A Look At Dry Eye

Overview

Dry eye is a common condition where your eyes don't make enough tears, or the tears evaporate too quickly. Tears keep the surface of the eye moist and healthy. When they don't work properly, your eyes can feel dry, gritty, or sore.

Yes, dry eye is very common. Millions of people around the world experience it at some point. It is one of the most frequent reasons people visit an eye care professional.

Dry eye can affect anyone, but it is more common in older adults, people who spend long hours staring at screens, contact lens wearers, and people with certain health conditions like rheumatoid arthritis or Sjögren's syndrome.

Symptoms

Common symptoms

• Dry, gritty, or scratchy feeling in the eyes
• Burning or stinging
• Redness
• Sensitivity to light
• Blurred vision that improves when you blink
• Watery eyes (the eye over-produces tears to try to compensate)

Causes

Main causes

• Not enough tear production
• Tears evaporating too quickly due to environmental factors like wind, dry air, or smoke
• An imbalance in the tear film – for example, not enough oil or mucus in the tears
• Problems with blinking, such as when you stare at a screen for a long time

Risk factors

• Age (more common over 50)
• Being female – hormonal changes can affect tear production
• Using contact lenses
• Taking certain medicines, such as antihistamines, antidepressants, or blood pressure medications
• Living in a dry, windy, or smoky climate
• Health conditions like diabetes, rheumatoid arthritis, or thyroid disease

When to see a doctor

Diagnosis

A doctor or eye care specialist will ask about your symptoms, medical history, and any medicines you take. They will examine your eyes carefully, including the front surface of your eyes and how your tears spread.

Tests that may be done

• A simple eye test with a special dye and a blue light to see how your tears cover your eye surface
• A test that measures how quickly your tears evaporate (called tear break-up time)
• A test that measures the amount of tears you produce (Schirmer test – using a small strip of paper under your eyelid)
• A thorough examination of your eyelids and glands with a slit lamp (a special microscope for the eye)

What to expect at your appointment

The examination is usually quick and painless. You may be asked to place your chin on a rest and look into a machine. Some drops may be used to dye your tears – these are harmless and will help the doctor see the pattern of your tears. After the tests, your doctor will talk through the results and suggest a treatment plan.

Treatment

Treatment for dry eye usually starts with simple steps you can try at home, such as using eye drops to replace missing tears and making changes to your surroundings. If these are not enough, your doctor may offer other treatments or refer you to an eye specialist.

Self-care at home

• Use preservative-free artificial tear drops (eye drops that replace tears) several times a day – you can buy them from a pharmacy or supermarket
• Place a warm, damp cloth over your closed eyelids for 5-10 minutes to help unblock oil glands
• Gently massage your eyelids with a clean finger to help release oil
• Take regular screen breaks – follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds
• Blink regularly and fully when using a computer or reading
• Protect your eyes with wraparound sunglasses outdoors in wind or sun

Medical treatments

Your doctor may prescribe eye drops that reduce inflammation or help your eyes make more tears. They may also recommend procedures like punctal plugs (tiny plugs placed in the tear ducts to keep tears in your eye longer), or intense pulsed light therapy. You should always follow your doctor's advice and never take any medicine intended for someone else.

When is surgery considered?

Surgery is rarely needed for dry eye. In some cases, if punctal plugs are not enough, a doctor may suggest surgery to permanently close the tear ducts to keep tears from draining away. Your eye specialist will discuss this only if other treatments have not worked.

Living with this condition

Living with dry eye involves building small habits into your daily routine. Keep your eyes clean and rest them regularly. Use a humidifier at home or at work, especially in winter when heating makes the air dry. Avoid exposing your eyes to smoke, wind, and air conditioning. If you wear contact lenses, give your eyes a break by wearing glasses from time to time.

Lifestyle tips

• Drink enough water throughout the day to stay hydrated
• Use a humidifier in dry rooms
• Avoid smoking and being around smoke
• Adjust your computer screen to be at or below eye level to reduce your blink effort
• Wear sunglasses on windy or sunny days
• Use a heating pad or warm mask for your eyes as recommended by your doctor

Diet and exercise

A balanced diet that includes omega-3 fatty acids (found in oily fish like salmon and mackerel) may help some people with dry eye. Regular exercise can improve overall circulation, but if you swim, wear goggles to protect your eyes from chlorine. Always check with your doctor if you are unsure about any dietary changes.

Mental health and emotional wellbeing

Living with a chronic condition like dry eye can be frustrating and can affect your mood. It may interrupt your daily tasks, make reading or working on a computer uncomfortable, and cause tiredness. If you feel sad, anxious, or overwhelmed, talk to your doctor. They can help you find ways to cope and support you. You can also reach out to a trusted friend or family member.

Prevention

Dry eye cannot always be prevented, especially if it is linked to age or a health condition. But you can reduce your risk by looking after your eyes: blink often, use your screen mindfully, protect your eyes from wind and sun, and stay well hydrated. If you have any underlying condition that raises your risk, keeping that condition under control may also help.

Complications

If left untreated

• Persistent dry eye can make your eyes feel constantly uncomfortable and affect your quality of life
• It can increase your risk of eye infections because tears help protect the eye
• In severe cases, the surface of your eye (the cornea) can become damaged, which may lead to scarring or vision problems
• It can also make it harder to wear contact lenses comfortably

Long-term outlook

The outlook for dry eye is generally good. Many people find that their symptoms improve with simple self-care and good habits. If you do need medical treatment, there are effective options to help your eyes feel comfortable. With the right approach, most people can manage their dry eye and continue with their normal activities. If your symptoms continue, seeing a specialist early gives you the best chance of finding a treatment that works for you.

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