Dry Eyes: Causes, Symptoms, Prevention, & Treatment

Have you ever felt scratchy or irritated in your eyes after using long hours of the screen?

Your answer might be Yes!

This might be due to dry eyes. 

Dry eyes are a common condition caused by the eyes' inability to produce enough tears to provide lubrication. The condition has become very common these days, affecting millions worldwide. 

But what’s the solution?

The condition can be manageable with the right treatment and lifestyle changes. You only need to take measures to control the symptoms of dry eyes.

In this blog, we will discuss the cause, symptoms, and treatment of dry eyes, along with preventive tips and home remedies. 

What is Dry Eye?

Dry eye is an eye problem that affects the tear film, the three layers of tears that protect the surface of your eyes. It occurs when your eyes cannot produce sufficient tears or the tears evaporate too fast.

Your eyes need a smooth film to work properly, and when there are not enough tears, you might feel uncomfortable, irritated, burning, itching, or blurred vision. 

Tears are important for keeping your eyes lubricated, washing away dust and debris, and providing a smooth surface for clear vision. 

Dry eye syndrome, also called keratoconjunctivitis sicca (KCS), can be a chronic condition that can be managed with proper treatment and lifestyle modifications.

Types of Dry Eyes

Dry eye can be categorized into several types based on its causes:

Aqueous Deficient Dry Eye

In this condition, your eyes do not produce enough tears. This occurs when the lacrimal glands, responsible for making the water layer of tears, fail to produce enough moisture. Some autoimmune conditions may lead to this issue and prevent enough aqueous tears. As a result, the eyes become dry and irritated.

Evaporative Dry Eye

In this case, tears evaporate too quickly because of problems with the oily layer of the tear film. This can occur due to dysfunction of the meibomian glands in the eyelids, which secrete oils that help prevent tear evaporation.

Mixed Dry eye

Some people have aqueous deficient dry eye and tear film instability. This means that their eyes do not produce enough tears, and the tear film is unstable. This condition may cause dry eyes. 

What Causes Dry Eyes?

There might be several reasons for dry eyes. Here are some common ones include-

• Aging decreases tear production, and it is common in people over 50.
• Hormonal changes during pregnancy, menopause, or using contraceptives.
• Long screen hours reduce the blink rate and lead to less eye moisture. 
• Exposure to dry air, wind, smoke, or pollution. 
• Wearing contact lenses for long hours without proper care. 
• Autoimmune diseases like Sjögren's syndrome, rheumatoid arthritis, and diabetes. 
• Certain medications like Acetophenazine, decongestants, hormone replacement therapy, and antidepressants. 

Some Medicines That May Cause Dry Eyes

Certain medications can interfere with tear production or cause the eyes to dry out as a side effect. These include:

• Antihistamines
• Decongestants
• Antidepressants
• Birth control pill
• Blood pressure medications (beta-blockers)
• Isotretinoin (Accutane)

Name of some medicines that may cause Dry eyes

• Acetophenazine
• Atropine
• Beta Blockers
• Brompheniramine
• Chlorpheniramine
• Cyproheptadine
• Desipramine
• Diphenylpyraline
• Doxylamine
• Ether
• Hexamethonium
• Morphine
• Nitrous Oxide
• Nortriptyline
• Opium
• Oxprenolol
• Practolol
• Promethazine
• Propranolol

If you’re on any of these medications and experience dry eye symptoms, consult with your doctor for potential alternatives or remedies.

Risk Factors of Dry Eyes 

Several factors may increase your chances of having dry eyes-

• Increasing age
• Hormonal changes
• Prolonged screen time or environmental exposure (e.g., working outdoors)
• Improper contact lens use can exacerbate dry eyes.
• Medicines like Anticholinergics, oral contraceptives, and systemic retinoids.

In India, the widespread use of digital devices and increasing pollution levels have significantly contributed to a rise in dry eye cases, particularly among urban populations.

Symptoms of Dry Eyes

Here are some common signs and symptoms of Dry eyes includes- 

• Redness in the eyes
• Blurred vision, particularly at the end of the day
• Sensitivity to light

Burning, stinging, or scratchy-like sensation in the eyes

• Eye fatigue after reading or using a laptop or phone
• Watery eyes (the body's response to irritation)
• Difficulty wearing contact lenses

These symptoms might look mild, but avoiding untreated, dry skin might lead to complications. 

Complications of Dry Eyes 

People who have dry eyes may experience the following complications if not treated early- 

• Corneal Damage- Severe dry eyes can cause corneal ulcers, infections, or even scarring, impairing vision.
• Eye Infections—Tears protect the eyes from infections by washing away harmful bacteria and particles. A lack of tears increases the risk of eye infections.
• Decreased quality of life—If you continuously ignore the symptoms of dry eyes, they may impact your daily activities, such as reading.

How to Diagnose Dry Eyes?

Your doctor may examine your medical history and an eye and then conduct testing. 

Medical history- Your eye specialist will ask you some questions like- 

• History of eye disease
• If you have any family history
• Symptoms of dry eyes 
• Environmental factors
• Your daily routine activities
• History of surgeries
• History of trauma
• History of medicines
• Whether you smoke
• Allergies

After this, your doctor will check your eyes to identify- 

• The signs of dry eyes
• Check the health of your tear film 
• Identify other causes of dry skin 

After examining the physical factors, your doctor may recommend the following tests-

• Schirmer Test- Measures the quantity of tears produced. A small strip of paper is placed under your lower eyelid to assess tear production.
• Tear Break-Up Time (TBUT)—This test measures how quickly tears evaporate. A dye is placed in the eye, and the time it takes for the tears to evaporate is measured. A time of fewer than 10 seconds may indicate dry eyes. 
• Osmolarity Test- This test assesses the concentration of particles in your tears. High osmolarity indicates poor tear quality.
• Slit Lamp test- This checks the amount of tears your eyes can produce. The healthcare provider shines the light in your eyes and uses a microscope to analyze your eyes and eyelids.

An accurate diagnosis helps tailor the treatment plan to your specific needs.

How to Treat Dry Eyes?

There are various treatments available to treat dry eyes. Your eye specialist may recommend treatment options based on your symptoms and medical history. The treatment options are- 

• Artificial Tears- Over-the-counter or prescription eye drops are commonly used to manage dry eye symptoms.
• Ointments- If you have dry eyes while sleeping, you can apply ointments for relief. 
• Prescription Medications-

•  Cyclosporine (Restasis): Helps reduce inflammation and increase tear production.
•  Lifitegrast (Xiidra): Another anti-inflammatory medication to treat dry eyes.

• Varenicline (Tyrvaya) nasal spray- Varenicline is a nasal spray that increases basal tear production by directly boosting your trigeminal nerve.
• Punctal Plugs- These small devices are inserted into tear ducts to block tear drainage. This allows tears to remain on the eye surface for a longer duration.
• Meibomian Gland Expression- A doctor may manually express the glands to release blocked oils, improving tear quality.
• Scleral Contact Lenses- These large, gas-permeable lenses create a moisture reservoir over the eye surface, relieving severe cases.

5 Best Preventive Tips for Dry Eyes

Here are 5 of the best preventive tips to manage and prevent dry eyes-

1. Take Regular Screen Breaks

Make a 20-20-20 rule: Look at something 20 feet away for 20 seconds every 20 minutes to reduce eye strain. This small exercise will help prevent eye dryness caused by prolonged screen time.

2. Blink More Often

Make an effort to blink your eyes frequently, especially when using digital devices. Blinking helps spread tears across the eye surface and prevents dryness.

3. Stay Hydrated

Keep yourself hydrated by drinking at least 8-10 glasses of water daily. Hydration supports healthy eyes and tear production. 

4. Use a Humidifier

Maintain moisture in the air by using a humidifier and air-conditioned or heated environments to prevent your eyes from drying out.

5. Wear Sunglasses Outdoors

Always wear sunglasses to protect your eyes from wind, dust, and harsh sunlight outside.

These helpful tips can reduce the risk of developing dry eyes and improve eye comfort.

Home Remedies to Treat Dry Eyes

If you are experiencing mild dry eyes, several home remedies can offer relief:

• Warm Compresses- Put a warm and moist cloth on your eyes to help unclog oil-producing glands and increase tear quality.
• Omega-3 Fatty Acids—Including omega-3-rich foods in your diet, like fish, flaxseeds, and walnuts, can improve tear production.
• Blinking Exercises- Practice blinking fully and slowly, which helps spread tears across the eye surface.
• Cucumber Slices- Place cool cucumber slices over your closed eyelids for at least 10–15 minutes to soothe irritated eyes.
• Castor Oil Drops- Some people find relief using castor oil-based eye drops to reduce tear evaporation.
• Avoid environmental triggers- Avoid cigarette smoke, air vents blowing towards your face, and allergens, as they may trigger your symptoms. 

When to See a Doctor?

You should see an eye doctor if you experience any of the following:

• Persistent redness or irritation
• Difficulty performing daily activities due to dry eyes
• Sudden changes in vision, like blurriness or light sensitivity
• Pain in the eyes
• No improvement with over-the-counter treatments

Dry eyes are a common issue, especially in the modern lifestyle. Increased screen time and environmental challenges can flare up symptoms. Therefore, it is essential to understand and take preventive measures and treatments to manage dry eyes. However, if you're experiencing persistent symptoms, don't hesitate to consult an eye care professional or Ophthalmologist for a personalized treatment plan.