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Dry Eye Disease: Symptoms, Causes, and Treatment - Your Complete Guide

If you regularly feel dryness, itchiness, and burning sensations in your eyes, you may have dry eye disease. This condition is very common, especially for older adults and women — so you’re far from alone in coping with these symptoms.

Dry eye disease is also known as dry eye syndrome, keratoconjunctivitis sicca, and keratitis sicca. It’s an uncomfortable daily experience for an estimated 9.3% of the population.

Understanding this chronic condition is the first step in living with it and managing its effects. We’ll explain the symptoms of dry eye, its underlying causes, and what to expect during diagnosis. We’ll also guide you through the various treatments.

What is dry eye disease?

Dry eye is a condition that reduces the number of tears your eyes produce — or brings down their quality, making them evaporate or drain back through the tear ducts more easily. Without enough tears, your eyes won’t have the right amount of lubrication. This increases your risk for vision problems and infections.

Dry eye disease is a chronic illness, meaning there’s no total cure. However, you can manage its symptoms and live a comfortable life despite having the diagnosis.

Dry eye disease symptoms

Dry eye can trigger the following effects around your eyes:

Dry eye disease symptoms checklist: Do you have dry eye?

If you’re unsure whether the discomfort in your eyes indicates the onset of dry eye disease, this checklist may help you identify symptoms.

Do the following statements apply to you?

🔲 I am physically unable to cry, but I feel like I want to.

🔲 I constantly feel like there’s dust or dirt in my eye, even though there’s n’t any.

🔲 These feelings of dryness and irritation continue even though my eyes are persistently watery.

🔲 I struggle more than I used to with vision during daily tasks like reading, writing, and watching TV.

🔲 My eyes are often red and itchy, especially in high winds or when I’m around tobacco smoke.

🔲 I wipe mucus away from my eyes regularly.

🔲 It hurts when I wear contact lenses.

If you have three or more of the symptoms above, you might benefit from speaking with an eye doctor and receiving an assessment for dry eye. An eye doctor may be able to recommend key treatments that will help reduce or even eliminate your discomfort.

Dry eye disease complications

Without treatment, dry eye symptoms can progress into other conditions. Tears defend your eyes against eye injury and infection. If dry eye causes a prolonged shortage of tears, it can impact your optical and general health long-term.

Conjunctivitis (pink eye)

Without treatment, dry eye can inflame your conjunctiva. This transparent wall of cells covers the whites of your eyes and the area inside your eyelids.

Conjunctivitis can make the redness and grittiness of dry eye feel even worse. When conjunctivitis strikes, you may also find that you become highly sensitive to light.

This light sensitivity usually resolves without treatment, and its effects are often milder than other complications. If symptoms persist, seek consultation with an eye doctor.

Corneal ulcer

A corneal ulcer is an open sore on the clear outer layer of your eye, also known as the cornea. If grit or dirt reaches the cornea's surface, tears usually wash away the debris. However, people with dry eyes can’t produce enough high-quality tears to remove the foreign matter altogether.

Debris in the eyes that isn’t flushed away by tears can cause a scratched cornea. Bacteria may then enter the scratch and trigger an infection, leading to an ulcer.

It’s vital to see an eye doctor about a corneal ulcer. An eye doctor can treat this complication of dry eye disease with antibiotic eye drops. If the ulcer spreads, it can scar the eyeball, leading to blindness.

Restricted choice of vision correction

If you prefer to manage near or farsightedness using contact lenses, dry eye could mean that you need to switch to framed spectacles.

A lack of tears means that contact lenses won’t have enough lubricant to feel comfortable on the eye. You also risk the contact lenses sticking to the eye's surface and making removal difficult.

Managing dry eye is a way to keep using the vision correction methods you find most comfortable.

Disruptions to daily life

Persistent dry eye can lead to blurry vision. Without treatment, this can worsen, sometimes progressing to double vision.

Dry eye can also make opening your eyes difficult due to extreme light sensitivity or grittiness. Using lubricant eye drops and artificial tears might soothe this complication, but it can still be challenging to open your eyes all the way. This will severely impair your ability to drive, watch TV, or even work.

Depression

Recent research found a strong correlation between dry eye, depression, and stress. Disruptions to daily life can make completing tasks difficult, affecting your mental health.

However, researchers debate whether this link comes from dry eye’s limiting effect on people’s lifestyles or the possible eye-drying side effects of certain antidepressant medications. Further studies around this area of dry eye disease need to take place.

Headaches

Researchers have identified a possible relationship between headaches and dry eye. Some people with dry eye live with headaches at the same time.

A 2019 study found that dry eye symptoms seem to have a higher prevalence among migraine sufferers than in the wider population.

Further studies are necessary to explore the link. But if the headaches become chronic, they may contribute to concentration difficulties, reduced enjoyment of time with others, and lower productivity in working life.

Dry eye disease causes

Two primary causes underpin dry eye’s negative impact on eye moisture: reduced tear production and lower tear quality. Several diseases, treatment side effects, and environmental risk factors can affect tear volume or quality.

Your eyes don’t produce enough tears.

The lacrimal and accessory glands around the eyelids play a crucial role in tear production. They provide the necessary hydrating and infection-countering components for tears.

An underlying cause might prevent these glands from fully working. This can slow tear production or mean that your tears are insufficient for protecting your eyes.

Your eyes produce lower-quality tears.

Tears are essential for eye health, as they consist of:

Dry eye effects might develop if any of these elements are defective or lacking.

Risk factors for dry eye

Some people have a higher risk of dry eye disease than others. It’s best to let your doctor know if you have any of the below risk factors. They can help you tackle the underlying cause and preserve some comfort while you go about your day.

Older females

Anyone can get dry eye, but the condition becomes more likely as you age, especially for women, and especially during menopause.

Estrogen and androgen, the sex hormones, contribute to production of the tear film. As a result, reduced levels of both during menopause can affect tear quality and volume.

Learn more about the link between dry eye and menopause in our guide, Does Menopause Cause Dry Eye?

People with certain chronic health conditions.

Some disorders disrupt how your immune system and hormones work, affecting tear production. These include:

People who have had health problems on their eyelids.

The eyelids contain mucus-producing glands that add essential ingredients to your tears. Any condition causing inflammation or physical disturbance to the eyelid increases your risk for dry eye, because it can block these important glands.

When your tear ducts become blocked, your tears can evaporate before they can fully nourish the eye. Such conditions include:

People who have received treatment for other eye conditions

Any treatment that irritates the surface of your eye might trigger temporary dry eye as a side effect. If you recently underwent LASIK corrective eye surgery, you might find that it leads to an extended period of dry eye.

This period can range anywhere from 3 weeks to over a year. The link between LASIK and dry eye is strong enough that the American Academy of Opthalmology excludes people who have dry eye from being candidates for the procedure.

Post-LASIK dry eye should usually self-resolve after your eyes have fully recovered. However, you can manage discomfort while healing using artificial tears and eye drops.

Wearing contact lenses as vision correction for long periods can also irritate the eye and lead to dry eye.

People who take medications for a chronic condition

Some medicines can cause dry eye disease as a side effect, including:

If the side effects of a particular course of treatment disrupt your daily life, speak to your doctor about changing to an option with fewer adverse effects.

People who spend a long time in front of a screen

If you use a computer for work, read a lot, or watch TV for several hours a day, you might experience dry eye.

Any activity that makes you blink less could lead to dry eye symptoms.

People who live in certain environments

Certain environmental characteristics can dry out the air, making your eyes work harder to retain lubrication. These include environments that are especially:

Using an air conditioning unit in the summertime can dry out the air (and your eyes) even further.

Dry eye disease diagnosis

Being diagnosed with dry eye disease can be the first important step in returning to eye comfort and high quality of life. Take the steps below to move closer to a healing diagnosis.

When to see a doctor

If you’ve been experiencing a burning, itchy, gritty sensation and redness in your eyes for a long time, seek the advice of your family physician or another healthcare professional.

Upon suspecting that you have dry eye, your doctor will refer you to a specialist who can provide the care you need.

Dry eye disease quiz: Do you have dry eye?

Still can’t figure out if you have dry eye? Visionology’s simple Dry Eye Quiz can help you discover if you should visit an eye health professional.

What to expect when visiting a doctor about dry eye disease

Your doctor will examine the eyelids and the eye’s surface to identify dry eye. They will also ask you to blink, and check for anomalies.

Your eye doctor will ask about your medical history to see whether you have any underlying health problems that might have caused dry eye.

Your doctor will then carry out one of several dry eye disease tests like Schirmer’s Test to measure tear production. Sometimes, they’ll use specialized dyes that highlight dry eye effects on the surface of your eye.

Your ophthalmologist will then confirm whether you have dry eye and devise a treatment plan.

Dry eye disease treatment

For many, dry eye disease may be caused by tear production, tear quality, or both. Several different treatments are available, depending on the underlying cause.

Medications: How can eye drops help people with dry eye disease?

Medications for dry eye disease aim to boost tear production and preserve moisture in the eye.

Lubricating eye drops help you administer artificial tears to the surface of the eye. Replacing your body’s natural tear supply can reduce your risk of dry eye disease complications and help you feel more comfortable.

Artificial tears are available over the counter. However, your ophthalmologist can prescribe more potent drops that lubricate the eye while stimulating increased tear production.

Artificial tears are a simple way to keep the more severe complications of dry eye at bay.

What are the best eye drops for dry eyes?

The best dry eye drops are those that your doctor prescribes and recommends. That’s because your doctor has developed a complete picture of your eye health during diagnosis.

However, ask your healthcare provider to make sure that your eye drop medication:

Whichever eye drops you choose, you should stick closely to your prescribed treatment plan for a smooth recovery.

Tear duct plugs

Severe dry eye may prevent conservative treatments like eye drops from helping you. When that happens, some eye doctors might use tiny silicone plugs to block the tear ducts. This stops tears from draining away. In some cases, a surgeon can permanently block excessive drainage with tear duct surgery, helping you retain more tears.

Preparing for your dry eye disease appointment

If you suspect you might have dry eye disease, you may not need to visit an ophthalmologist right away. Your family doctor can often prescribe what you need.

If your symptoms are severe, consider self-referring to a specialist who can provide a quicker diagnosis and more personalized treatment.

Preparing for your appointment can help you get the most precise and effective results from your prescription. Here are a few important steps to take:

Write down your symptoms a few days before.

Keep a record of your symptoms. Along with any dry eye symptoms, also note other effects across the body. As dry eye can occur with lupus and RA, a symptoms list may help your doctor find a link.

Prepare questions that help you and your doctor.

Learning more about dry eye disease can help you live with it, so ask questions such as:

  1. Why are my eyes dry?
  2. What else might happen to my eyes?
  3. What types of treatments are available — and which do I need?
  4. Will treatment cure it completely?
  5. Can I just make minor lifestyle adjustments? Will they help?
  6. What are the side effects of my treatment?
  7. Do you have any dry eye resources you can share?
  8. How many times will I need to visit you after taking the eye drops?
  9. What kind of tests do you use during diagnosis?

Get your answers ready.

While learning about your dry eye symptoms, know that your doctor will ask the following questions:

It’s also important to know your medical history and provide information about any medications, supplements, and treatments you take for other conditions.

Be ready for bright lights.

Your doctor will switch on a bright light to examine your eye. If you find this sensation uncomfortable, remember that it will be brief and can help your doctor prevent more discomfort later on.

Dry eye disease - in conclusion

Dry eye disease is uncomfortable and often ongoing in people’s lives.

It has many possible causes, but treatment involves stimulating tear production with eye drops and lubricating your eyes to soothe them.

Dry eye can cause severe complications like a corneal ulcer, so it’s important to use artificial tears and prescription drops to manage persistent presentations. Consider using Visionology’s doctor-recommended dry eye drops to soothe your symptoms and restore your quality of life.

For more Visionology resources related to dry eyes, read further:

Does Diabetes Cause Dry Eyes?

Is Your Eye Pain a Symptom of COVID-19 or From Wearing a Mask?

Common Causes of Dry Skin Around the Eyes

Medical resources