The tear meniscus height THM is the second diagram shown which measures the middle aqueous layer. Sometimes with severe dry eye it can be mixed  dry eye when both the middle (aqueous) layer and the top (Oily) layer are reduced. Common problems with the middle (aqueous) layer are dehydration and nutritional deficiencies such as zinc deficiency.

For dehydration – on waking the urine is yellow as patients have not drunk all night. During the day it is fine to drink tea, coffee, wine etc., which can be diuretics but enough water (or water with squash) should be drunk to keep the urine relatively clear. On a hot day or if you have been exercising you may be dehydrated so if your urine is yellow please drink a glass of water.

Two years after becoming vegetarian or vegan you may have depleted on Zinc as the biggest source of Zinc is red meat. This also applies to patients who only eat fish or chicken . There are over a 108 micro-nutrients in your tear film including copper, magnesium, manganese, B12, etc. We recommend a nutritional support from France called Lagad Lacrima.

The oily layer is secreted by the meibomian glands in the eyelid margin. As we age the melting temperature of the oil goes higher and higher so the oil sets blocking the glands. The Myah machine can measure how many glands are blocked using infrared. Heat treatments help to open the glands and get the oil to cover the eye surface and prevent evaporation of the aqueous layer below.

We use three heat treatments