What to Know About Dry Eye Symptoms, Causes, and Treatments
Dealing with scratchy, burning, and bloodshot eyes? Here's a look at what causes dry eye syndrome and how to treat and prevent symptoms.
When your eyes are dry
You’re going on two hours of staring at your computer screen. Is that a film on the screen or… Nope, it’s your eyes. They’re definitely blurry (not to mention red, stingy, and a little scratchy). It’s another episode of dry eye syndrome.
Dry eye is a common and chronic problem. An estimated 4.88 million Americans over the age of 50 have dry eye symptoms, according to the American Academy of Ophthalmology. It affects more women than men.
Dry eyes can develop for several reasons, including aging, medication, and—you guessed it—screen use. Although dry eye syndrome can be irritating, there are things you can do to prevent and treat it.
What is dry eye?
Every time you blink, tears wash over your eyes. They keep the eye’s surface smooth and clear and wash away any debris.
But sometimes your eyes don’t make enough tears or the quality of tears isn’t very good. This is dry eye syndrome. It goes by a few other names too: dry eye disease, keratoconjunctivitis sicca, and keratitis sicca.
How tears work
The tear film on your eye is made up of three layers, and each plays a different role.
Oily layer: This outside layer keeps the eye’s surface smooth and keeps tears from evaporating too fast.
Watery layer: The middle layer is most of what we normally see as tears. This cleans the eyes and washes away anything that doesn’t belong there.
Mucus layer: This inner layer helps tears stick to the eye. It spreads the watery layer across the eye’s surface.
As you age, your eyes make fewer tears. But sometimes things can affect one of these layers, which impacts how long tears stay on the eyes and keep them lubricated.
What causes dry eye?
There are several reasons your eyes may be making fewer tears. The most common dry eye causes are:
- Aging: Dry eyes typically affect people over age 50. Most people over 65 have some dry eye symptoms, according to the American Optometric Association.
- Sex: Women are more likely to have dry eyes than men, especially if they use birth control pills or have gone through the hormonal changes of pregnancy or menopause.
- Computer use: Staring at a screen for long periods of time without blinking can decrease tear production.
- Medication: Certain medicines, including antihistamines, antidepressants, beta-blockers, decongestants, and diuretics for high blood pressure, can cause you to make fewer tears.
- Laser eye surgery: Having vision correction surgery such as LASIK can decrease the amount of tears your eyes make.
- Medical conditions: Certain health issues, such as diabetes, rheumatoid arthritis, and thyroid problems, can be closely linked to dry eye symptoms.
- Other eye issues: Both blepharitis (eyelid inflammation) and eyelids that turn in or out can eventually trigger dry eyes.
- Contact lenses: Wearing contacts for long periods of time, or not changing them regularly, can impact tear amount and quality. Here’s how to choose the best contacts for dry eyes.
- Wind and smoke: Exposure to smoke, wind, and dry air can increase how quickly tears evaporate.
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Dry eye symptoms
Dry eye symptoms can come and go, especially early on when the condition is mild. As it gets worse, symptoms typically linger.
Dry eye symptoms can include:
- Stinging, burning, or scratching feeling in the eye
- Blurry vision
- Watery eyes
- Gritty feeling in the eye
- Trouble wearing contact lenses
- Strings of mucus in eyes
- Light sensitivity
How is dry eye diagnosed?
Your eye doctor will examine your eyes, inspecting the surface of your eyes as well as your eyelids. You’ll have to blink a couple times then answer questions about your symptoms and when your eyes feel dry.
Sometimes a doctor will put dye in your eye to watch how your tears flow and/or to highlight the areas of your eyes that are dry.
Your doctor may do a procedure called a Schirmer’s test, putting small strips of filter paper under your lower eyelids to measure the amount of tears your eyes make after a few minutes.
You may get blood work if your doctor suspects you have an underlying disorder such as the autoimmune disease Sjogren’s syndrome. If you have this condition, your immune system mistakenly attacks the glands that make tears and saliva.
(Here’s why you might have dry eyes at night or waking up in the morning.)
Dry eye treatments
The two most common treatments for dry eyes work by adding more tears or saving the ones you have.
These eye drops for dry eyes mimic your own tears. You can use them many times throughout the day, whenever your eyes bother you.
There are many brands available without a prescription. Products without preservatives are less likely to irritate your eyes.
Thick gels and ointments can provide more moisture than drops. Because they can make your vision blurry, they’re best used at bedtime.
Your doctor may suggest saving your tears by blocking your tear ducts. Plugging the ducts keeps tears in your eyes longer and stops them from draining through the nose.
For this procedure, a doctor will insert tiny, silicone or collagen plugs (called punctal plugs) into the tiny holes in the corner of your eyes. These holes can also be closed permanently, via surgery, in serious cases.
Your doctor may also suggest some medications to ease dry eye symptoms. They can include prescription eye drops, such as cyclosporine (Restasis), lifitegrast (Xiidra), and corticosteroids. These medicines encourage your eyes to make more tears.
Keeping your eyelids clean helps with blocked or irritated oil glands that can affect the quality or quantity of tears you make.
Apply warm compresses to your eyelids to open blocked glands and then gently massage them to release natural oils.
You can clean eyelids with over-the-counter eyelid scrubs or with a mixture of baby shampoo and water, applied with a cotton swab.
Dry eye prevention
There are home remedies that you can do every day to help prevent and treat dry eyes:
- Take breaks from screen time.
- Use a humidifier.
- Wear wraparound glasses outdoors, especially in windy weather.
- Add omega-3 fatty acids to your diet, either from supplements and/or foods like oily fish and flaxseeds.
- Avoid warm and dry environments when possible.
Products that may help dry eye
- American Academy of Ophthalmology: “What is Dry Eye?”
- American Optometric Association: “Dry Eye”
- National Eye Institute: “Dry Eye”
- Harvard Health Publishing: “Dry Eye Syndrome”
- Kellogg Eye Center, Michigan Medicine: “Dry Eye Syndrome”
- Medscape: “Dry Eye Disease (Keratoconjunctivitis Sicca)”
- U.S. National Library of Medicine: “Sjogren’s Syndrome”
- American Journal of Ophthalmology: “Prevalence of dry eye syndrome among U.S. women”
- Archives of Ophthalmology: “Prevalence of dry eye disease among U.S. men: estimates from the Physicians' Health Studies”
- American Academy of Ophthalmology: “Eye Health Statistics”
- Cornea: “Efficacy of Omega-3 Fatty Acid Supplementation for Treatment of Dry Eye Disease: A Meta-Analysis of Randomized Clinical Trials”