Dry eye living in adults

Overview

Dry eye is a condition where your eyes do not make enough tears, or the tears evaporate too quickly. This can cause your eyes to feel dry, gritty, or uncomfortable. Tears are needed to keep the front surface of the eye healthy and to see clearly.

Yes, dry eye is one of the most common eye conditions. It affects millions of adults worldwide. In the UK, around 1 in 3 adults may have some symptoms of dry eye at some point.

Dry eye can affect anyone, but it is more common in people over 50, women (especially after menopause), and those who spend long hours looking at screens, in dry or windy environments, or who wear contact lenses.

Symptoms

Common symptoms

• Stinging, burning, or scratchy feeling in your eyes
• A feeling of something in your eye (grittiness)
• Redness of the eyes
• Blurry vision, especially when reading or using a screen
• Watery eyes (the eyes may produce too many tears in response to dryness)
• Sensitivity to light
• Difficulty wearing contact lenses

Symptoms in children

• Children may not complain of dryness; look for frequent eye rubbing, sensitivity to light, or trouble focusing in school.

Symptoms in older adults

• Older adults often have more severe dryness and are more likely to have other eye problems like blepharitis (inflammation of the eyelids). They may also have trouble using artificial tears regularly.

Causes

Main causes

• Not enough tear production (often due to aging or health conditions like Sjögren's syndrome, rheumatoid arthritis, or diabetes)
• Tears that evaporate too quickly (often because the oil layer of the tears is poor, for example due to blocked glands along the eyelid called meibomian glands)
• Environmental factors like dry air, wind, smoke, or air conditioning
• Prolonged screen time without blinking enough
• Certain medications, including some antihistamines, decongestants, antidepressants, and blood pressure drugs

Risk factors

• Being older than 50
• Being female (especially after menopause)
• Spending many hours on a computer or smartphone
• Wearing contact lenses
• Having a condition like rosacea, diabetes, or thyroid problems
• Living in a dry, windy, or polluted climate
• Having had laser eye surgery or other eye procedures

When to see a doctor

See a doctor urgently if:

• Sudden or severe eye pain, vision loss, or eye injury – call your local emergency number or go to the nearest emergency department immediately.

Book a routine appointment if:

• Symptoms that last more than a few days and do not improve with artificial tears
• Redness, discharge, or crusty eyelids
• Symptoms that interfere with your daily activities like reading, driving, or working
• A feeling that something is in your eye that does not go away

Diagnosis

A doctor or eye specialist will ask about your symptoms, your health history, and any medications you take. They will then examine your eyes using a special microscope called a slit lamp. The exam is painless and usually takes about 20 minutes.

Tests that may be done

• Schirmer test – a small strip of paper is placed under your lower eyelid to measure how much tears your eye produces in a few minutes.
• Tear film breakup time – a dye is placed in your eye and the doctor watches how long it takes for tears to break apart. This tells if your tears evaporate too quickly.
• Staining with a special dye – to see if the surface of the eye has any dry spots or damage.

What to expect at your appointment

Most of the tests are simple and do not hurt. You may feel a slight sting from the eye drops used for the dye. The results help your doctor understand the type and severity of your dry eye so they can recommend the best treatment for you.

Treatment

Treatment for dry eye focuses on keeping your eyes comfortable and preventing damage. The right approach depends on what is causing your dry eye and how severe it is. Many people manage well with self-care, but others need medical treatments.

Self-care at home

• Use artificial tears (lubricating eye drops) regularly, especially before activities that make symptoms worse like reading or using screens. Choose preservative-free drops if you use them more than 4 times a day.
• Take regular breaks from screens – follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.
• Place a humidifier in your room or at your desk to add moisture to the air.
• Avoid smoke, wind, and air conditioning blowing directly in your face.
• Warm compresses on your eyes for 5-10 minutes can help if your eyelids are blocked (a common cause).

Medical treatments

If self-care is not enough, your doctor may prescribe anti-inflammatory eye drops like cyclosporine or liftitegrast (these are not specific brands, but examples of the type of medication). They may also recommend oral medications that help increase tear production, or procedures to block your tear ducts (punctal plugs) to keep tears on your eyes longer. Always follow your doctor's advice – never use any prescription eye drops without a prescription.

When is surgery considered?

Surgery is rarely needed for dry eye. In very severe cases that do not respond to other treatments, a minor procedure to permanently block the tear ducts (punctal cautery) may be considered. Your eye specialist will discuss this if it is an option for you.

Living with this condition

Living with dry eye means building habits into your daily routine to keep your eyes comfortable. Use your artificial tears as directed (even if your eyes do not feel dry yet), take screen breaks, and protect your eyes from wind and sun with wrap-around sunglasses. Keep a small bottle of artificial tears with you.

Lifestyle tips

• Blink often when looking at screens – make a conscious effort to blink fully.
• Wear sunglasses or wraparound glasses outdoors to block wind and UV light.
• Avoid smoking and second-hand smoke.
• Use a humidifier at home, especially in the bedroom.
• Keep your eyes clean – gently wash your eyelids with warm water if they feel crusty.

Diet and exercise

A healthy diet and staying hydrated are good for your overall health and may help your eyes. Some studies suggest that omega-3 fatty acids (found in oily fish like salmon, flaxseed, and walnuts) can improve tear quality. Drink enough water throughout the day, but avoid caffeine and alcohol if they make your symptoms worse. Exercise is fine, but if you exercise in a dusty or windy environment, consider protective eyewear.

Mental health and emotional wellbeing

Chronic dry eye can be frustrating, painful, and affect your mood. It may make it hard to focus at work or enjoy hobbies. It is normal to feel annoyed or down about it. Talk to your doctor if your symptoms are affecting your mental well-being – they can help you find better treatments and may suggest support groups or counselling.

Prevention

You cannot always prevent dry eye, especially if it is caused by aging or certain medical conditions. But you can reduce your risk by taking regular screen breaks, using a humidifier in dry environments, wearing protective eyewear in windy conditions, and avoiding smoke. Keep your eyes moist when you start tasks that cause symptoms.

Complications

If left untreated

• Damage to the surface of the cornea (the clear front part of the eye)
• Increased risk of eye infections
• Scarring of the cornea, which can lead to vision problems
• Difficulty performing daily activities like reading or driving at night

Long-term outlook

With proper care and treatment, most people with dry eye can manage their symptoms effectively and maintain good vision. It is a chronic condition for many, but treatments continue to improve. Talk to your doctor about a plan that works for you.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.