Dry eye disease affects the layers of tears that cover your cornea. It happens when you don’t have enough tears or when your tears evaporate too quickly. Symptoms include burning, itching and a gritty feeling in your eye. You may need to try several different treatments, including eye drops and procedures, to find a solution that works for you.
Dry eye is a condition that affects your tear film, the three layers of tears that cover and protect the surface of your eyes. You need a smooth and stable tear film to help you see clearly and comfortably. Disruptions to your tear film can cause uncomfortable symptoms like burning, itching, watering or blurred vision.
Many different factors can prevent your tear film from working as it should and lead to dry eye. That’s why healthcare providers consider dry eye a multifactorial disease. Its causes and risk factors are numerous and complex. So, it may take a while to get to the root of the problem and figure out what’s causing your symptoms. If you have dry eye, it’s important to establish care with an ophthalmologist or optometrist to manage your condition.
From its name alone, you might think dry eye disease simply means your eyes don’t produce enough tears. That’s actually only part of the story. There are several types of dry eye disease.
Dry eye disease is common. Research estimates that 16 million people in the U.S. have dry eye. Around the world, dry eye affects tens of millions of people. It’s more common in Asia compared with North America and Europe. It’s also more common among people who’ve gone through menopause.
Dry eye may occur on its own or along with other medical conditions. In some cases, dry eye is a sign of:
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When you have dry eye, you might feel like there’s something in your eye that just won’t come out. This can feel like a scratchy, gritty or sandy sensation. Symptoms may also include:
The watery eyes symptom may seem confusing. But it’s a common aspect of dry eye. It happens when your meibomian glands aren’t making enough oils for the outer layer of your tear film. So, the middle, watery layer of your tear film evaporates too quickly. In response, your lacrimal glands try to make more watery tears to compensate. But these tears can’t properly coat your eye, as the oily layer would. So, they can’t solve the underlying problem.
Dry eye happens when:
Many different factors can make you more likely to develop dry eye disease or have symptoms that get worse over time.
Some risks you can’t control. For example, the older you get, the more likely you are to develop dry eye. But other risks you may be able to manage through lifestyle changes or adjustments to your medications.
Talk to your provider if you have any of the risk factors listed below. You may be able to make some changes to lower your risk for dry eye or lessen bothersome symptoms.
Healthcare providers diagnose dry eye through your medical history, an eye exam and testing.
Your provider may ask you to fill out a questionnaire to learn about your symptoms and medical history. You should be prepared to provide lots of information, including:
Your provider will give you a thorough eye exam to check the health of your eyes and determine what’s causing your symptoms. During your exam, your provider:
There’s no single test that diagnoses dry eye. Rather, providers may use many tests, including:
Healthcare providers also may order other tests, such as antibody tests, to check for underlying conditions that could be causing your dry eye.
The goals of dry eye treatment include:
There are many possible treatments that may help you (described below).
Your provider will decide which treatments are most appropriate for you based on the severity of your symptoms and any underlying conditions you have. You may need to try many different treatments before finding a solution that works best for you.
Your provider may suggest you start with home remedies, especially if your symptoms are mild. Here are some things you can do:
There are many types of eye drops your provider may recommend. Talk to your provider about the options that are best for you.
If your eyes don’t produce enough tears, punctal occlusion (temporary or permanent) may be a helpful option for you. Through a painless procedure, a provider inserts a plug into the tear drain (punctum) in your lower eyelid. This “plugging” allows more tears to stay in your eyes.
With temporary punctal occlusion, the plug dissolves quickly. If your dry eye improves, your provider may then suggest permanent punctal occlusion. In this case, your provider uses a silicone plug that stays in your tear ducts for as long as needed.
Your provider can perform in-office procedures to help your dry eye. Some common options include:
Dry eye disease can make the simple act of blinking very painful. That’s because your eyelid rubs against the dry, irritated surface of your eye. Therapeutic contact lenses can help by protecting and lubricating the surface of your eye. These lenses come in several forms, including:
Your provider will discuss the different contact lens options with you to find the most suitable option.
Dry eye disease has many causes, so it can be hard to prevent. You may be able to reduce your risk by:
Dry eye is a chronic condition. It doesn’t have a cure, but treatments can help manage your symptoms.
You may have to try several different treatments to find what works best for you. This can be a stressful process, but it’s worth the effort. Talk to your provider if your current treatments aren’t working or you want to discuss other options.
Living with dry eye isn’t easy. Many people experience stress, anxiety and exhaustion from trying to manage symptoms. If your condition affects your quality of life, talk to your healthcare provider. You may need to try many different treatments before finding an approach that manages your symptoms.
Keep in mind that millions of people have dry eye. So, you don’t have to deal with it alone. Connect with support communities online, and ask your provider for suggestions. Sharing your challenges with others who understand what you’re going through can be a huge help in your day-to-day life.
Your ophthalmologist will tell you how often you need to come in for appointments. If other medical conditions are causing your dry eye, you may need regular follow-ups with other healthcare providers, too. Be sure to go to all of your appointments so your care team can monitor your condition and help you receive treatment.
Call your ophthalmologist if you experience:
A note from Cleveland Clinic
Dry eye disease can affect much more than the comfort of your eyes. It can affect your ability to work, socialize and enjoy life. Dry eye can take a toll on your emotions and your mental health, too. You may feel isolated, but you’re not alone. Connect with others who have this condition, and share your experiences. It takes patience and perseverance, but it’s definitely possible to find relief.
If your current treatments aren’t working, don’t hesitate to reach out to your provider. Tell them how you’re feeling and ask what other treatments are available to manage your condition and restore your quality of life.
Last reviewed by a Cleveland Clinic medical professional on 11/28/2022.
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