Dry Eye - Symptoms, Causes and Treatment
Written By: Dr. Ammar Majbour
Updated On:January 30, 2025

What is Dry Eye?
A common illness known as dry eye disease arises when your tears are insufficient to lubricate your eyes adequately. For a variety of causes, tears may not be sufficient or steady. For instance, inadequate tear production or low-quality tear production might lead to dry eyes. The instability of tears causes inflammation and surface damage to the eye.
It hurts to have dry eyes. Your eyes may burn or sting if they are dry. In some circumstances, such as while riding a bike, in an air-conditioned room, on an airline, or after staring at a computer screen for a few hours, you might get dry eyes.
Dry eye treatments could help you feel more at ease. Eye drops and lifestyle changes are possible treatments.
Causes of Dry Eye
- When you don't generate enough aqueous fluid, or liquid tears, you may have dry eyes. This disorder is known medically as keratoconjunctivitis sicca. Typical reasons for reduced tear production are as follows:
- Growing Older
- Certain illnesses, such as sarcoidosis, thyroid issues, lupus, rheumatoid arthritis, scleroderma, graft versus host disease, Sjogren's syndrome, or vitamin A deficiency
- A few medications, such as hormone replacement therapy, decongestants, antidepressants, antihistamines, and medications for high blood pressure, acne, birth control, and Parkinson's disease
- Corneal nerve de-sensitivity brought on by using contact lenses, injury to the nerves, or laser eye surgery, however the symptoms of dry eyes associated with this treatment are often transient
- It is possible for the meibomian glands, which are tiny glands on the border of your eyelids, to clog and form an oily film. In those with rosacea or other skin conditions, blocked meibomian glands are more prevalent. Higher tear evaporation is frequently caused by:
- Meibomian gland dysfunction, or posterior blepharitis.
- When you're focused on anything, like reading, driving, or using a computer, you may blink less frequently, which is common in situations like Parkinson's disease.
- Issues with the eyelids, such as entropion (the turning inward of the lids) and ectropion (the expanding of the lids)
- Allergies
- Preservatives in topical eye drops
- Air dry, smoke, or wind
- Low levels of vitamin A
Symptoms of Dry Eye
Symptoms of dry eye usually impact both eyes as opposed to one. These include the following:
- A burning, itching, or stinging feeling in your eyes
- A feeling as though something is in your eyes
- Challenges in driving at night
- Difficulty in using contact lenses
- Light sensitivity
- Mucus that is stringy in or around your eyes
- Redness in the eyes
- Vision problems or eye fatigue
- Watery eyes
When to see a doctor for Dry Eye?
If you have had persistent dry eye symptoms, such as red, itchy, fatigued, or painful eyes, consult your doctor. If something is affecting your eyes, your provider can investigate further or send you to a specialist.
Dry Eye Risk Factors
You're more prone to get dry eyes if you have the following factors:
- Over 50-year-olds are more likely to have dry eyes.
- Women are more likely to suffer decreased tear production, particularly if they are pregnant, are using birth control, or are going through menopause.
- Consuming low amounts of vitamin A, which is present in liver, broccoli, and carrots, or omega-3 fatty acids, which are present in walnuts, salmon, and vegetable oils
- Having already had refractive surgery or used contact lenses
Dry Eye Complications
These complications might arise for those with dry eyes:
- Eye infections. Your tear film shields your eyes' surface from germs. An eye infection might be more likely if you're not making enough tears.
- Injury to your eyes' exterior. Severe dry eyes can cause inflammation, surface abrasion of the cornea, corneal ulcers, and vision loss if medical attention is not received.
- Lower standard of living. Performing daily tasks like reading might be challenging when one has dry eyes.
Dry Eye Diagnosis
To identify the reason behind your dry eyes, the following tests and procedures might be used:
- A thorough examination of the eyes: An eye exam that involves a thorough medical history of both your eyes and general health will assist your eye care professional in determining the reason behind your dry eyes.
- An evaluation to gauge the number of tears you produce: Your eye care professional may use the Schirmer tear test to gauge how much tear your body produces. Paper blotting strips are inserted behind your lower eyelids for this examination. The amount of the strip wet by your tears is measured by your eye care professional after five minutes.
- The phenol red thread test provides an additional means of determining tear volume. This test involves covering the lower eyelid with a thread loaded with pH-sensitive dye (tears cause the dye to change colour), wetting it with tears for 15 seconds, and then measuring the number of tears.
- Different examinations assess your eyes' surface quality by using specific dyes included in eye drops. Your eye care expert analyses the amount of time it takes for your tears to evaporate and checks for staining patterns on the corneas.
- An osmolarity test on tears to analyse the water and particle content of your tears. Your eyes will contain less water if you have dry eyes.
- Tear samples will be examined for signs of dry eye disease, such as reduced lactoferrin or higher matrix metalloproteinase-9.
Dry Eye Treatment
The majority of people find that using non-prescription eye drops, often known as artificial tears, daily is sufficient for treating moderate or sporadic dry eye problems. You have more alternatives if your symptoms are more severe and persistent. What causes your dry eyes will determine what you do.
Certain therapies aim to cure the underlying cause of your dry eyes, either by controlling or reversing the problem. Additional therapies may be able to stop your tears from evaporating too soon or enhance the quality of your tears.
Sometimes the signs and symptoms of dry eyes might be resolved by addressing an underlying medical condition. For example, your eye care professional can suggest switching to a different medication if the one you are taking is making your eyes dry.
The eye care professional could recommend an oculoplastic surgeon—an eye surgeon who specializes in plastic surgery of the eyelids—if you have an eyelid issue, such as ectropion, which is the turning out of the lids.
If you are suffering from inflammation in the cornea or eyelid, your doctor might prescribe medication. Medication may also be needed to induce tears and to lubricate the eyes.
Additional methods for treating dry eyes might include the following:
- Reducing tear loss by closing your tear ducts
- Punctal plugs, which are microscopic silicone plugs, can be used to seal tear ducts.
- Wearing customized contact lenses
- Clearing clogged oil glands
- Light treatment and massage of the eyelids
Dry Eye Prevention
Consider the circumstances that are most likely to result in your symptoms if you have dry eyes. Then, figure out how to stay out of those circumstances to stop the symptoms of dry eyes. For example:
- Don't let air blow into your eyes.
- Think about using wraparound sunglasses or other eye protection.
- When working on lengthy chores, take breaks to rest your eyes.
- Place the screen of your computer lower than your eyes.
- Give up smoking and stay away from smoke.
- Make frequent use of artificial tears.
References
Bron, A. J. (2001). Diagnosis of dry eye. Survey of ophthalmology, 45, S221-S226.
Lemp, M. A., & Foulks, G. N. (2007). The definition and classification of dry eye disease. Ocul Surf, 5(2), 75-92.
Clayton, J. A. (2018). Dry eye. New England Journal of Medicine, 378(23), 2212-2223.
Gayton, J. L. (2009). Etiology, prevalence, and treatment of dry eye disease. Clinical ophthalmology, 405-412.
McGinnigle, S., Naroo, S. A., & Eperjesi, F. (2012). Evaluation of dry eye. Survey of ophthalmology, 57(4), 293-316.
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