Dry Eyes: Causes, Treatment, and Prevention

Published on June 6th, 2023

Updated on December 6th, 2024

The dry eyes definition states this is a common condition that can be described as a lack of tears produced or an inadequate quality of tears. This hinders the eye from retaining moisture, which is vital in protecting the eye from infections and debris. According to the American Optometric Association, dry eyes symptoms can include watery eyes, redness, and sensation of stinging, burning and scratching. Other vision-related symptoms may include sensitivity to light, blurry vision and stringy eye mucus. Treating dry eyes may involve using artificial tears or special eye drop solutions that help generate more tears. Another form of dry eyes treatment is intentionally blocking your tear ducts to retain your tears. Dry eyes cause may be due to reduced tear production from factors such as hormonal changes and certain medications. The other cause may be a result of tears drying out too quickly due to a decreased blink rate, contact lenses and certain medications. Dry eyes are diagnosed by an optometrist through a slit lamp biomicroscope, using sodium fluorescein dye or by measuring your tear production.

What are Dry Eyes?

Dry eyes are defined as having an insufficient amount of moisture in your eyes to maintain their health and is one of the many common eye problems that can easily develop from a range of causes. Tears are produced by glands in the eye and blinking throughout the day coats your eyes with a thin layer of tear film. The tear film aids in keeping the eyes safe from a build-up of foreign matter and maintaining moisture. When there is not enough moisture in the eye, you may experience irritation, itchiness and a gritty sensation.

How Common Are Dry Eyes?

Dry eyes are common across all age groups and it is reported that most Australians have experienced dry eyes according to the 2022 Vision Index. Respondents who experienced dry eye symptoms in this study amounted to 85%.

How Dry Eyes Developed?

Dry eyes are developed when the eyes are producing tears but they evaporate before effectively lubricating the eye. The quality of the tears that are produced is essential due to how they particularly moisturise the eye. The lacrimal (tear) glands produce tears consisting of a combination of water, mucus and oil. Each of these substances contributes to creating moisture in the eye, while the mucus layer aids in evenly distributing the tears over the eye. The oil that is produced prevents the water layer from evaporating too quickly. Poor-quality tears can result from factors like meibomian gland dysfunction, a reduced blink rate, contact lens wear, and certain medications. Meibomian gland dysfunction is when the meibomian (oil) glands in the eyelid do not produce enough or quality oil according to the National Institutes of Health. Meibomian gland dysfunction can be managed through a warm compress over the eyes, antibacterial eye drops and artificial tears. The amount of tears that can be generated is also vital in maintaining the health of the eye. As you age, you tend to generate fewer tears or as a side effect of some medications. According to the American Optometric Association, during dry or windy climates, your tears are more vulnerable to tear evaporation, which can increase the risk of dry eye.

What Do Dry Eyes Feel Like?

Dry eyes can feel like there is foreign material in your eye and a sensation of grittiness. Other symptoms related to the feeling of dry eyes are pain, burning, itching and light sensitivity.

What are the Causes of Dry Eyes?

The causes of dry eyes can be a consequence of many factors such as aging, medical conditions, wearing contact lenses, hormonal changes, eye surgery, frequent eye-rubbing, phone and computer screen time and infrequent blinking. The different causes of dry eyes and their definitions are listed below.

Aging: Aging can be a cause of dry eyes as you naturally produce fewer tears as you get older.
Medical conditions: Medical conditions such as diabetes, thyroid and rheumatoid arthritis can increase the risk of developing dry eye.
Wearing contact lenses: Wearing contact lenses may cause dry eye due to the thin disk of the contact lens allowing less oxygen to flow to the eye.
Hormonal changes: Hormonal changes can affect the glands in and around the eye which can disrupt tear production.
Eye surgery: Types of eye surgeries such as cataract surgery can affect the stability of your tears which may trigger dry eye.
Eye-rubbing frequently: Eye-rubbing frequently can worsen the feeling of dryness in your eyes.
Looking at a phone or computer screen for long periods: Looking at a phone or computer screen for long periods can cause you to blink less, which may lead to dry eye.
Not blinking regularly: Not blinking regularly can cause fewer tears to coat your eyes which may lead to dry eyes.

1. Aging

Aging can significantly contribute to developing dry eye as a result of the lacrimal gland changing as you get older. According to Stefano Barabino in a paper published in BMC Ophthalmology, the increased use of topical and systemic medications, changes to eyelid structure and menopause are factors that can cause the lacrimal gland to generate fewer tears. Other major causes of reduced tear production as a result of tear film deterioration are eyelid abnormalities, meibomian gland dysfunction and reduced reactions to corneal stimulation. An optometrist may prescribe eye drops, warm compress or cleaning solution for eyelids to relieve symptoms of dry eye and any inflammation.

An elderly patient receiving treatment for dry eyes.

2. Medical Conditions

Medical conditions such as autoimmune diseases can result in the development of dry eyes due to their impact on the essential regions of the eye. Diabetes may lead to dry eyes as high insulin levels can damage nerves in the lacrimal glands. These nerves allow for the tears to stick to the eye according to the American Diabetes Association. Thyroid conditions may lead to dry eye as it can cause lacrimal gland inflammation and affect the cells around the eye. According to Mayo Clinic, rheumatoid arthritis can affect the tissues around your eyes, which can cause unusual tear production. It is important to consult with your optometrist if you have any of these conditions as they will be able to determine the cause of your dry eye.

3. Wearing Contact Lenses

Wearing contact lenses may increase the risk of developing dry eye as it reduces the amount of oxygen that can flow to the eye. According to the National Library of Medicine, wearing contact lenses can result in tear film separation, creating pre and post-lens film. This may lead to complications in the distribution of the outer layer of the tear film, tear evaporation and instability of the tear film. The three layers in the tear film also include an outer lipid layer which functions to stabilise the tear film. It is advised to consult with an optometrist if you have dry eyes and use contact lenses as they may recommend using lubricating eye drops.

4. Hormonal Changes

Hormonal changes can be a factor in developing dry eyes, especially for women who may be on birth control pills, going through pregnancy or menopause. According to the Wellington Eye Centre, hormone receptors are found in the lacrimal glands and meibomian glands. These glands are responsible for producing tears and oils within the eye. Changes in hormones may also result in inflammation around the eye, which may cause symptoms of dry eye. An optometrist can assist with prescribing eye drops or gels to relieve these symptoms and determine the underlying cause.

5. Eye Surgery

Eye surgery such as cataract surgery or laser eye surgery may trigger symptoms of dry eyes as they can mainly affect the tear film. Cataract surgery may cause the lipid layer to become thinner, which can impair the tear film and trigger dry eye symptoms. The other effects of cataract surgery that can link to dry eyes include corneal nerve damage, inflammation, light exposure and eye drop medications. The changes to your cornea shape from laser eye surgery can cause unusual tear distribution when blinking. This occurs due to the surgery’s impact on the relationship between the ocular surface and the eyelids according to the National Library of Medicine.

6. Eye-Rubbing Frequently

Eye-rubbing frequently can worsen symptoms of dry eyes as it may cause damage to the surface of the eye. Damage or scratches to the surface of the eye can increase the risk of dryness occurring. You may need to rub your eye due to itching or irritation which may be triggered by eye allergies or debris. In this case, it may be best to use eye drops to help alleviate itching or to wash out any debris according to the Vision Eye Institute.

7. Looking at a Phone or Computer Screen for Long Periods

Looking at a phone or computer screen for long periods may cause you to blink less, causing incomplete blinking, tears to dry out quickly and dry eye. According to the National Library of Medicine, extended periods of screen time weakens the spread of tears on the eye's surface. This results in tears drying out too quickly, causing dry eyes. Actively remembering to blink more while looking at computer screens and taking regular breaks may help.

A female looking at a computer and experiencing dry eyes symptoms

8. Not Blinking Regularly

Not blinking regularly can prevent your tears from coating your eyes with the moisture it needs to stay healthy. The eyelid’s main purpose of protecting the health of the cornea is achieved by retaining the tear film. Ensuring frequent blinking can help strengthen the lipid layer that sits on top of the aqueous layer, according to the National Library of Medicine. A stronger lipid layer can reduce the evaporation of tears.

Can Dry Eyes Cause Vision Loss?

Yes and no. Most cases of dry eyes are not vision threatening and while it cannot be cured, the symptoms can be managed with treatment such as using lubricating eye drops. According to the Mayo Clinic, a complication of severe untreated dry eyes may cause eye inflammation and vision loss. If you are experiencing dry eye symptoms, it is recommended you have your eye health assessed by an optometrist by booking an eye test.

Can Medications Cause Dry Eyes?

Yes, in some cases, certain medications may cause dry eyes. According to Penn Medicine, the medications that may cause dry eyes include diuretics, birth control pills, certain heart medications, tranquilisers and ulcer medications.

What Medical Conditions Cause Dry Eyes?

The medical conditions that can cause dry eyes include diabetes, autoimmune diseases, thyroid conditions and rheumatoid arthritis. Autoimmune diseases impact the essential regions of the eye which can lead to dry eyes. High insulin levels as a result of diabetes can damage certain nerves in the eyes leading to dry eyes. Thyroid conditions may cause dry eyes as it can affect the cells around the eyes. Finally, rheumatoid arthritis may cause unusual tear production as it affects the tissues around the eyes, causing dry eyes.

Can Dry Eyes be a Result of Wearing Contact Lenses?

Yes, dry eyes can be a result of wearing contact lenses due to less oxygen flowing through to the eye. Wearing contact lenses may increase the risk of developing dry eye as it reduces the amount of oxygen that can flow to the eye. According to the National Library of Medicine, wearing contact lenses can result in tear film separation, creating pre and post-lens film. This may lead to complications in the distribution of the outer layer of the tear film, tear evaporation and instability of the tear film. The three layers in the tear film also include an outer lipid layer which functions to stabilise the tear film. It is advised to consult with an optometrist if you have dry eyes and use contact lenses as they may recommend using lubricating eye drops.

What are the Symptoms of Dry Eyes?

The symptoms of dry eyes may include a sensation of grittiness, stinging and burning, itchiness, redness, blurred vision and tearing according to Better Health. These dry eye symptoms are common, however, you may not experience all of them. The symptoms of dry eyes are listed below.

Sensation of grittiness: Sensation of grittiness is a symptom of dry eye that can be described as a scratchy or rough feeling in the eye.
Stinging and burning: Stinging or burning is a dry eye symptom that can occur when your eyes are excessively dry.
Itchiness: Itchiness is a symptom of dry eye that can occur when your eyes do not have enough moisture.
Redness: Redness is a symptom of dry eye that can be caused when not enough tears are being produced to cover the eye.
Blurred vision: Dry eyes may cause blurred vision as the eye’s tear film is not able to wash away foreign matter in the eye.
Tearing: Tearing can occur as a result of dry eye as it triggers the lacrimal gland to generate tears.

A diagram of the different symptoms of dry eyes.

What are the Dry Eyes Complications?

If dry eyes are untreated they can lead to complications which can further affect the eyes. According to BetterHealth, complications of untreated dry eyes include fluctuations in a person’s vision which can affect visual clarity, eye discomfort and damage to the cornea, which in extreme cases can lead to permanent scarring. Another complication of dry eyes discussed by the Mayo Clinic is an increased risk of eye infections due to the eyes’ lack of tear production.

Can Dry Eyes Cause Eye Pain When Blinking?

Yes, dry eyes can cause eye pain when blinking as the lack of moisture in the eye may leave a gritty or rough feeling in the eye. When the eye doesn’t have optimal levels of tear film which serves as a protective barrier and provides ocular comfort, your eyes may feel discomfort and pain when blinking according to the Dean Mcgee Eye Institute. If you are wondering why your eyes hurt when you blink, you can see professional advice from your optometrist so they examine your eyes.

How are Dry Eyes Diagnosed?

Dry eyes are commonly diagnosed by an eye care professional, typically an optometrist. If a person is experiencing dry eye symptoms, it is recommended that they book an eye test so that a professional can assess their eye health. According to the Mayo Clinic, to diagnose dry eyes, an optometrist will perform a comprehensive eye test to determine the health of a patient’s eyes. Next, an optometrist will typically perform a test to measure the volume of tears the patient is producing. This can help determine if the eyes are producing enough tears to lubricate the surface of the eye. You can read more helpful information in our how to detect eye disease article.

Can Dry Eyes be Diagnosed Just by Their Symptoms?

No, dry eyes are not only diagnosed just by their symptoms, there are other tests typically involved to reach a diagnosis. While the diagnosis will include an evaluation of the patient’s symptoms and medical history, there are commonly additional tests performed such as a comprehensive eye test.

Can a Slit Lamp Exam Diagnose Dry Eyes?

Yes, a slit lamp exam can diagnose dry eyes as it can help the optometrist examine different structures of the eye including the conjunctiva, cornea, eyelids, iris, lens and sclera. As a result, the slit lamp examination can identify signs of not only dry eyes but also cataracts, macular degeneration, inflammation and retinal detachment.

What are the Treatments for Dry Eyes?

The treatments for dry eyes typically involve adding moisture to the surface of the eyes. According to BetterHealth, common dry eye treatments include using lubricating eye drops, also known as artificial tears, trying to blink more often, using a humidifier or placing bowls of water around a room to make the air less dry, using medication after consulting with an eye care professional and, for severe cases, treatment may include surgery. Dry eyes cannot be cured permanently, therefore, there is no answer to the question, how to cure dry eyes permanently.

What is the Best Type of Eye Drop for Dry Eyes?

The best type of eye drop for dry eyes are artificial tears. Also known as lubricating eye drops, artificial tears can be purchased over the counter for relief from dry eye symptoms. Artificial tears work by bringing moisture back to the eye to reduce dryness. They add lubrication to the surface of the eye in place of tears as the eyes may not be producing enough. For more severe dry eye, a person can use prescription eye drops when recommended by an eye care professional.

Does Dry Eyes Heal Itself?

No, dry eyes do not heal themselves as there is no cure for this eye condition, rather its symptoms can most often be easily managed with treatment. Therefore, dry eye condition does not go away but can become less prominent with treatment.

How Long Does it Take for Dry Eyes to Heal?

As mentioned above, there is no specific time it takes for dry eyes to heal as this eye condition cannot be cured, rather its symptoms can be managed. Dry eye management typically involves using eye drops regularly to add moisture to the surface of the eye and avoiding situations that trigger dry eye symptoms.

How are Dry Eyes Prevented?

According to the Mayo Clinic, dry eyes can be prevented by paying attention to the situations that trigger the symptoms and attempting to find ways to avoid these situations. Some common ways to prevent dry eyes include taking breaks from tasks, wearing sunglasses, using artificial tears, quitting smoking and avoiding air blowing on the eyes. The different ways dry eyes may be prevented are listed below.

Take breaks from tasks: It is important to give the eyes a rest by taking breaks from long tasks that require the eyes to concentrate intensely. These activities can include reading, working on a computer and driving.
Wear sunglasses: Sunglasses should be worn to protect the eyes from the harmful UV rays emitted by the sun. Sunglasses can also help prevent dry eyes as they shield the eyes from aggravating environmental factors such as wind and dust.
Use artificial tears: Artificial tears, also known as lubricating eye drops, help bring moisture to the eyes and reduce dryness. They are available over the counter and mimic the tears produced by the eyes.
Quit smoking: Quitting smoking can potentially improve overall eye health and eyesight as tobacco has been proven to cause damage to various parts of the eye. Smoking can also worsen dry eye symptoms, therefore, it is beneficial to quit smoking.
Avoid air blowing on the eyes: To help prevent dry eyes, a person should avoid air blowing directly in the eyes as this can dry out the eyes causing irritation and other dry eye symptoms.

Can Blue Light Glasses Help Prevent Dry Eyes?

Blue light glasses may help prevent dry eyes. The purpose of blue light glasses is to protect the eyes from the potential effects of blue light from digital devices. Some of the effects of high blue light exposure include eye strain and dry eyes. However, the effectiveness of blue light glasses may vary from individual to individual.

Does Drinking Enough Water Help Prevent Dry Eyes?

Yes, drinking enough water can help to prevent dry eyes as it aids the eyes in producing an adequate amount of tears. According to the Canadian Association of Optometrists, staying hydrated helps to keep the eyes moisturised, avoiding dry eye symptoms. Dehydration affects the whole body, not just the eyes, but some eye-related signs that indicate you need to drink more water include sensitivity to light, a gritty feeling in the eyes and a burning sensation in the eyes. It is important to stay hydrated by drinking plenty of water throughout the day to help prevent dry eyes.

Is Wearing Sunglasses Outside Helpful in Preventing Dry Eyes?

Yes, wearing sunglasses outside can be helpful in preventing dry eyes. Sunglasses have tinted lenses that protect the eyes against ultraviolet radiation emitted from the sun. People often suffer from dry eyes due to environmental factors such as wind and dry climates. Wearing sunglasses can protect the eyes from aggravating environments as they block wind and dust from entering the eye which can cause dry eyes. Sunglasses are also beneficial in preventing certain eye diseases as, according to UPMC HealthBeat, prolonged exposure to the sun can increase a person’s risk of developing cataracts and macular degeneration. Read our article on the best UV sunglasses for eye protection to find a pair that suits your needs.

Does Lutein Help Prevent Dry Eyes Symptoms?

Lutein can help prevent dry eye symptoms. Lutein is a fat-soluble antioxidant nutrient in the carotenoid family that can be found in dark green, leafy vegetables such as spinach and kale. A study done by Frontiers Organisation showed the beneficial effects of 6 months of lutein and zeaxanthin supplementation were done by regular users of electronic screens. There were improvements in several ophthalmic examinations done for dry eyes and visual health.

How Can Presbyopia Patients Experience Dry Eyes?

Patients with presbyopia may experience dry eyes as age can significantly contribute as a risk factor for developing both presbyopia conditions and dry eyes. As you get older, the eye’s ability to produce a sufficient amount of tears to sustain moisture declines and can therefore lead to dry eyes. The same can be said for developing presbyopia, with increased age, the lens becomes less flexible, making it more difficult for the lens of the eye to focus on objects.

Does Smoking Make Dry Eyes Worse?

Yes, smoking can make dry eyes worse. It can lead to Dry Eye Syndrome, an eye condition that can be aggravated or caused by smoking. Tobacco is a known eye irritant and can worsen dry eye symptoms. Tobacco smoke breaks down the lipid layer of the tear film, making it a potential factor in dry eyes.

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