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Dry Eye Syndrome

Also known as dry eye, keratoconjunctivitis sicca, evaporative dry eye

Burning, gritty, tired eyes — and often watery ones — caused by a tear film that is not doing its job.

About 1 minute to read

Overview

A healthy tear film has three layers: mucus that helps it stick, water that does the work, and a thin oil layer on top that stops it evaporating. Dry eye happens when any of those fails. In most people the problem is the oil layer, because the glands in the eyelid margins are blocked.

The counter-intuitive part is watering. When the surface dries and stings, the eye floods with reflex tears that lack the oil to stay put — so a constantly watering eye is often a dry one.

What are the common symptoms?

  • Burning, stinging or a gritty, sandy feeling
  • Watery eyes, especially in wind or cold
  • Blur that clears when you blink
  • Red, tired eyes that are worse by evening
  • Contact lenses that used to be comfortable and are no longer
  • Light sensitivity, and heavy eyelids

What causes it, and who is at risk?

  • Blocked oil glands in the eyelids, often alongside blepharitis
  • Age, and hormonal change — it is much more common after menopause
  • Screen use, which halves blink rate
  • Medications: antihistamines, antidepressants, diuretics, some blood pressure drugs, isotretinoin
  • Autoimmune conditions such as Sjögren's syndrome and rheumatoid arthritis
  • Contact lens wear, previous laser surgery, air conditioning and low humidity

How is it treated?

Treatment depends on which layer is failing, which is the point of having it properly assessed rather than working through the pharmacy shelf.

  • Warm compresses and lid hygiene for blocked glands, done consistently
  • Preservative-free lubricating drops, gels or overnight ointment
  • Prescription anti-inflammatory drops for the underlying inflammation
  • In-practice gland expression, intense pulsed light, or thermal treatments
  • Punctal plugs to keep the tears you have on the eye for longer
  • Omega-3 intake, humidifiers, screen breaks and reviewing medications

This page is general information, not a diagnosis. Only an eye care professional who has examined you can tell you what is actually going on.

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Related conditions

Computer Vision Syndrome Tired, dry, aching eyes at the end of a screen-heavy day — usually from focus, posture and blink rate rather than the screen itself. Blurry Vision The most common eye complaint there is — and the cause ranges from an outdated prescription to an emergency. Ocular Allergies Itchy, streaming, puffy eyes triggered by pollen, dust or animals — itch is the giveaway. Pterygium A fleshy wedge of tissue growing from the white of the eye onto the cornea, driven mostly by sun exposure.
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