Dry eye happens when your eyes don’t make enough tears or when tears dry up too quickly. It can affect one or both eyes. Simple lifestyle adjustments might help, but in serious cases, medication or even surgery could be needed.
Dry eye can range from mild to severe. You might notice symptoms like eye pain, blurry vision, or extra sensitivity to light.
This article covers the signs, causes, and risk factors for dry eye. We’ll also talk about how it’s diagnosed, treated, and prevented, plus possible complications.
Symptoms of Dry Eye
Dry eye syndrome can cause a bunch of different symptoms, including:
- Red or sore eyes
- Lots of tearing (ironic, right?)
- A stinging or burning feeling
- Feeling like there’s grit or sand in your eyes
- Stringy mucus in or around the eyes
- Sensitivity to wind or smoke
- Light sensitivity
- Blurry vision, especially later in the day
- Double vision
- Tired eyes after reading, even for a short time
- Trouble keeping your eyes open
- Discomfort with contact lenses
- Eyelids sticking together when you wake up
Some people even get intense eye pain, which can make daily life tough and cause anxiety.
Causes of Dry Eye
Healthy eyes stay moist thanks to a tear film—a fluid layer that keeps vision clear and prevents dryness. Tears come from your tear glands.
The main causes of dry eye are:
- Not making enough tears
- An imbalance in your tear mix, making them evaporate too fast
Tear Mixture Imbalance
Tear film has three layers: oil, water, and mucus. If any of these are off, dry eye symptoms can pop up.
Top Layer (Oil):
This comes from glands in your eyelids and keeps tears from drying too fast. If there’s not enough oil, tears vanish quickly. Clogged glands (thanks to conditions like blepharitis or rosacea) can mess with oil production.
Middle Layer (Water & Salt):
This layer washes away irritants. If it’s too thin, the oil and mucus layers can mix, causing that gross stringy discharge.
Inner Layer (Mucus):
Helps tears spread evenly. Without enough, dry patches can form on the cornea (the clear front part of your eye).
Reduced Tear Production
After age 50, tear production slows down. Dry, irritated eyes become more common—especially in women after menopause.
Risk Factors for Dry Eye
Certain things make dry eye more likely:
Eyelid Problems:
Blinking spreads tears across your eyes. If your eyelids aren’t working right (like with ectropion—lid turns outward—or entropion—lid turns inward), tears don’t spread well. Even contact lenses can mess with blinking.
Other Health Issues:
Some conditions cut down on tear production, like:
- Vitamin A deficiency
- Autoimmune diseases (Sjögren’s, lupus, rheumatoid arthritis, etc.)
- Diabetes
- Radiation therapy
Environmental Stuff:
- Dry, windy, or hot weather
- Indoor heating/AC
- High altitude
- Smoke
- Staring at screens (slows blinking)
- Long drives or reading sessions
Medications & Procedures:
Some drugs and treatments can dry out your eyes, including:
- Diuretics
- Antihistamines
- Decongestants
- Sleeping pills
- Birth control
- Antidepressants
- Acne meds (like isotretinoin)
- Painkillers (e.g., morphine)
- LASIK (temporarily raises dry eye risk)
Diagnosing Dry Eye
A doctor will ask about symptoms, check your eyes, and might do a dilated eye exam (using drops to widen your pupils). This helps them see:
- How many tears you’re making
- How fast they evaporate
- Your eyelid structure
They’ll also review your health history and meds.
Treating Dry Eye
The goal? Keep eyes moist, comfy, and healthy. Treatment depends on the cause and might include:
1. Adding Tears:
- Over-the-counter artificial tears (avoid ones with preservatives).
- Ointments at night (they’re thicker but can blur vision).
2. Conserving Tears:
- Tiny plugs in tear ducts to keep tears in.
- Surgery for a permanent fix.
3. Boosting Tear Production:
- Prescription drops (like Restasis or Xiidra).
4. Fixing Underlying Issues:
- Antibiotics for infections like blepharitis.
- Adjusting meds for autoimmune diseases.
Home Remedies:
- Clean eyelids with a special cleanser.
- Warm compresses + gentle massage.
Diet Tweaks:
Low vitamin A or omega-3s can worsen dry eye. Try:
- Vitamin A sources: Liver, eggs, leafy greens, red veggies.
- *Omega-3 sources:* Fish, flaxseeds, soybeans.
Special Treatments:
- Thermal pulsation (like Lipiflow): Warms and presses glands to unclog them.
- Intense Pulsed Light (IPL): Helps with gland issues.
Surgery:
If eyelids are too loose (letting tears drain too fast), surgery can tighten them.
Preventing Dry Eye
Tips from the American Optometric Association:
- Blink often when reading or on screens.
- Wear wrap-around sunglasses outside.
- Avoid dry, windy places.
- Use a humidifier indoors.
- Stay hydrated.
- Ask your doc about supplements.
Complications
Most mild cases don’t cause trouble, but severe dry eye can lead to:
- Conjunctivitis (pink eye)—usually treatable, but bad cases risk vision loss.
- Corneal ulcers/scarring—painful and can damage vision.
See a doctor ASAP if you have:
- Severe eye pain
- Vision changes