Dry eye disease

Overview

Dry eye disease happens when your eyes don't make enough tears, or your tears evaporate too quickly. Tears are important for keeping the surface of your eyes healthy and comfortable. Without enough good-quality tears, your eyes can feel gritty, dry, or irritated.

Yes, dry eye disease is very common. Millions of people worldwide experience it, and it becomes more frequent as you get older.

Dry eye can affect people of all ages, but it is more common in women, people over 50, contact lens wearers, and those with certain health conditions like rheumatoid arthritis or diabetes.

Symptoms

Common symptoms

• A dry, gritty, or sandy feeling in your eyes
• Stinging or burning sensation
• Redness of the eyes
• Blurry vision that may improve with blinking
• Sensitivity to light
• A feeling of something in your eye

Symptoms in children

• Children may not complain of dry eyes, but you might notice them rubbing their eyes often, blinking a lot, or having red eyes.

Symptoms in older adults

• Older adults may have more persistent dryness, fluctuating vision, and may not produce as many tears.

Causes

Main causes

• Not enough tears being made (low tear production)
• Tears that evaporate too quickly (often due to problems with oil glands in the eyelids)
• An imbalance in tear composition

Risk factors

• Getting older, especially over 50
• Being female (hormonal changes can affect tear production)
• Wearing contact lenses for long periods
• Spending a lot of time looking at screens (computer, phone, TV)
• Living in dry, windy, or air-conditioned environments
• Having certain medical conditions like rheumatoid arthritis, Sjögren's syndrome, or diabetes
• Taking certain medications, such as antihistamines, decongestants, or antidepressants

When to see a doctor

See a doctor urgently if:

• If you have sudden severe eye pain
• If you have a sudden loss of vision
• If you recently injured your eye

Book a routine appointment if:

• If your eyes feel dry, gritty, or irritated most of the time
• If blurry vision does not go away with blinking
• If self-care steps (like eye drops) do not help after a week or two

Diagnosis

A doctor or optometrist can diagnose dry eye by asking about your symptoms, examining your eyes, and performing simple tests to check your tear production and tear quality.

Tests that may be done

• Schirmer test: a small strip of paper is placed under your lower eyelid to measure how much tear your eye produces.
• Tear breakup time: a special dye is placed in your eye, and the doctor watches how long it takes for the tear film to break apart.
• Slit-lamp exam: using a microscope with a bright light to examine your eyelids, cornea, and tear film.

What to expect at your appointment

These tests are quick and painless. They help your doctor understand what is causing your dry eye, so they can suggest the best treatment for you.

Treatment

Treatment for dry eye focuses on relieving symptoms, improving tear quality, and managing any underlying causes. Most people find relief with a combination of self-care and medical treatments.

Self-care at home

• Use artificial tears or lubricating eye drops (available over the counter; ask your pharmacist for advice).
• Apply warm compresses to your eyelids for a few minutes each day to help oil glands work better.
• Clean your eyelids gently with a warm, damp cloth to remove any debris or crust.
• Blink often, especially when using a screen.
• Use a humidifier in dry rooms to add moisture to the air.
• Wear wrap-around sunglasses outdoors to protect from wind and dust.
• Avoid smoke, air conditioning, and fans blowing directly in your face.

Medical treatments

If self-care is not enough, a healthcare provider may recommend prescription eye drops or ointments that reduce inflammation or help your eyes make more tears. They might also suggest treatments like punctal plugs (tiny plugs placed in tear ducts to keep tears on the eye longer) or in-office procedures like intense pulsed light therapy. Always discuss treatment options with your doctor.

When is surgery considered?

Surgery is rarely needed, but for very severe cases that do not respond to other treatments, a procedure called punctal occlusion (permanently closing the tear ducts) can be considered.

Living with this condition

Living with dry eye often means making small changes to your daily routine. Use eye drops regularly, remind yourself to blink, and take breaks from screens. Keeping a simple eye care routine can help you feel more comfortable.

Lifestyle tips

• Take frequent breaks from screens (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds).
• Avoid direct air from fans, air conditioners, or heaters blowing into your eyes.
• Wear sunglasses or wraparound glasses outdoors.
• Get enough sleep and reduce eye strain.

Diet and exercise

Eating a healthy diet rich in omega-3 fatty acids (found in oily fish, flaxseed, and walnuts) may help improve tear quality. Staying well-hydrated is also important. Regular exercise is good for overall health, but try to avoid environments that worsen your dry eye, such as very dry or windy gyms.

Mental health and emotional wellbeing

Chronic dry eye can be frustrating and may affect your mood or ability to enjoy daily activities. It is normal to feel bothered, but remember that many people find relief with treatment. Talk to your doctor if your eye symptoms are causing you stress or affecting your life.

Prevention

It may not be possible to prevent dry eye entirely, but you can reduce your risk by protecting your eyes from dry environments, taking breaks from screens, blinking often, and staying hydrated. Regular eye exams can help catch any problems early.

Complications

If left untreated

• Inflammation or infection of the cornea (the clear surface of your eye)
• Scratches or sores on the cornea
• Blurry vision that becomes more frequent
• Discomfort that makes it hard to focus or enjoy daily life

Long-term outlook

For most people, dry eye is a manageable condition. With the right treatment and self-care, symptoms can be relieved, and serious complications are rare. It is important to work with your healthcare provider to find a plan that works for you.

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