Dry Eye Syndrome: Symptoms, Causes & Treatment

Dry eye syndrome occurs when the eyes do not produce enough tears or when tears evaporate too quickly. It can cause intense itching, redness, burning, stinging, a gritty or foreign-body sensation, sensitivity to light, and blurred vision.

Dry eye syndrome, also known as keratoconjunctivitis sicca, is more common in older adults because tear production can decrease with age. It can also affect people who spend many hours in front of a computer or those with rheumatoid arthritis, Sjögren syndrome, lupus, or blepharitis.

Treatment for dry eye syndrome should be guided by an ophthalmologist (eye doctor) and depends on the cause and severity of the symptoms. It may include daily care measures, artificial tears, warm compresses, prescription eye drops, or ophthalmic ointments.

Main symptoms

The main symptoms of dry eye syndrome are:

• Stinging, burning, a gritty feeling, or the sensation that something is in the eyes

• Redness or a feeling of pressure in the eyes

• Heavy eyelids or difficulty opening the eyes

• Increased sensitivity to light or blurred vision

• Glare or halos around lights, especially at night

• Difficulty driving at night or reading

• Itchy eyes or sharp eye pain

Other symptoms may include tired eyes, frequent blinking, and watery eyes, which can occur as the body’s response to excessive dryness. In more severe cases, the person may be unable to produce tears.

Dry eye symptoms mainly develop when the quantity or quality of tears decreases. This reduces eye lubrication and can lead to irritation and inflammation.

Confirming a diagnosis

Dry eye syndrome is diagnosed by an eye doctor based on the person’s symptoms, lifestyle habits, medical history, and a comprehensive eye examination.

The doctor may also perform tests to evaluate tear production and tear-film stability. According to the National Eye Institute, tests used to diagnose dry eye may include a slit-lamp examination, the Schirmer test, and a tear breakup time test.

The results of these tests, together with the eye examination and medical history, help confirm the diagnosis, assess the type and severity of dry eye, and guide the most appropriate treatment.

Possible causes

Dry eye syndrome can be caused by reduced tear production, excessive tear evaporation, or an insufficient amount of oil in the tear film.

Risk factors

The main factors that can contribute to dry eye syndrome are:

• Age, as dry eye is more common after age 50

• Wearing contact lenses for long periods

• A history of refractive surgery, such as LASIK

• Eye conditions such as inward- or outward-turning eyelids, blocked meibomian glands, or blocked tear glands

• Autoimmune diseases, such as rheumatoid arthritis, lupus, or Sjögren syndrome

• Other conditions, such as scleroderma, Parkinson’s disease, thyroid disorders, or graft-versus-host disease

• Vitamin A deficiency

Dry eye can also be linked to menopausal hormone therapy and certain medications, including oral contraceptives (birth control pills), decongestants, antihistamines, antidepressants, beta-blockers, and diuretics.

Other common triggers include prolonged exposure to sunlight, wind, or air conditioning, as well as spending long periods using a computer or cell phone.

Dry eye during pregnancy

Dry eye is common during pregnancy and usually improves after the baby is born. Eye drops can help relieve discomfort but should only be used if recommended by a healthcare provider.

Dry eye syndrome treatments

Treatment for dry eye should be guided by an ophthalmologist and focuses on improving eye lubrication. The recommended approach depends on the underlying cause and the severity of the symptoms.

The main treatments for dry eye syndrome are:

1. Environmental changes

Environmental changes can help relieve dry eye symptoms.

Reducing exposure to air conditioning, taking breaks from computers and cell phones, and using a humidifier to add moisture to the air may help.

2. Using artificial tears

An ophthalmologist may recommend preservative-free artificial tears to keep the eyes moist and relieve dry eye discomfort.

3. Applying warm compresses

Applying a warm compress to the eyelids with sterile gauze for about 5 minutes can help keep the eyelids clean and relieve dry eye discomfort.

4. Taking supplements

Omega-3 supplements may help improve tear quality and support tear production in some people.

A doctor may also recommend vitamin A supplements if a deficiency is confirmed.

These supplements should only be taken under medical supervision, as they are not FDA-approved treatments for dry eye syndrome.

5. Using eye drops

An ophthalmologist may prescribe eye drops or ophthalmic ointments containing anti-inflammatory medications or antibiotics to reduce inflammation or treat an eye infection.

According to the US Food and Drug Administration, cyclosporine ophthalmic eye drops may be prescribed to increase tear production in certain people with keratoconjunctivitis sicca, also known as dry eye syndrome.

These medications should only be used as directed by an ophthalmologist and according to the underlying cause of dry eye syndrome.

6. Therapeutic contact lenses

Therapeutic contact lenses, such as scleral lenses or bandage contact lenses, may be recommended for dry eye syndrome because they help protect the eyes and retain moisture.

7. Thermal pulsation therapy

Thermal pulsation therapy or intense pulsed light (IPL) therapy may be recommended for dry eye syndrome caused by meibomian gland dysfunction. This condition affects the oil glands in the eyelids, causing tears to evaporate too quickly and leading to dry eyes.

8. Surgery

Depending on the cause, the doctor may recommend placing a small silicone or gel plug, known as a punctal plug, in the tear duct. The plug reduces tear drainage, allowing tears to remain on the surface of the eye for longer.

Prevention measures

To help prevent dry eye syndrome, it is recommended to:

• Blink more often throughout the day or whenever you remember

• Avoid direct exposure to wind, air conditioning, or fans whenever possible

• Wear sunglasses outdoors to protect the eyes from sunlight

• Drink about 2 liters of water per day to stay hydrated

• Take a break every 40 minutes when using a computer or watching television

• Use a humidifier indoors, especially during winter

These measures can also be followed by people who wear glasses or contact lenses. They can help prevent eye dryness and dehydration, reducing the risk of dry eye syndrome.