What is Dry Eyes? Symptoms, Causes, & Treatment

Dry eyes happen when your tears can't keep your eyes moist and comfortable. This common condition affects millions of people and occurs when you either don't produce enough tears or your tears evaporate too quickly.

Your tears aren't just water. They're a complex mixture of oils, water, and mucus that work together to keep your eyes healthy and your vision clear. When this delicate balance gets disrupted, you experience the uncomfortable symptoms we call dry eyes.

What are the symptoms of dry eyes?

The most common sign is a gritty, sandy feeling in your eyes, like something is stuck under your eyelid. You might also notice your eyes feel tired or heavy, especially after reading or using screens for extended periods.

Here are the symptoms you might experience, ranging from mild discomfort to more noticeable issues:

• Stinging or burning sensation in your eyes
• Scratchy or gritty feeling, like sand in your eyes
• Excessive tearing or watery eyes (your body's attempt to compensate)
• Blurred vision that comes and goes
• Eye fatigue, especially during reading or computer work
• Difficulty wearing contact lenses comfortably
• Sensitivity to light or wind
• Red or irritated-looking eyes
• Stringy mucus around your eyes

Interestingly, watery eyes can actually be a sign of dry eyes. When your eyes feel dry, they sometimes produce excess tears as a protective response, but these tears often lack the right balance of ingredients to properly lubricate your eyes.

What causes dry eyes?

Dry eyes develop when your tear production decreases or when your tears evaporate too quickly. Age is one of the biggest factors, as tear production naturally declines as we get older, particularly after age 50.

Several everyday factors can contribute to this condition:

• Prolonged screen time reducing your blink rate
• Air conditioning or heating systems that dry out the air
• Windy or dry weather conditions
• Wearing contact lenses for extended periods
• Certain medications like antihistamines, decongestants, and antidepressants
• Hormonal changes, especially during menopause
• Medical conditions like diabetes, thyroid disorders, or autoimmune diseases
• Previous eye surgery, including LASIK
• Eyelid problems that prevent proper blinking

Some less common but important causes include autoimmune conditions like Sjögren's syndrome, which specifically targets the glands that produce tears and saliva. Certain medications for blood pressure, anxiety, or allergies can also significantly reduce tear production.

Environmental factors play a bigger role than many people realize. Air travel, smoking, and even ceiling fans can accelerate tear evaporation and worsen symptoms.

What are the types of dry eyes?

There are two main types of dry eyes, and understanding which type you have helps determine the best treatment approach. Most people actually have a combination of both types.

Aqueous deficient dry eye happens when your tear glands don't produce enough of the watery layer of tears. This type is often related to aging, medications, or autoimmune conditions that affect the tear-producing glands.

Evaporative dry eye occurs when tears evaporate too quickly from your eye surface. This is usually caused by problems with the oil-producing glands in your eyelids, called meibomian glands, which normally help seal in your tears.

Mixed dry eye combines both problems. You might not produce enough tears and the tears you do make evaporate too quickly. This is actually the most common form of dry eyes.

When to see a doctor for dry eyes?

You should see an eye doctor if over-the-counter eye drops aren't providing relief after a few weeks of regular use. Persistent symptoms that interfere with your daily activities warrant professional evaluation.

Seek medical attention if you experience severe symptoms like intense pain, significant vision changes, or discharge from your eyes. These could indicate a more serious underlying condition that needs prompt treatment.

Consider scheduling an appointment if your dry eyes are affecting your quality of life, making it difficult to read, drive, or work comfortably. An eye care professional can determine the underlying cause and recommend more effective treatments.

What are the risk factors for dry eyes?

Age is the most significant risk factor, with dry eyes becoming increasingly common after age 50. Women are more likely to develop dry eyes than men, particularly due to hormonal changes during pregnancy, menopause, or while using birth control pills.

Several lifestyle and health factors can increase your risk:

• Spending long hours looking at screens without regular breaks
• Living in dry, windy, or air-conditioned environments
• Wearing contact lenses regularly
• Having autoimmune diseases like rheumatoid arthritis or lupus
• Taking medications that reduce tear production
• Having had refractive eye surgery
• Having vitamin A deficiency
• Experiencing incomplete eyelid closure during sleep

Certain occupations also increase risk, including jobs that require intense visual concentration or exposure to dry environments. Pilots, drivers, and office workers who spend hours at computers are particularly susceptible.

Having a family history of dry eyes or autoimmune conditions can also increase your likelihood of developing this condition.

What are the possible complications of dry eyes?

Most cases of dry eyes are manageable and don't lead to serious complications. However, if left untreated, chronic dry eyes can potentially cause problems that affect your vision and eye health.

The most common complications include increased risk of eye infections, since tears help protect against bacteria and other harmful microorganisms. Without adequate tear protection, your eyes become more vulnerable to bacterial and viral infections.

More serious complications can develop in severe cases:

• Corneal damage, including small scratches or ulcers on the eye surface
• Scarring of the cornea, which can affect vision
• Increased difficulty with daily activities like reading or driving
• Chronic eye inflammation that becomes harder to treat
• Decreased quality of life due to persistent discomfort

In rare cases, severe dry eyes can lead to corneal perforation, where the cornea develops a hole. This is a serious condition that requires immediate medical attention and typically occurs only in cases of severe autoimmune disease or major injury.

The good news is that these complications are preventable with proper treatment and regular eye care. Early intervention can help maintain your eye health and prevent these more serious issues from developing.

How can dry eyes be prevented?

You can take several simple steps to reduce your risk of developing dry eyes or prevent existing symptoms from worsening. Making small changes to your daily routine often makes a significant difference.

Environmental modifications can help protect your eyes throughout the day. Use a humidifier in your home or office to add moisture to dry air, especially during winter months when heating systems can make indoor air particularly dry.

Here are practical prevention strategies you can start today:

• Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds
• Blink more frequently and completely when using screens
• Position computer screens slightly below eye level to reduce eye opening
• Wear wraparound sunglasses outdoors to protect from wind and sun
• Stay hydrated by drinking plenty of water throughout the day
• Include omega-3 fatty acids in your diet through fish or supplements
• Avoid directing air from fans, heaters, or air conditioners toward your face
• Take regular breaks from contact lens wear

Good eyelid hygiene also plays an important role in prevention. Gently cleaning your eyelids with warm water and mild soap can help keep the oil glands functioning properly.

If you're at higher risk due to age, medications, or medical conditions, talk with your eye doctor about additional preventive measures that might be appropriate for your situation.

How are dry eyes diagnosed?

Your eye doctor will start by asking about your symptoms and medical history, including any medications you take and your work environment. This conversation helps identify potential causes and triggers for your dry eyes.

The examination typically includes several simple, painless tests to evaluate your tear production and quality. Your doctor will look at your eyes under magnification to check for signs of dryness or irritation on the eye surface.

Common diagnostic tests include:

• Schirmer test: small paper strips placed under your lower eyelids measure tear production
• Tear break-up time test: special drops help evaluate how quickly tears evaporate
• Corneal staining: harmless dye highlights any damaged areas on your eye surface
• Meibomian gland evaluation: checking the oil glands in your eyelids
• Tear osmolarity test: measuring the salt concentration in your tears

Your doctor might also examine your eyelids and blinking pattern to identify any structural issues that could contribute to dry eyes. In some cases, blood tests may be recommended to check for autoimmune conditions.

The entire evaluation usually takes about 30 minutes and helps your doctor determine the type and severity of your dry eyes, which guides the most appropriate treatment plan.

What is the treatment for dry eyes?

Treatment for dry eyes depends on the underlying cause and severity of your symptoms. Most people start with over-the-counter artificial tears, which can provide immediate relief for mild to moderate dry eyes.

Your doctor will likely recommend starting with preservative-free artificial tears, especially if you need to use them more than four times per day. These come in different formulations, and you might need to try several types to find what works best for you.

Treatment options range from simple to more advanced approaches:

• Preservative-free artificial tears for frequent use
• Prescription eye drops like cyclosporine (Restasis) or lifitegrast (Xiidra)
• Warm compresses and eyelid massage to improve oil gland function
• Punctal plugs: tiny devices that block tear drainage to keep tears on your eyes longer
• Prescription eye ointments or gels for nighttime use
• Oral medications like omega-3 supplements or prescription drugs
• Specialized procedures like intense pulsed light therapy
• Scleral contact lenses for severe cases

For moderate to severe dry eyes, your doctor might recommend prescription medications that help reduce inflammation and increase tear production. These typically take several weeks to show full effects.

In severe cases, minor procedures might be helpful. Punctal plugs are small, painless devices inserted into your tear ducts to help tears stay on your eye surface longer. This procedure can be done in your doctor's office.

How to take home treatment for dry eyes?

Home treatment focuses on keeping your eyes moist and comfortable while addressing lifestyle factors that might be contributing to your symptoms. Consistency with your treatment routine is key to getting the best results.

Start by using preservative-free artificial tears regularly throughout the day, not just when your eyes feel dry. Think of this as preventive care for your eyes, similar to using moisturizer for your skin.

Here are effective home care strategies:

• Apply warm compresses to closed eyelids for 10-15 minutes twice daily
• Gently massage your eyelids to help oil glands function better
• Use a humidifier in your bedroom and workspace
• Clean your eyelids daily with diluted baby shampoo or specialized eyelid wipes
• Take omega-3 supplements or eat more fish rich in these fatty acids
• Wear wraparound sunglasses when outdoors
• Position your computer screen below eye level
• Take regular breaks from screen time and contact lens wear

The warm compress routine is particularly helpful for people with oil gland problems. Use a clean, damp washcloth warmed in the microwave for about 20 seconds, then apply it to your closed eyelids.

Stay patient with home treatments, as it can take several weeks to notice significant improvement. Keep track of what helps and what makes your symptoms worse, so you can discuss this with your doctor.

How should you prepare for your doctor appointment?

Come prepared with a detailed description of your symptoms, including when they started and what makes them better or worse. Your doctor will want to know about your daily activities, work environment, and any recent changes in your routine.

Bring a complete list of all medications you're taking, including over-the-counter drugs, supplements, and eye drops. Some medications can contribute to dry eyes, so this information helps your doctor identify potential causes.

Consider keeping a symptom diary for a week before your appointment, noting when your eyes feel worst and what you were doing at those times. This can help identify patterns and triggers.

Write down questions you want to ask, such as what type of dry eyes you have, which treatments might work best for you, and how long it might take to see improvement. Don't hesitate to ask about lifestyle changes that could help.

If you wear contact lenses, bring them to your appointment along with your lens case and cleaning solutions. Your doctor might want to examine how the lenses fit and whether they're contributing to your symptoms.

What's the key takeaway about dry eyes?

Dry eyes are a common, manageable condition that affects millions of people. While they can be uncomfortable and frustrating, effective treatments are available to help you find relief and protect your long-term eye health.

The most important thing to remember is that you don't have to suffer through dry eye symptoms. Early treatment not only provides comfort but also prevents potential complications that could affect your vision.

Success often comes from combining the right treatments with lifestyle modifications. What works best varies from person to person, so be patient as you and your doctor find the most effective approach for your specific situation.

With proper care and treatment, most people with dry eyes can maintain comfortable vision and continue their normal daily activities without significant disruption.