Just about everyone has had dryness in their eyes at some point. Acute irritations are common, with everything from staring at your phone to low humidity potentially triggering symptoms, says Whitney Hauser, MD, an optometrist in California.
While fleeting cases of dry eye may not bother you, prolonged, frequent, and severe dry eye symptoms may be signs of a more serious, chronic condition.
Common dry eye symptoms include:
- Stinging, burning, or itchiness
- Pain or redness
- Feeling as though something is in your eye
- Stringy mucus discharge
- Watery eyes
- Blurry vision
- Sensitivity to light
- Difficulty wearing contact lenses
- Trouble driving at night
Dry eye comes from inadequate eye lubrication, either because you are not producing enough tears or because the tears are evaporating too quickly.
A layer of tears covers your eyes each time you blink, which protects your eyes from infections, keeps them moist, washes away dust and debris, and keeps your vision clear. Tears are a mix of water, mucus, and oils.
Things that put you at risk of dry eye include:
- Wearing contact lenses
- Eye surgery, such as refractive surgery (LASIK) and cataract surgery
- Hormonal changes in women, such as from pregnancy, menopause, or using birth control pills
- Age
- Insufficient vitamin A intake
- Various medications, such as antihistamines, nasal decongestants, blood pressure medication, and antidepressants
- Autoimmune disorders, such as Sjögren’s syndrome and lupus
- Environmental irritants, such as wind, high temperature, and smoke
- Allergies
- Extended time looking at a screen
- Skin conditions, such as eczema and rosacea
There are two types of dry eye:
- Aqueous Tear-Deficient Dry Eye Your eyes’ lacrimal glands fail to produce enough of the middle aqueous, or watery, layer of tears.
- Evaporative Dry Eye Your eyes’ meibomian glands have an issue that leads to production of low-quality tears that evaporate too quickly.
Dry eye often is called dry eye syndrome. But other names for it include:
- Ocular surface disease
- Dysfunctional tear syndrome
- Keratoconjunctivitis sicca
- Lacrimal keratoconjunctivitis
See a doctor if you have frequent symptoms of dry eye or if your dry eye symptoms worsen.
Your doctor will examine your eyes and eyelids to diagnose the condition. This may include testing tear quantity and quality, as well as the composition of your tears.
Prognosis of Dry Eye
Regardless of severity, dry eye isn’t life-threatening. In fact, it’s highly treatable.
Symptoms of mild cases can be resolved with over-the-counter medications, such as artificial tears.
If your dry eye is chronic, however, your healthcare team may search for underlying causes. These may include inflammation of the cornea or eyelids, tear-duct issues, or other conditions.
When environmental factors, health problems, or medications cause dryness in your eyes, your symptoms may improve or resolve after you identify and treat the cause.
Severe cases may not have a long-term cure, however. If your dry eye lingers, it is a good idea to get it checked out.
“The best way to identify the cause of dry eye is to see your eye doctor,” says Arian Fartash, a California-based optometrist. “With the right tools and consistency, it can be managed.”
The right dry-eye treatment for you often depends on the cause of your condition.
Over-the-Counter Options
For mild or occasional dry eye, artificial tears can help lubricate the eyes and relieve symptoms while protecting the surface of your eyes. Many are available over the counter.
Check product descriptions to find which is right for your situation. Eye drops or gels with preservatives, for example, may irritate your eyes if you have moderate to severe dry eye or use them more than a few times a day. Eye drops without preservatives are recommended for people who use drops more than four times a day.
Prescription Options
While artificial tears are often the first line of defense for dry eye, treating more severe symptoms requires a prescription medication from your ophthalmologist or optometrist. You may use these medications in tandem with over-the-counter products.
- The medication cyclosporine (Restasis, CEQUA) relieves dry eyes by stopping inflammation that interferes with tear production.
- Lifitegrast (Xiidra) is a nonsteroid drug that can reduce inflammation, Dr. Hauser says.
- Corticosteroid eye drops can reduce inflammation, but long-term use poses health risks.
- Antibiotic eye drops can also reduce eyelid inflammation, helping with the secretion of oil into your tears.
- Medications such as cevimeline (Evoxac) or pilocarpine (Salagen) stimulate tear production. They are available as pills, drops, or gels.
- Hydroxypropyl cellulose (Lacrisert) is an insert that you place between your lower eyelid and eye that dissolves into a lubricant.
- The nasal spray varenicline (Tyrvaya) also stimulates an increase in tear volume.
- Perfluorohexyloctane ophthalmic (Miebo) is a drop that reduces tear evaporation on the surface of the eye.
Surgery Options
Some surgeries may plug the tear ducts in your eyelids permanently or temporarily. They allow tears to stay on your eyes longer before evaporating.
Other Treatments
Aside from eye drops, medications, and surgery, treatment options for dry eye include:
- Light therapy and eyelid massage
- Using warm compresses or eye masks to unclog oil glands
- Wearing contact lenses called scleral or bandage lenses that trap moisture
- Changing your diet, as omega-3 fatty acids in foods or supplements may reduce eye irritation, Fartash says
Other ways to prevent or alleviate dry eye include:
- Protecting your eyes from fans and wind, using certain eyewear
- Using a humidifier, Fartash says
- Looking away from screens at least every 20 minutes
- Stopping smoking
- Blinking often
- Avoiding using a hair dryer
- Washing your eyelids with soap and warm water
If you take prescription medications for another condition, Fartash advises checking with your doctor to see if dry eye is a common side effect.
Contact Lenses and Dry Eye
You may be able to wear contact lenses with dry eye. But irritation is possible, and wearing contacts is a risk factor of dry eye. Talk to your doctor about the type of lens that is appropriate for your situation, Fartash says.
Contact lenses can cause corneal nerve desensitization, which can decrease tear production and lead to or worsen dry eye.
Conditions that can damage the cornea include corneal abrasions and corneal ulcers. Severe cases of dryness can also worsen vision, Fartash says.
Another possible complication is
conjunctivitis (pink eye), or inflammation of the conjunctiva, the clear tissue covering the white part of the eyes and inner surfaces of the eyelids.
Depending on the severity, dry eyes can also reduce your quality of life.
Blurry vision and sensitivity to light can make it hard to complete routine everyday tasks such as driving and reading. Dry eyes might also make it difficult to complete work, and your work performance could suffer as a result.
Dry eye can occur at any age, but it’s most common in people ages 50 and older. Nearly five million Americans ages 50 and older have dry eye, with millions more having light symptoms.
It’s also more common in women than men.
Adults of Asian descent also may be more than twice as likely to have dry eye than white adults, according to research.
Black adults also are more likely to have dry eye than white ones.
