Dry eye can happen if your tear (lacrimal) gland doesn’t make enough tears. It can also happen if tears don’t contain enough oil, which causes them to evaporate too fast.
The tear film that covers the cornea (the clear, front part of the eye) is made up of water, oil, and mucous. It provides a protective barrier for your eye. Without enough tears, you can experience eye pain and, in extreme cases, eye damage and even vision loss.
Several things can cause dry eye like:
Age: As we get older, dry eye becomes more common because we make less tears. This is especially true for people undergoing menopause, since hormone changes can change how much oil is in tears.
Medical conditions: Some autoimmune conditions can cause dry eye — especially Sjogren’s syndrome and rheumatoid arthritis. COVID-19 infection can also cause dry eye.
Medications: Some medications can make us produce less tears, including blood pressure medications and allergy medications.
Eye conditions: Blepharitis (inflammation of the eyelids) and previous eye surgery can also cause dry eye.
Environment: People who live in drier or windier climates are more likely to develop dry eye.
Dry eye can be uncomfortable and cause eye pain. Other symptoms of dry eye include:
Burning sensation in the eye
Temporary blurred vision, often with reading
Gritty sensation in the eye
Watery eyes
It seems counterintuitive that your eyes feel watery when you’re experiencing dry eye. When the eyes are irritated by dry eye, your tear glands try to help by making more tears. But this isn’t usually enough to resolve the condition.
There are several ways to treat dry eye. Some people respond better than others to specific treatments.
Artificial tears: Artificial tears are the first-line treatment for dry eye. There are many different types of artificial tear drops available over the counter. Some artificial tears are thicker and prevent the tear film from evaporating as quickly. If you need artificial tear drops frequently during the day, try preservative-free artificial tears, which can safely be used multiple times a day. Make sure to throw away your single-use vial within 24 hours after opening it.
Punctal plugs: These are plugs that your ophthalmologist can place in your tear ducts. They keep tears from draining so they can stay on your eye longer.
Omega-3 fatty acids: Omega-3 supplements can improve dry-eye symptoms in some cases.
You may also need to try medicated options. Some medications for dry eye include:
Medicated eye drops: Restasis (cyclosporine) and Xiidra (lifitegrast) work by preventing eye inflammation. Restasis has been FDA-approved since 2002, while Xiidra is a newer drug that was approved for use in 2016.
Autologous serum tears: This is an alternative for people with severe dry eye. Serum tears are made from your own blood. This option can be very effective for people who have dry eye and an autoimmune condition.
Prescription nasal spray: In 2021 the FDA approved Tyrvaya (Varenicline) for the treatment of dry eye. This medication has been used for years to help people quit smoking. It’s now used as a twice-daily nasal spray that activates the pathway to increase tear production. Tyrvaya can help relieve symptoms for people who didn’t have success with other therapies.
To prevent dry eye or to keep it from getting worse you can:
Move your fan: Point fans away from your face. The air stream evaporates tears, worsening dry eye.
Take screen breaks: Prolonged screen time can cause eye strain and dry eye. Usethe 20-20-20 rule — every 20 minutes, take a 20-second break and look 20 feet away.
Get a humidifier: Humidifiers increase moisture in the air, keeping tears from evaporating too quickly.
Take out your contacts: Don’t leave contact lenses in for longer than recommended. Take out your contact lenses for sleeping.
Avoid smoke: Smoke can trigger dry eye — including cigarette and wood smoke.
Try a warm compress: A warm compress lets more oil flow into tears so they evaporate slower. Place a warm eye mask over both eyelids for about 10 minutes a day.
Use lid scrubs: Using baby shampoo or over-the-counter pads like Ocusoft lid scrubs, gently clean the base of the eyelashes on your upper and lower lid while keeping the eye closed. Try this a few times a week.
There are many options to treat the symptoms of dry eye. These include over-the-counter options, like artificial tears and prescription eye drops and nasal sprays. What works well for one person might not work well for another. Over time, you might need to change your routine or add on new treatment options.
Some medical conditions can trigger or worsen dry eye. Getting treatment for these conditions can also lessen dry eye symptoms.
Dry eye doesn’t usually get better or go away on its own.
If your dry eye is due to medications you’re taking, talk to your healthcare provider about switching to another option. This may improve your dry eye symptoms. Don’t stop taking prescribed medications without first talking to your healthcare provider.
Contact lenses can worsen and trigger dry eye. You can consider other options for treating your myopia, like glasses or surgery such as PRK and LASIK.
Without proper treatment, dry eye can lead to other serious eye conditions. You can develop corneal abrasions and keratitis. In some cases, these conditions can lead to serious eye injuries and even vision loss.
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Miljanović, B., et al. (2005). Relation between dietary n−3 and n−6 fatty acids and clinically diagnosed dry eye syndrome in women. The American Journal of Clinical Nutrition.
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