Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.

Signs and Symptoms of Dry Eye

Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.

Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the glands that make tears to moisten the eye don’t make enough tears, or the tears are made of chemicals that make them evaporate too fast.

There are many reasons why people get dry eyes. There is:

As a normal part of getting older, especially in women over 40.
As a side effect of many drugs, like antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications, and birth control pills.
You live in a dry, dusty, windy, or low-humidity place.

Having air conditioning or a dry heating system in your home or office can also make your eyes feel dry. Another reason is not blinking enough, which can happen when you stare at a computer screen all day.

Some systemic diseases, like lupus, rheumatoid arthritis, rosacea, or Sjogren’s Syndrome, which is a trio of dry eyes, dry mouth, and lupus or rheumatoid arthritis, are also linked to dry eyes.

Other reasons include wearing contact lenses for a long time, not being able to close your eyelids all the way, having an eyelid disease, or not having enough tear-making glands.

Dry eye syndrome is more common in women, which may be because of changes in hormones. New study shows that smoking can also make you more likely to get dry eye syndrome. Dry eye has also been linked to eyelids that don’t close all the way after blepharoplasty, a common cosmetic surgery to fix droopy eyelids.

How to Treat Dry Eyes

Dry eye syndrome is a long-term disease that may not be able to be cured by treatments. But dry eye symptoms, like dryness, scratchiness, and burning, can usually be handled well.

Your eye doctor may suggest that you use fake tears, which are lubricating eye drops that can help relieve the dry, scratchy, and “foreign body” feelings that come with dry eyes. Prescription eye drops for dry eyes take it a step further by helping your eyes make more tears. In some cases, your doctor may also give you a stimulant to help you feel better right away.

Another way to treat dry eyes is with a tiny patch that is filled with a lubricant. The patch is put right inside the lower eyelid, where it keeps releasing moisture all day long.

If you wear contact lenses, you should know that you can’t use many fake tears at the same time. Before using the drops, you may need to take out your contacts. Check the sticker to see how long you should wait before putting them back in. For mild dry eye, contact lens rewetting drops may be enough to make your eyes feel better, but the effect is generally only temporary. You could also try a different brand of lens.

Before you buy over-the-counter eye drops, check the package or, better yet, talk to your doctor. Your eye doctor will know which formulas work and last and which ones don’t, as well as which eye drops will work with your contact lenses.

When you go outside, wear sunglasses to protect your eyes from the sun, wind, and dust. The best safety comes from styles that wrap around.

Indoors, an air cleaner can filter out dust and other particles from the air, and a humidifier can add moisture to air that is too dry because of air conditioning or warmth.

If your dry eyes are really bad, your eye doctor may suggest punctal plugs. Small devices like these are put into the tubes in your eyelids to slow the flow of tears away from your eyes. This keeps your eyes moister.

If your dry eyes are caused by meibomian gland dysfunction (MGD), your doctor may suggest warm compresses and/or an in-office treatment to unblock the glands and get them back to working normally.

Doctors will also sometimes suggest special nutritional supplements with certain important fatty acids to help reduce the symptoms of dry eyes. You might also feel better if you drank more water.

If the dry eyes are caused by a medicine, stopping the drug usually fixes the problem. But in this case, the drug’s benefits must be weighed against the fact that it can cause dry eyes. Switching to a different type of medicine can help relieve the signs of dry eyes while still giving the needed treatment. In any case, you should never change or stop taking your medicines without first talking to your doctor.

It also helps to treat any underlying eyelid disease, such as blepharitis. This could mean that you need antibiotic or steroid drops and to scrub your eyelids often with an antifungal shampoo.

If you want to get LASIK, you should know that if you have dry eyes, you might not be able to get the surgery, at least until your dry eyes are fixed. Dry eyes make it more likely that you won’t heal well after LASIK, so most doctors will want to treat the dry eyes first to make sure the surgery goes well. This is also true for other kinds of surgery to fix eyes.