on screens, because a long day at a screen halves your blinking. Everything you have tried already. And an honest conversation about what you will actually do at home, because the routine has to fit around your life.
- 03
A first look, before anything is touched
Your lids, lashes and the surface of the eye under the microscope, with no drops in, so we see it as it really is. Your health and your medicines too, because dry eye rarely comes from nowhere.
Which means the plan is built around you, not around a leaflet.
Your tears
Enough of them, lasting long enough, and what the surface shows
- 04
The amount
The thin strip of tears along your lower lid is measured to a fraction of a millimetre. Too little means you are short of water, the rarer type, which needs a different treatment.
- 05
The staying power
We count the seconds your tear film lasts between blinks. When it collapses almost at once, the oil that should be holding it has gone, and the problem is in your lids.
- 06
The damage so far
A drop of dye lights up every tiny point of damage on the front of the eye and the white, and we count and map them. The inside edge of your upper lid is checked too, because it sweeps the eye with every blink and can be rubbing it raw.
Which means we know your type of dry eye for certain, and the treatment that fits it.
The cause, and your plan
Glands, inflammation, blinking, then the way forward
- 07
Your glands, photographed and pressed
In the Essential assessment the photograph lets you see for yourself which glands are full length, which have shrunk, and which are missing. Gentle pressure on each shows which still give oil, and whether it runs clear or thick, because oil like paste stays stuck.
- 08
Inflammation, mites, rosacea
In the Essential assessment a swab detects the inflammation that keeps re-blocking glands. Along the lashes we look for the waxy collars of mites, for crusting, and for the fine vessels of rosacea, since each is treated differently.
- 09
Your blink, and your plan
Ten blinks, watched while you chat. Three or more that do not fully close mean the bottom of the eye dries all day, so blink training joins the plan. Then it all comes together: each result shown against healthy, your type of dry eye, and a written plan of options that goes home with you.
Which means you walk out knowing what is wrong, how far it has gone, and exactly what will put it right.
Three quarters of an hour, and your eyes finally make sense. You take away your results against healthy, your own gland photographs, and a written plan, and £50 of the £225 comes off whatever treatment you choose.
“This is the first time anybody has mentioned the problems with dry eyes, which I have had for a number of years. I was advised how it occurs, what causes the problem and given a course of action.”
The £145 assessment covers everything above except the gland photographs and the inflammation swab test; the £225 full assessment includes both. £50 of either comes off any treatment.
Let us show you your eyes
Your own glands on the screen, and a plan you understand.
Most people have never been shown their own eyes. The dry eye assessment changes that. The optometrist measures how quickly your tears break up and how much you make, checks the surface of the eye with dye and looks at your lashes; the Essential assessment adds gland photographs and the inflammation test. Then you see it all on the screen, each result against healthy, and we talk you through it plainly.
That is what the assessment is for: knowing exactly where you are today, so the right treatment can be chosen, and measuring you again at every visit, so improvement is something you can see rather than something you take on trust. £50 of the assessment comes off any treatment you go on to have.
Not sure it is dry eye at all? Gland Scan: £15 with any eye examination (included in our Gold eye examination).
Does this sound familiar?
Take the same six-question check our optometrists use — it takes about a minute.
The first appointment
What happens, step by step
Nothing here commits you to anything. Each step ends with a conversation, and you decide whether to take the next one.
The first visit
Nothing here commits you to anything
- 01
The assessment, £145
Thirty minutes with the optometrist: your tears timed and measured, the surface checked with dye, your lashes examined, and photos or video where they help. Each result is shown against healthy, and you take a written plan home. £50 of it comes off any treatment.
- 02
The Essential assessment, £225, if your lids are inflamed
It adds gland photographs and the inflammation test, because inflamed lids need a different plan. £50 of it comes off any treatment, and treatment is available within the week.
- 03
Your options, discussed, not sold
We go through what would help, what it costs, and what happens if you do nothing for now. You take the plan home. Nothing has to be decided in the room.
What you take away
A plan, not a guess
- 04
What is wrong
Each result against healthy, your score, and which type of dry eye you have, with gland photographs if you had the Essential assessment.
- 05
What we recommend
The treatment that fits what we found, and what to do at home starting tonight.
- 06
What happens next
When we would see you again, and what better should look like as a number. Treatment, if you choose it, is chosen from the assessment, not from a menu.
What you take away
You leave the assessment with a one-page report, on paper and by email. It’s simple on purpose. It tells you three things:
- What’s wrong — each result against healthy, your score, and which type of dry eye you have, with gland photographs if you had the Essential assessment
- What we recommend — the treatment that fits what we found, and what to do at home starting tonight
- What happens next — when we’d see you again, and what “better” should look like as a number
Prices are on a separate sheet, so the report is about your eyes, not the bill. It’s written so your GP, the hospital or another optician can read it too.
Treatment
How we treat dry eye
We understand your symptoms. We understand what causes them. We take the time to understand you. Then we run the tests that matter, and the assessment gives you a plan with options that fit. These are the three courses, so you know what each one involves before anyone recommends it.
Treatment available within the week. Have your assessment and start treatment the same day, where we can.
For blocked oil glands
- 3 EyeClean sessions: warm mask, every gland cleared, lid edges cleaned
- Home kit
- End of treatment follow-up
£480 as a course.
Add red light therapy to all 3 EyeClean sessions: +£95. Add red and blue light therapy: +£180. For anyone who can’t have IPL.
Most recommended
For blocked glands and inflamed lids
- 4 IPL (intense pulsed light) sessions: each one IPL, then red light, then the glands cleared
- 1 EyeClean session
- Home kit
- End of treatment follow-up
Sessions 2 weeks apart, done within about 3 months.
£900 as a course.
For inflamed lids and blepharitis
- 5 IPL sessions with red light, and blue light when your optometrist decides
- 4 EyeClean sessions, one a month
- Home kit
- Follow-up at 6 months, with your 5th IPL
Over about 6 months.
£1,495 as a course.
Single sessions: EyeClean £195 · IPL £295. Red and blue light session: £95. Warm mask included with every EyeClean and light session.
IPL is at our Middleton and Cheadle practices. The other practices refer to them.
Additional treatments
Tiny plugs in the tear ducts that keep your own tears on the eye longer. For the water-shortage type. Both eyes, fitted in the chair.
A soft gel placed in the tear duct, lasting about half a year. The gentler alternative to plugs.
Scleral lenses that hold a layer of fluid over the eye all day, for the most stubborn dry eye. Every lens is custom, so the price follows the assessment.
Staying well
Once your glands are clear, the aim is to keep them clear. At the end of treatment follow-up we repeat your tests and agree what keeps them that way: the home routine, and a single session when you need one.
Paying for treatment. Every price is shown before you decide. Pay in full, or half today and half at your next visit. £50 of your assessment comes off whatever you choose. Every price on one page →
Before
AfterWhy we would rather look now
What happens if you wait
A blocked gland can be cleared
Oil that has thickened inside a gland can be softened and expressed. The gland goes back to work. That is what EyeClean is for, and it is why most people who come early need three visits and a home routine, not more.
A blocked gland left alone shortens
Months and years of blockage and the gland begins to shrink from the back. Gland photographs show this clearly: glands that used to run the full depth of the lid now stop half way.
A lost gland does not come back
Shortened glands can be lost altogether. We have never been able to bring one back, and nobody else has either. What is left can be looked after, and symptoms can still be helped, but the aim is to get to you before this.
This is not a reason to panic. It is the reason we look properly, and the reason we say what we see, plainly, on the day.
Not sure it is dry eye?
Most people do not arrive saying “dry eye”. They arrive saying one of these.
- My eyes are itchy and gritty→
- My eyes water all the time→
- My eyes are tired and blurry after the screen→
- It started with the menopause→
- I wake with sore, sticky eyes and I use CPAP→
- My contact lenses became uncomfortable→
- My eyelids are red, crusty or sore→
- My eye is red. Should I worry?→
Each one is explained on its own page, with what it usually is and what to do. Or skip the reading and book a Dry Eye Assessment.
See the assessment and the treatment
Ninety seconds inside the clinic: what the assessment looks like, what the gland treatment looks like, and what nothing-sharp-nothing-that-stings actually means.
The equipment, and where it is
Everything you read about on the Manchester page is done with the same kit and the same protocol. Here is what’s here, and what we arrange for you.
Gland imaging here in Middleton
Occify meibography at every visit: we photograph the glands, map the tear film and keep the images for your next visit, here on 36 Long Street.
Eye-light — IPL and red light
The handpiece delivers the IPL flashes across the cheek and lower lid; the mask delivers the red light to the gland tissue. Fifteen minutes, no gel, nothing touches the eye.
HD Firefly digital slit lamp
Ophthalmology-grade microscope with a built-in HD camera and infrared meibography — the sharpest gland picture in the group. Your glands on a 24-inch screen, and the recording kept for your next visit.
Device photographs from the manufacturers; ours look the same, minus the studio lighting.
Three patients, three different answers
Because the treatment is chosen from what the assessment finds, three people with “dry eyes” can leave with different plans. The quotes are from our patients, as published on this site.
“I’d been using drops eight to ten times a day for years. After the EyeClean Programme, I barely need them anymore. I only wish I had found this sooner.”
“I could actually see the blocked oil coming out during the treatment. It was oddly satisfying, and the relief was immediate.”
“I was told by two other opticians that it was just dry eye and there was nothing to be done. The imaging showed me exactly what was wrong. Seeing my blocked glands on the screen made it all make sense.”
Read more: why nothing else worked, and how the two conditions connect
Where our Middleton dry eye patients come from
We’re at 36 Long Street, Middleton, with the Long Street car park two minutes on foot.
Middleton
On the doorstep, and the town most of our dry eye patients call home.
Heywood
About eight minutes. Close enough to fit an EyeClean session into a lunch break.
Blackley and north Manchester
About ten minutes. For much of north Manchester we’re the nearest clinic that treats dry eye with IPL rather than referring it on.
Chadderton
About ten minutes, and an easy run for anyone on a screen all day who has given up on drops.
Rochdale
About fifteen minutes. A lot of Rochdale patients come to us after years of being told it’s “just age”.
Oldham
About fifteen minutes. Tell us you’re travelling and we’ll try to put your assessment and first treatment in one visit.
Prestwich
About fifteen minutes.
Bury
About twenty minutes, and worth the drive if light treatment is likely to be part of your plan.
Who this clinic is for
Some dry eyes only need a better drop. These are the people who usually need more, and we would rather you recognised yourself here than booked on a guess.
- Drops help for minutes, not hours. That pattern points to blocked glands rather than too few tears.
- Your lids are red along the edge, crusty in the morning, or you have been told it’s blepharitis. Light treatment was made for exactly this.
- Screens fill your day and your eyes are at their worst by late afternoon. Staring at a screen roughly halves how often you blink, and the oil sits in the gland and sets.
- Contact lenses stopped being comfortable and you went back to glasses without quite knowing why.
- The menopause changed your eyes along with everything else. Hormones act on the oil glands directly.
- Rosacea on the cheeks or nose. It often reaches the eyelids too, and IPL is one of the few things that settles it there.
- You’ve had cataract or laser surgery and your eyes never felt right afterwards.
If none of that sounds like you and your eyes are only dry when the heating goes on, a good drop and a warm compress may be enough, and we’ll say so at the assessment.
What the first appointment is like
You sit down and tell us what your eyes do and when. The optometrist measures your tears, checks the surface of the eye with a drop of dye, looks closely at your lashes and lid edges, and shows you the pictures on the screen. Nothing is decided for you in the room.
The Dry Eye Assessment takes thirty minutes: a symptom score to compare against later, how quickly your tears break up and how much you make, the surface stained and checked, your lashes examined, each result shown against healthy, and a written plan to take home. The Essential assessment, forty-five minutes, adds gland photographs and the inflammation test.
What it costs, plainly
The assessment is £145, or £225 with gland photographs and the inflammation test, and £50 of either comes off any treatment. EyeClean, three sessions that clear the glands, is £480. EyeRelief, four IPL sessions with an EyeClean, is £900, and it is done here. EyeRelief Max, for inflamed lids and blepharitis, is £1,495. Pay in full, or half today and half at your next visit. None of it is on the NHS, and we’d rather tell you here than at the desk.
What we do on Long Street
Everything: the assessment, EyeClean, IPL and light therapy, plugs and Lacrifill. Middleton and Cheadle are our two IPL practices, and patients from our other practices are referred here.
Blepharitis, the lid-edge inflammation that so often comes with dry eye, is treated here as part of the same programme. Our blepharitis guide explains it if that’s your main problem.
Reviews
What people in Middleton say
4.9★★★★★
G 164 Google reviews of the Middleton practice
“Brilliant service very friendly staff and a no rush service Really informative and helpful when reviewing and selecting a new pair of glasses would highly recommend”Tom Linaker · Google review · July 2026
“Came in and was assisted by Aaron. Overall, great experience. He was helpful, patient and provided a large assortment of options. The “style guide” was useful in helping come to a decision since I can be indecisive with glasses. Highly recommended.”Rene Jacinto · Google review · April 2026
“Many thanks to Abra & Co. I greatly appreciate the time that they spent helping me select the perfect glasses. The staff are friendly, informative and knowledgeable. I’ll be returning for years to come.”Ciaran · Google review · April 2026
Book
Book at Abra & Co — Middleton
Every Book button on this page comes here. Choose the practice, and the number and the booking link are for that practice.
Treatment available within the week. Have your assessment and start treatment the same day, where we can. No referral needed. Gland Scan: £15 with any eye examination (included in our Gold eye examination).
Want to understand it first?
Plain guides written by our optometrists: what is going on, what you can do yourself, and when you need us.
Frequently asked questions
My eyes feel gritty and sore by the evening. Is that dry eye?
Most of the time, yes. Grit and soreness that build through the day are the classic sign of oil glands in the lids that have clogged. The Dry Eye Assessment shows whether yours have. Gritty, burning eyes →
How can my eyes be dry when they keep watering?
A dry surface sets off a reflex flood of thin tears. They spill over instead of protecting the eye, so you get watering and dryness together. It is one of the most reliable clues that the glands are blocked. Why dry eyes water →
Do you do IPL in Middleton?
Yes. IPL and light therapy are done here on Long Street, and at our Cheadle practice. It is part of EyeRelief (£900) and EyeRelief Max (£1,495), always alongside clearing the glands, and a single IPL session is £295. If your assessment says it will help, it can start within the week.
Which assessment should I book?
Most people start with the Dry Eye Assessment, £145: thirty minutes, your tears and the surface of the eye measured, your lashes checked, and a written plan. If your lids are inflamed or the optometrist recommends it, the Essential Dry Eye Assessment, £225, adds gland photographs and the inflammation test. £50 of either comes off any treatment.
How soon can I start treatment?
Treatment is available within the week. Have your assessment and start treatment the same day, where we can.
Do I need my GP to refer me?
No. Book online or ring Long Street directly.
Is any of this on the NHS?
No. An NHS sight test covers your vision and the health of the eye; it does not include dry eye treatment. Every price is shown before you decide.
How do I pay?
Pay in full, or half today and half at your next visit. Nothing on credit, and £50 of your assessment comes off whichever treatment you choose.
Show all 9 questions
I’m already under a hospital eye clinic. Can I still come?
Yes. Tell us who you are under and we will write to them. Plenty of people come to us while they wait, and what we do does not get in the way of hospital treatment.