What Is Dry Eye Syndrome, and How Is It Treated? Ophthalmologists Explain the Often Chronic Condition
There's probably no greater annoyance in life than when your eyes are irritated—the scratchiness, the redness, the blurriness. But constantly feeling like something is in your eye isn't exactly normal, and it could signal that you're dealing with a common eye condition that plagues millions of people a year.
Dry eye syndrome—sometimes called "dry eye disease" or just "dry eye"—is a condition in which your eyes don't make enough tears, or enough quality tears, to lubricate and nourish the eye, William T. Reynolds, OD, president of the American Optometric Association, tells Health. This lack of tears can make your eyes feel uncomfortable, and it can also cause some vision issue, according to the National Eye Institute (NEI).
Dry eye syndrome is a common and oftentimes chronic problem, especially for older adults, says Dr. Reynolds. Still, people of all ages can suffer from dry eyes. An estimated 16 million Americans have been diagnosed with dry eye disease, though the actual number with symptoms is likely much higher, according to a 2019 article in Ophthalmology Times. You can have dry eye in one or both eyes.
What are the symptoms of dry eye syndrome?
Not everyone with dry eye actually has symptoms, says Dr. Reynolds. But when symptoms do crop up, they include both things you can see and feel, Arti Shah, OD, fellow of the American Academy of Optometry and optometrist at Elander Eye Care in Santa Monica, California, tells Health. The main symptoms of dry eye, per the NEI, include:
- Itchy, scratchy eyes
- Stinging or burning in the eyes
- Red eyes
- Sensitivity to light
- Blurry vision
Dry eye syndrome can absolutely be uncomfortable, but for most people, "it's usually not a 10 out of 10 pain," says Dr. Cruse. "It's usually more of an annoying pain."
What causes dry eye syndrome?
Dry eye syndrome is caused by a lack of tears or a lack of good quality tears—but we're not talking about the tears that come with crying; the tears associated with dry eyes are tears that spread across the front surface of the eye (aka the cornea) every time you blink. They come from glands above your eyes, and they're extremely important for keeping the cornea healthy and for helping you see clearly. "[They] provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and keep the surface of the eyes smooth and clear," says Dr. Reynolds.
It's easy to assume that tears are simply a watery substance, but they're actually made of three different components, says Dr. Shah: A mucous layer, which helps anchor and spread tears across the cornea; a watery (aqueous) layer, which contains important proteins and enzymes and helps combat inflammation; and an oily layer, which helps protect the watery layer. Dry eye typically occurs when there's a disruption in one or more of those layers—about 85% of dry eye cases are due to issues with the watery and oily layers, says Dr. Shah.
Dry eye is an extremely common condition, and there are certain risk factors that can increase your likelihood of developing the eye issue. Those include:
- Age: Dry eyes are a part of the natural aging process. The majority of people over age 65 experience some dry eye symptoms. And you are more likely to have dry eye if you are 50 or older, per the NEI.
- Gender: Women are more likely than men to develop dry eyes due to hormonal changes caused by pregnancy, menopause, and birth control pills, the NEI says.
- Medications: Certain medicines—including antihistamines, decongestants, blood pressure medications, and antidepressants—can reduce tear production and increase the likelihood of dry eye, according to the American Academy of Ophthalmology (AAO).
- Medical conditions: People with rheumatoid arthritis, diabetes, and thyroid problems are more likely to have dry eye symptoms, per the NEI. Inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, and the inward or outward turning of eyelids can also trigger dry eye, per the AAO.
- Environmental conditions: Exposure to smoke, wind, and dry climates can cause tears to evaporate and induce dry eye symptoms, the AAO says.
- Failure to blink regularly: Decreased blinking, which can happen when you stare at a computer for long periods of time, can contribute to dry eyes.
- Dietary habits: People who don't get enough vitamin A (found in foods like carrots, broccoli, and liver) or omega-3 fatty acids (found in fish, walnuts, and vegetable oils) are more likely to have dry eye, according to the NEI.
- Contact lenses: Wearing contacts long-term can result in dry eyes, according to both the AAO and NEI
- Refractive eye surgeries: Procedures to improve your vision, including LASIK, PRK and cataract surgery, can decrease tear production and contribute to dry eyes, the AAO says. (Usually, dry eye is just a temporary side effect of these surgeries, says Dr. Shah.)
How is dry eye syndrome usually treated?
Unfortunately, there is no cure for dry eye syndrome, Tom Cruse, OD, optometrist with Insight Vision Group in Denver and site residency director for the Illinois College of Optometry, tells Health. But there are a variety of treatments that can help lessen the intensity of your symptoms.
Because dry eyes can be a chronic condition, treatments often strive to restore or maintain the normal amount of tears in the eye, explains Dr. Reynolds. There is no one-size-fits-all treatment for dry eye, but some options, per the NEI, include:
- Over-the-counter (OTC) artificial tears: These can be used as often as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives than solutions with preservatives (which can further irritate the eyes). Many times, mild cases of dry eyes can be managed using OTC tears.
- Prescription eye drops: For moderate to severe cases of dry eye, an eye doctor can prescribe drops that, depending on the cause of your dry eye, either increase tear production or decrease inflammation around the surface of the eyes.
- Tear duct plugs or surgery: Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes; this can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with removable tiny silicone or gel-like plugs, or with surgery.
- At-home remedies: You may be able to reduce the severity of your dry eye symptoms with DIY steps, including increasing the humidity of the air at your home and work, wearing sunglasses outside, taking nutritional supplements (like omega-3 fatty acid, which may help boost tear production), changing your diet, and drinking enough water to avoid dehydration.
- Other options: Warm compresses and eyelid massage, ointments, or eyelid cleaners can help decrease inflammation around the surface of the eyes. A specific type of contact lens called a scleral lens can hydrate dry eyes, as can specialized goggles worn at night.
When should you see a doctor about dry eye syndrome?
If you notice any dry eye symptoms, it's worth a chat with your eye doctor, Dr. Shah advises. They can perform a variety of tests to determine if you are indeed suffering from dry eye, or if something else—like a problem with your eye muscle, for example—is causing your symptoms.
According to the NEI, your doctor will check for dry eye by doing a comprehensive eye exam—some of the more specific things your eye doctor will look for include: the amount of tears your eyes make, how long it takes for your tears to dry up, and the structure of your eyelid.
Don't delay this visit. "We just want to be preventative," says Dr. Shah. And getting your dry eye symptoms checked out sooner rather than later can boost your quality of life and help prevent eye infections and damage to the cornea.
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter.