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What do YOUR eyes say about your health?

10 months ago
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The eyes are the first part of the face to show signs of ageing, and after two stressful years  and many hours spent on Zoom, many peple are noticing the impact on their ocular health.  

But if you're struggling with dark circles, puffy or dry eyes, or crow's feet, it might be useful to know what’s causing your specific eye issue and what you can do to treat it.

Eye expert, Dr Elizabeth Hawkes, who is a Consultant Ophthalmic and Oculoplastic surgeon based in West London, is keen to emphasise the importance of maintaining eye health.

‘It’s wrong to assume that visiting an eye specialist is something that you only do when you’ve got something wrong with your eyes, because maintaining regular check-ups is vital,’ she says. ‘Your eyes reveal a great deal about your overall health and through a thorough examination problems can be identified early in order to get treatment quickly.’

Here Femail reveals the different issues that can affect your eyes and Dr Hawkes’ advice about what causes them and how to treat them. 


People with dry eyes often don’t make enough tears to lubricate their eyes or the ones that are made are of poor quality, as a result the front of the eye dries up too quickly resulting in irritation (stock image)

Dry eye is a common condition affecting one in four people in the UK. It’s more prevalent in women. 

It's estimated that 15 to 33 per cent of people aged 65 years or over have dry eye disease, although this is likely to be much higher because many people with mild symptoms don’t go to the doctor. 

It’s more common during menopause and pregnancy and celebrity sufferers include Jennier Aniston who has previously spoken of her addiction to eye drops as a result.

‘People with dry eyes often don’t make enough tears to lubricate their eyes or the ones that are made are of poor quality, as a result the front of the eye dries up too quickly resulting in irritation,' explained Dr Elizabeth Hawkes. 'This can cause discomfort and also cause the eye to produce watery or excessive tears.'

‘Symptoms of dry eyes include eyes that are itchy, sore, feel gritty, red, blurry, sensitive to light or are more watery than normal.’

What causes it 

‘There are a number of reasons why people might get dry eyes, these are some examples..

Blepharitis is the most common cause of dry eye disease. This is an inflammatory condition where the oil secreting eyelid glands, meibomian glands, become blocked.

The elements - exposure to cold, dry air and wind, as well as central heating which can be extremely drying to the eyes because heating the air evaporates the water in it, creating a dry atmosphere.

Lifestyle factors can exacerbate dry eyes such as long periods working at a computer screen, a lack of sleep, a poor diet lacking in omega-3 and other nutrients that are vital for healthy eyes, as well as smoking and drinking alcohol.

Contact lens wearers are sometimes more prone to dry eyes too, as are people over 50, especially women. This is largely due to the hormone changes that occur for women during pregnancy, when using birth control medication or during the menopause.’

Some medical conditions are linked with dry eye disease.

How to treat 

‘You can treat dry eyes yourself by keeping them clean and taking regular breaks from computer screens,’ advised Dr Elizabeth. 

‘Also making sure you’re not straining your eyes when using a computer. Do this by making sure the screen is at eye level. Humidifiers at home can help to stop the air getting dry.

'If you wear contact lenses it can help to take them out and wear glasses to give your eyes a rest occasionally. 

'Getting plenty of sleep is essential too. A pharmacist may be able to help by advising on possible treatments such as eye drops, gels, or allergy medicines. However if the problem persists it’s advisable to see an eye specialist for a thorough eye examination.’


Puffy eyes are a common eye complaint. It is caused be a variety of factors such as lack of sleep, allergies, nasal congestion and dehydration (stock image)

Puffy eyes are an extremely common eye complaint, especially at this time of year with summer being allergy season.

'Puffy eyes typically present as mild swelling of the upper and lower eyelid,’ explained Dr Elizabeth. ‘They may or may not be accompanied by itchy eyes, watery eyes, and itching of the eyelid skin.

What's the cause?   

'Puffy eyes tend to be caused by a variety of factors such as lack of sleep, allergies, nasal congestion, and dehydration as well as eating too much salt. 

'Festoons, or malar mounds (the medical term for skin folds or swelling in the lower eyelids and upper cheek area) can also be caused by poor lymphatic drainage within the eye area.

Eye infections such as viral conjunctivitis and blepharitis can also cause puffiness and unfortunately cold tools won’t fix this. 

Eyelid infections may be caused by certain bacteria that overgrow on the skin and it’s therefore important to treat the underlying cause to provide relief to the eyelid puffiness.’

How to treat 

If you believe an eye infection is to blame for the swelling, make an appointment to see an eye specialist as soon as possible to receive proper treatment.

Cold tools like ice globes can be very effective and work in a number of ways.  

There are a number of different types of eyes and eye conditions, and each have their own distinct features. Consultant Ophthalmic and Oculoplastic surgeon Dr Elizabeth Hawkes (pictured) explains what they all are and how to treat them 

'Using ice-cold tools gives a cold shock to the skin which then sees our body send more blood to the targeted area,’ explained Dr Elizabeth. ‘More blood essentially means more oxygen and a richer nutrient delivery which in turn helps to flush away toxins that have built up and reduce water retention.

‘Used correctly, they can minimise inflammation and puffiness - especially in the morning - help lymphatic drainage and sinus pressure as well as offering benefits for the skin too by reducing redness and kick starting the circulation to provide a radiant glow to the skin.’

‘I'd generally suggest that people use them for no longer than 15 minutes each morning. Apply them to the skin and very gently roll them underneath the eye from the side of the nose out towards the cheekbone. 

'Follow by cleansing and applying your daily anti-oxidant eye serum and a broad-spectrum SPF.’

Be warned though. While ice globes and cooling tools do have benefits, it’s important not to keep the skin in direct contact with something very cold for too long.

Other treatments include getting more sleep, elevating your pillow slightly and drinking more water. 


Dark circles under the eyes could be caused be a variety of factors such as genetics, allergies or dehydration (stock image)

Dark circles under the eyes are traditionally thought of as a sign of tiredness. However, Dr Elizabeth Hawkes reveals that this is not always the case.

‘Eyelid skin is unique to the rest of the body. Importantly there is no subcutaneous fat underneath the skin. The eyelid layers are skin, orbicularis muscle, septum, fat (eyebags). 

How to avoid getting dark cirlces and how to cover them up 

Stay hydratedDon’t smokeWear UV protection such as sunglasses in the day as well as SPF, and use retinol at nightConsult a makeup artist and invest in good quality undereye makeup to help camouflage the appearance of dark circlesReduce salt intake which causes puffinessBe careful when removing eye makeup, remember the eyelid skin is very delicate and to remove makeup thoroughly yet carefullyDo not rub the eyes excessivelyGet enough sleepUse a night cream to keep the skin hydrated

'Whereas in the rest of the face there is a subcutaneous layer of fat directly underneath the skin. For this reason eyelid skin is prone to appear darker than the rest of the face.

What's the cause? 

Genetics – pigmented skin due to ethnicity because of higher levels of melanin. Family history of dark circles.Vascular - The eyelids are very vascular, due to poor circulation the vessels can become dilated. This will make them more apparent under the eyelid skin and cause appearance of dark circles.Allergies - such as hayfever and eczema can cause hypertrophy and erythema of the eyelid skin which contributes to the appearance.Dehydration and Smoking.Ageing – volume loss and descent of the structures around the eyelid will cause the appearance of the tear trough and also worsen the appearance of dark circles. Over the years, the bone of the orbit atrophies and this causes the eyes to sit further back in the socket and appear sunken. This enhances the appearance of dark circles.'

How to treat:

‘Whilst topical creams can help to address some dark circles, it depends on the cause,’ explains Dr Elizabeth Hawkes. ‘Topical creams are good for dehydration & allergy relief but they will not restore volume. 

'They will not cause the blood vessels under the eyes to constrict, nor will they reverse a family history of dark circles. 

'There is a prescription only treatment that will help reduce the production of melanin in the skin and can be a useful tool in improving the appearance of dark circles, however it has to be used under the guidance of a specialist only.

'It is possible to treat dark circles in-clinic however in order to do this effectively it’s important to visit an oculoplastic specialist who will take a full medical history and perform a thorough examination to ascertain the underlying cause and ultimately determine the correct management,’ explains Dr Elizabeth Hawkes.

‘The treatments vary depending on the cause, and include; topical prescription creams, a chemical peel, dermal filler to restore volume or surgical lower eyelid blepharoplasty may be required as an option for dark circles. 

'A thorough ophthalmic examination is necessary to exclude an eye disease or allergy that could be affecting the skin such as allergic conjunctivitis secondary to pollen. 

'Anti-wrinkle injections to the eye muscle, the orbicularis muscle can play a role too to reduce the appearance of dark circles.'


If you’re experiencing red, burning or sticky eyes you could be suffering from Blepharitis. It is a chronic inflammatory condition of the eyelids (stock image)

If you’re experiencing red, burning or sticky eyes you could be suffering from Blepharitis.

The symptoms of Blepharitis include red eye, burning, sticky eyes, excessive watering, ocular discomfort, light sensitivity and foreign body sensation. 

It can also cause excessive eyelid closure or twitching, ‘blepharospasm’, which sometimes requires regular botulinum toxin injections around the eye and brow region.’

What's the cause?

‘This is a chronic inflammatory condition of the eyelids,secondary to an overgrowth of bacteria on the eyelashes and eyelids,’ explained Dr Elizabeth. 

‘The meibomian glands are situated in the upper and lower eyelids in close proximity to the eyelashes. They secrete lipid which is the outer layer of our tear film and protects the ocular surface.

Many people know about the common menopause symptoms, such as hot sweats, low libido and brain fog, however not many people realise that it can affect your eyes too.

‘The hormone changes that occur during the menopause can result in Blepharitis,’ said Dr Elizabeth.

How to treat 

‘There is unfortunately no cure as such for blepharitis,’ Dr Elizabeth said. ‘And so the mainstay of treatment at all stages is lid hygiene to control the bacterial build-up. 

'Other treatments such as antibiotics, steroids and ocular lubrication may also be necessary for different sequelae of the condition.'

Crow’s Feet

Crow’s Feet is the common name given to wrinkles at the sides of the eyes that stretch out towards the temples, in a similar shape to a crow’s claw (stock image)

Crow’s Feet is the common name given to wrinkles at the sides of the eyes that stretch out towards the temples, in a similar shape to a crow’s claw.

‘The eyes are the first place on the face to show signs of ageing,’ explains Dr Elizabeth Hawkes. 

‘The skin in this area is thinner and more delicate than the skin on the rest of the face and therefore more susceptible to lines and wrinkles. 

What's the cause? 

'Actions such as laughing, squinting, and frowning causes your face to contract and over a prolonged period of time this, alongside the depletion of collagen and elastin as part of the natural ageing process, combined with lifestyle factors such as sun damage and pollution can result in Crow’s Feet forming.’

How to treat

‘People often apply sunscreen to their face but forget to protect the delicate eyelid skin,' said Dr Elizabeth. 

'It’s vital that you protect the eyelids and skin around the eyes with a high factor SPF and also sunglasses in order to protect the skin in this area from premature ageing.

‘Facial wrinkles start as dynamic wrinkles, which are caused by the sub-dermal movement of muscles that cause the skin above to bunch up and wrinkle. Dynamic wrinkles are temporary, lasting only as long as the muscular contraction is sustained. 

'However, dynamic wrinkles that occur repeatedly lead to permanent lasting 'static wrinkles. Muscular relaxation through anti-wrinkle treatment such as Botulinum Toxin inhibits muscle movement acting as a solution to fine lines and wrinkles. 

'This can be particularly effective to treat forehead lines, frown lines, crow’s feet or smile lines, as well as a long list of other medical issues.’

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