Why Every Dry Eye Patient Is Stressed: An Optometrist's Holistic Approach
The Stress-Dry Eye Connection: What’s Actually Happening in Your Body
When patients present with dry eye, the instinct is often to treat what’s visible — the redness, the grittiness, the discomfort. But according to optometrist and yoga teacher Sal, the real story starts somewhere else entirely: the nervous system.
“If you’re stressed, first of all, your sympathetic nervous system is switched on and can’t turn off,” she explains — in other words, the body is stuck in fight-or-flight. That constant state of alert sends cortisol levels soaring, and it’s this hormonal surge that quietly undermines eye health. As cortisol rises, the glands responsible for tear production begin to underperform, leaving the eyes chronically under-lubricated.
The knock-on effect doesn’t stop there. Reduced tear production triggers inflammation, releasing what Sal describes as “inflammatory cytokines” that travel through the blood vessels to the front of the eye — the very mechanism behind many chronic dry eye cases.
It’s a compelling reframe for practitioners used to treating dry eye symptom-first. Rather than starting with drops, heat masks, or IPL, Sal’s approach begins with a question: what’s happening in this patient’s life that’s keeping their body in a stress response?
As she puts it plainly: “Every patient that has dry eye has an element of stress in their life for some reason or another.” For opticians and optometrists rethinking how they approach patient care, that single insight might be the most useful takeaway of all.
Add YouBreathwork as Treatment: Bringing Yoga Into the Consultation Roomr Heading Text Here
If stress is the root cause, then addressing it has to be part of the solution — and that’s exactly where Sal’s yoga background comes in. Rather than treating eye care and mental wellbeing as separate disciplines, she’s built her entire practice model around the idea that they’re one and the same.
Her thinking draws on a concept she describes as “neuro aesthetics” — the idea that being surrounded by beauty and calm has a measurable effect on mental wellbeing, and by extension, on physical health. It’s a principle she first came across at an optometry conference, where she met an ophthalmologist teaching breathwork for dry eye. “I already do that,” she recalls thinking. “I need to do this too.”
For Sal, breathwork isn’t an add-on — it’s diagnostic and therapeutic in equal measure. “I need to know you as a person,” she says. “I need to figure out what’s going on in your life. Let’s have a conversation.” That conversation, she believes, is often the missing piece in traditional eye care: treating the patient holistically rather than isolating the prescription from the person behind it.
It’s an approach that flips the typical consultation on its head — and one that’s about to be put into practice in a very literal sense, in a treatment space designed for exactly this kind of care
Building From Scratch: Inside Sal’s New Bristol Practice
Most people advised Sal to take the safer route. “People have been telling me, don’t start from scratch. Acquire a practice,” she admits. But for Sal, a ready-made client list wasn’t the point — the vision was.
“I have a dream, I have a vision. The location is right, I have everything I need,” she says. That vision is now becoming reality on White Ladies Road in Clifton, Bristol, where her new practice is set to open within three months — complete with a dedicated space for yoga and breathwork sessions alongside traditional optometry.
The timeline isn’t accidental. With most commercial leases offering a rent-free period at the start, Sal is using every week of it to get the practice launch-ready — sourcing equipment, finalising frame partnerships, and building the holistic treatment space that sits at the heart of her offering.
It’s a bold move in an industry where, as Sal puts it herself, “any new idea is frowned upon.” But rather than shy away from that resistance, she’s leaning directly into it — betting that patients are ready for an optician’s experience that treats stress and eye health as one and the same.
The result, she hopes, isn’t just a new practice — it’s a new blueprint for what holistic eye care in the UK could look like.
About the Author
Garry Kousoulou FBDO is a dispensing optician with over 36 years of experience and the founder of Good Looking Optics in Enfield, London, which he built around the vision of making a trip to the opticians “a wonderful experience, primarily improving people’s sight, enhancing their looks and making customers feel good about themselves.” He is a former director of the Association of British Dispensing Opticians (ABDO) and a former board member of ABDO, as well as a UK Business Book Awards judge. In 2025, Garry led the Borough of Enfield’s entry in the London New Year’s Day Parade, curating a display of multilingual eye charts representing the 88 languages spoken across Enfield, an initiative that earned Enfield a commendation and was supported by Birmingham Optical, Forever and a Day Eyewear, and GoodLooking Optics. He is the host of The Optician Show, a weekly podcast exploring the people and ideas shaping optical business and patient care. GARRY KOUSOULOU (director) :: OpenCorporates +4
The Science: Why Stress and Inflammation Matter for Dry Eye
The link Sal describes between stress and dry eye isn’t just anecdotal — it’s an active area of clinical research. Studies measuring cortisol directly in tear samples have found elevated cortisol levels in patients with ocular surface disease compared to healthy controls, supporting the idea that the hormone plays a role in eye surface health. Separately, research into the tear film shows that chronic stress on the ocular surface activates pathways in surface cells that trigger a pro-inflammatory response involving cytokines, chemokines, and other inflammatory mediators — mirroring exactly the mechanism Sal describes. Broader reviews of dry eye disease note it is a multifactorial condition where loss of tear film balance can lead to ocular surface damage, with lifestyle factors such as reduced sleep and increased screen exposure — both stress-linked behaviours — named among the known contributors. Effect of Topical Antioxidants in Dry Eye Disease and Diabetic Retinopathy +3
Why Loving Social Media Covers Stories Like This
At Loving Social Media, we work exclusively with opticians and healthcare brands — which means we don’t just market to this industry, we understand it from the inside. That perspective comes from genuine operational experience running an optical practice, not just running campaigns for one.
It’s also exactly why we created The Optician Show: a platform built to surface the people in optics doing something genuinely different, and to give their story the reach it deserves. Conversations like the one with Sal — where clinical expertise meets a completely fresh way of thinking about patient care — are precisely what we set out to find when we started the podcast.
You can listen to the full conversation on Spotify here: The Optician Show — Episode with Sal
If you’re an optician or healthcare brand looking to tell your own story with the same clarity and reach, this is exactly the kind of work we do.
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