Dry Eyes: Top 5 Remedies, Prevention and Causes

Chronic dry eyes are a common condition that result in a gritty, dry feeling in the eyes especially when blinking. Most often, the condition can be treated effectively by using over-the-counter rewetting drops and modifying your environment.

  1. Dry Eyes Symptoms
  2. Dry Eyes Causes
  3. 3 Possible Dry Eyes Conditions
  4. Dry Eyes Treatments & Prevention
  5. Real-Life Stories
  6. Questions Your Doctor May Ask
  7. Statistics
  8. Related Articles

Dry Eyes Symptoms

Dry eyes are a relatively common condition, especially in older adults, that can be very uncomfortable and lead to damage of the surface of the eye. They are caused by a decrease in the tear production of the eye or an increase in tear evaporation. Risk factors include age, female gender, use of contacts, Sjogren’s syndrome, diabetes, use of certain medications, and vitamin A deficiency. The predominant symptoms are dry and red eyes, irritation of the eye, and a feeling that there is an object in the eye. The primary treatment for dry eyes is to use rewetting drops or artificial tears, which are available over-the-counter.

Main symptoms

The symptoms of dry eyes are generally the result of the increased friction of the eyelid rubbing on the dry eye surface. This can lead to inflammation as a result.

  • Eye dryness: The predominant symptom is a feeling that your eyes are “drying out.”
  • Eye redness: This is a result of an inflammatory response to the irritated eye surface and is reversible.
  • Foreign body sensation: This is the feeling that there is something in the eye or that there is a general “grittiness” or “coarseness” of the eye during blinking.
  • Reactive tearing: In response, the eye may produce a large number of tears.
  • Stinging/burning eyes
  • Inability to wear contact lenses

Symptoms of Sjogren’s Syndrome

If dry eyes are also present with the following symptoms, they can indicate the presence of an immune condition, called Sjogren’s Syndrome.

  • Dry mouth
  • Difficulty swallowing
  • Waking up at night to drink water
  • Vaginal dryness

Consequences of dry eyes

If untreated, dry eyes can lead to some serious complications, including:

  • Decreased visual sharpness
  • Eye infection
  • Eye ulceration

Dry Eyes Causes

There are a wide variety of causes of dry eyes. Many tests are available to diagnose the origin of dry eyes, however, these tests may only tell you that have dry eyes, not why you have dry eyes. Every diagnosis begins with a thorough patient history, which may reveal certain environmental or family risks that may give a clue to the source of the dry eyes. Some of these tests include fluorescein tear breakup time, the Schirmer test, and ocular surface dye staining.

The fluorescein test places a dye in your eye and then observes how long it takes for evaporation of eye tears. The Schirmer test is like a car oil dipstick test: a piece of filter paper is inserted into the eye and the column of tears that forms is measured to see if it is enough. Lastly, the ocular surface dye stain test uses a variety of dyes and a microscope to examine the tear surface of your eye. None of these tests causes pain since numbing drops are used.

The most important risk factor for dry eyes is aging. Aging results in a decline of tear production.

Environmental

There are a number of exposures that can decrease tear production and/or increase tear evaporation:

  • Contact lens use
  • Pollution level
  • Air dryness and wind level
  • Damage to the tear gland from radiation or burns

Autoimmune causes

Disorders of the immune system that cause damage to the tear glands include:

  • Sjogren’s
  • Rosacea
  • Lupus

Non-autoimmune causes

Non-autoimmune conditions can also cause dry eyes:

  • Diabetes
  • Thyroid disorders
  • Previous surgery on the eye
  • Structural abnormality of the eyelid
  • Blepharitis
  • Use of medications: Such as antihistamines (i.e. Benadryl), decongestants (i.e. Sudafed), antidepressants, hormone replacement therapy and birth control, and Parkinson’s disease [1] Vitamin A deficiency

3 Possible Dry Eyes Conditions

The list below shows results from the use of our quiz by Buoy users who experienced dry eyes. This list does not constitute medical advice and may not accurately represent what you have.

Inflamed eyelid (blepharitis)

Inflamed eyelid, or blepharitis, is a bacterial infection of the skin at the base of the eyelashes.

If the oil glands around the eyelashes become clogged, normal skin bacteria will multiply in the oil and cause infection. The glands can become blocked due to dandruff of the scalp and eyebrows; allergies to eye makeup or contact lens solution; or eyelash mites or lice.

Symptoms include red, swollen, painful eyelids; oily, dandruff-like flakes of skin at the base of the eyelashes; and eyelashes that grow abnormally or fall out.

If the symptoms do not clear with hygiene, see a medical provider. Blepharitis can become chronic and lead to infections of the eyelids and cornea; dry eyes which cannot take contact lenses; and scarring and deformity of the eyelids.

Diagnosis is made through physical examination of the eyelids, under magnification and through skin swab of the eyelashes.

Treatment includes warm compresses and careful washing of the eyelids; antibiotics in pill or cream form; steroid eyedrops; and treatment for any underlying condition such as dandruff or rosacea.

Rarity: Common

Top Symptoms: eye itch, sensitivity to light, eye redness, feeling of something in the eye, dry eyes

Symptoms that never occur with inflamed eyelid (blepharitis): severe eye pain

Urgency: Self-treatment

Dry Eyes Symptom Checker

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Chronically dry eyes

Chronically dry eyes are a relatively common condition, especially in older adults, that can be very uncomfortable and lead to damage of the surface of the eye. They are caused by a decrease in the tear production of the eye or an increase in tear evaporation. Risk factors inc...

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Vernal conjunctivitis

Vernal conjunctivitis is long-term (chronic) swelling (inflammation) of the outer lining of the eyes due to an allergic reaction. Vernal conjunctivitis often occurs in people with a strong family history of allergies, such as allergic rhinitis, asthma, and eczema.

Rarity: Ultra rare

Top Symptoms: wateriness in both eyes, eye itch, eye redness, sensitivity to light, feeling of something in the eye

Urgency: Primary care doctor

Dry Eyes Treatments and Relief

Treatment

The mainstay of treatment of dry eyes is eye rewetting drops or “artificial tears.” These tears are designed to mimic human teardrops. They consist of saline (salty water) solution that is not irritating to the eye. Certain “heavier duty” drops exist that contain some oil in them in order to increase how long the drop stays in your eye. These drops are typically milky white in color but do not cloud your vision after a few blinks. Generally, you should put one drop in each eye as needed, but if you use rewetting drops more than six times a day, it is recommended to use a preservative-free formulation. Most of the time, improvement is instantaneous, but it can take a few weeks for the full effect to be reached.

If rewetting drops are insufficient, a doctor may prescribe other medications that are dripped into the eye, such as:

  • Cyclosporine: This decreases inflammation of the eye.
  • Liftegrast
  • Sodium hyaluronate: This provides a jelly-like gel to the eye.
  • Steroids: This decreases inflammation of the eye.
  • Pilocarpine: This increases tear production.

In addition, if your dry eyes are caused or worsened by another condition, then it is important to treat the primary condition, such as diabetes, Sjogren’s Syndrome, thyroid disease, Lupus, etc. Obtaining medical management for these conditions may decrease dryness.

Prevention

Adequate prevention of dry eyes depends on the cause of dry eyes. If the cause is autoimmune (such as Sjogren’s, Lupus, or rosacea), then adequate control of the autoimmune condition may improve eye dryness.

Once you have dry eyes, it is important to treat the condition so as to avoid development of complications of dry eyes. Please see the treatment section above for strategies.

Avoid these activities

The following activities have been linked with worsening dry eyes. Avoiding them may decrease the severity of dry eyes

  • Smoking
  • Multivitamin use
  • Working in conditions that cause air to blow into the eye
  • Staring at a screen for long periods of time

Consider these activities

These are some preventative strategies to decrease the development of dry eyes:

  • Humidification of the air: Using a humidifier for rooms that are dry may help.
  • Eyewear: Eyewear can block excess dry air from entering the eye.
  • Take a break from contacts: Every now and then, give your eyes a rest from contacts, and when you do use contacts, use rewetting drops to prevent damage to the eye.
  • Caffeine use: Caffeine may be protective against developing dry eyes, but we do not suggest you start using caffeine as a treatment for dry eyes.

When to Seek Further Consultation for Dry Eyes

If you do not see improvement in your dry eyes with the alteration of your environment (as above) and use of rewetting drops, it is time to seek a doctor. A doctor can help diagnose why you have dry eyes and prescribe medication to decrease your symptoms. Sometimes, your doctor may refer you to an eye specialist, called an ophthalmologist, if he or she cannot diagnose your condition.

Another time to see a doctor is if you notice other conditions besides dry eyes. For example, if you also notice that you have difficulty swallowing, vaginal dryness, and dry mouth in addition to your dry eyes, then it is important to consult a doctor to see if you have a condition called Sjogren’s Syndrome. Dry eyes can also indicate a worsening of another condition, such as diabetes. It is important to tell all your doctors that you have dry eyes as this may be an indication that treatment for another condition requires refinement.

Real-life Stories

Once your story is reviewed and approved by our editors, it will live on Buoy as a helpful resource for anyone who may be dealing with something similar. If you want to learn more, try Buoy Assistant.

Questions Your Doctor May Ask About Dry Eyes

To diagnose this condition, your doctor would likely ask the following questions:

  • Do you feel like there is something in your eye?
  • Does light bother your eyes more than usual?
  • Is your mouth very dry?
  • Have you recently used Atropine eye drops? It's an eye drop used to treat anterior uveitis to allow your eyes to rest and recover. It is also used sometimes to dilate your eyes for an examination, but this is pretty uncommon.

If you've answered yes to one or more of these questions

Dry Eyes Symptom Checker

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Dry Eyes Symptom Checker Statistics

People who have experienced dry eyes have also experienced:

  • 6% Fatigue
  • 4% Headache
  • 4% Dry Mouth

People who have experienced dry eyes were most often matched with:

  • 60% Vernal Conjunctivitis
  • 20% Inflamed Eyelid (Blepharitis)
  • 20% Chronically Dry Eyes

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

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