Dry eyes can cause soreness, grittiness, burning, blurred vision and even excessive watering. For some people, symptoms are occasional and mild. For others, dry eye becomes a persistent problem that affects reading, screen use, driving and everyday comfort.
Understanding the causes of dry eyes is an important first step towards finding the right treatment. Dry eye is not always simply a case of producing too few tears. Problems with tear quality, evaporation, eyelid function and inflammation can all contribute.
At The Medical Eye Clinic in Exeter, dry eye assessment focuses on identifying the factors behind each patient’s symptoms so that treatment can be tailored accordingly.
What Is Dry Eye?
Every time you blink, a thin layer of tears spreads across the surface of your eye. This tear film helps keep the eye lubricated, protects the cornea and supports clear vision.
Dry eye develops when the eyes either do not produce enough tears or when the tear film becomes unstable and evaporates too quickly.
The result can be an irritated and uncomfortable ocular surface.
Common symptoms can include:
- Gritty, sandy or scratchy eyes
- Burning or stinging
- Redness
- Soreness
- Intermittent blurred vision
- Sensitivity to light
- Tired or heavy-feeling eyes
- Excessive watering
Although watery eyes may seem like the opposite of dry eye, irritation can trigger reflex tearing. These watery tears may not contain the right balance of oils and other components needed to keep the eye comfortably lubricated.
What Are the Most Common Causes of Dry Eyes?
There is rarely one single explanation for persistent dry eye. Several factors can contribute at the same time.
Identifying the underlying causes of dry eyes can therefore be more useful than repeatedly trying different lubricating drops without knowing what is driving the problem.
Ageing
Dry eye becomes more common as we get older.
Tear production can decrease with age, while changes to the eyelids and oil-producing glands can make it more difficult for the tear film to remain stable.
Hormonal changes can also contribute, which is one reason dry eye is particularly common among women during and after the menopause.
Age-related dry eye does not mean that symptoms simply have to be accepted. Appropriate treatment can often significantly improve comfort.
Meibomian Gland Dysfunction
Tiny glands along the eyelids, known as the meibomian glands, produce the oily layer of the tear film.
This oil slows the evaporation of tears.
If the glands become blocked or do not produce enough good-quality oil, tears may evaporate too quickly. This is known as meibomian gland dysfunction, and it is a common cause of evaporative dry eye.
Patients may experience irritation, fluctuating vision and a sensation of dryness that becomes worse as the day progresses.
Blepharitis
Blepharitis is inflammation affecting the edges of the eyelids.
It can cause crusting around the eyelashes, irritation, itching and redness. It may also interfere with the function of the meibomian glands and reduce the quality of the tear film.
Managing underlying blepharitis can therefore be an important part of treating dry eye.
Too Much Screen Time
Computer, smartphone and tablet use can contribute to dry eye symptoms.
When concentrating on a screen, people tend to blink less frequently. Blinks may also become incomplete, meaning that the tear film is not distributed evenly across the eye.
This allows tears to evaporate more quickly.
If you notice your eyes becoming increasingly dry, tired or blurry during the working day, your screen habits may be contributing.
Regular breaks, conscious blinking and adjusting your screen position can sometimes help.
Contact Lens Wear
Contact lenses sit directly on the tear film and can contribute to dryness in some patients.
Symptoms may become particularly noticeable after wearing lenses for several hours or in dry environments.
Dry eye can also make contact lenses less comfortable than they once were.
If you’re struggling with contact lens comfort, an eye examination can help determine whether dry eye is contributing and whether changes to your lenses or wearing routine are appropriate.
Air Conditioning and Heating
Environmental conditions can have a significant effect on the tear film.
Air conditioning, central heating and fans can reduce humidity and increase tear evaporation.
People who work in air-conditioned offices or spend long periods in heated rooms may therefore notice worsening dry eye symptoms.
Avoiding direct airflow towards the face and using a humidifier in particularly dry environments may help.
Wind and Dry Weather
Windy conditions increase evaporation from the surface of the eye.
Some patients notice that their symptoms become significantly worse when walking outdoors, cycling or spending time in cold and windy weather.
Wraparound glasses or sunglasses may provide some protection by reducing airflow across the eyes.
Certain Medications
Some medications can contribute to dry eye as a side effect.
These can include certain antihistamines, antidepressants, blood pressure medications and other treatments.
However, you should never stop taking prescribed medication because you think it is causing dry eyes without first speaking to the healthcare professional responsible for your treatment.
If medication may be contributing, your GP or prescribing clinician can advise on the appropriate next steps.
Medical Conditions
Some medical conditions can affect tear production or the surface of the eye.
Autoimmune diseases, for example, can sometimes be associated with significant dry eye.
Persistent or unusually severe symptoms may therefore require a more detailed assessment, particularly if you have other health conditions.
Previous Eye Surgery
Temporary dry eye symptoms can occur after certain eye procedures.
Changes to the surface of the eye, medications used during recovery and reduced corneal sensitivity can all affect the tear film.
Symptoms often improve during the healing process, although some patients need additional dry-eye management following surgery.
How Are the Causes of Dry Eyes Diagnosed?
A dry eye assessment looks beyond whether your eyes simply “feel dry”.
Your eye-care professional may examine the surface of the eye, eyelids and tear film and assess whether tears are evaporating too quickly.
Understanding whether your symptoms are primarily related to reduced tear production, excessive evaporation, eyelid disease or inflammation allows treatment to be more targeted.
This is particularly valuable for patients whose symptoms have not improved despite using over-the-counter eye drops.
How Are Dry Eyes Treated?
Treatment depends on the underlying cause and severity of your symptoms.
For mild dry eye, lubricating drops and simple changes to your environment may provide enough relief.
Patients with more persistent symptoms may require treatment aimed at improving eyelid function, reducing inflammation or helping tears remain on the eye for longer.
Lubricating Eye Drops
Artificial tears are one of the most common treatments for dry eye.
They help supplement the natural tear film and can reduce irritation and discomfort.
Different formulations are available, including preservative-free drops, gels and ointments.
Patients who require drops frequently may be advised to use a preservative-free preparation.
Eyelid Care
If blepharitis or meibomian gland dysfunction is contributing to your symptoms, treatment may involve an eyelid-care routine.
This can include appropriate warm compresses, eyelid cleaning and massage as advised by your eye-care professional.
Improving the function of the oil glands may help stabilise the tear film and reduce evaporation.
Anti-Inflammatory Treatment
Inflammation can be an important part of chronic dry eye disease.
In suitable patients, prescription treatments may be recommended to help control inflammation on the ocular surface.
These treatments need to be prescribed and monitored by an appropriate clinician.
Punctal Plugs
Tears normally drain away through tiny openings in the eyelids known as puncta.
In some patients, small plugs can be placed into these drainage openings to help tears remain on the surface of the eye for longer.
Punctal plugs are not appropriate for every type of dry eye, so specialist assessment is important before treatment.
Lifestyle Changes
Small daily changes can complement medical treatment.
Taking regular breaks from screens, avoiding direct airflow from fans, maintaining good eyelid hygiene and managing contact lens wear can all help reduce dry eye symptoms.
The most effective approach usually combines appropriate treatment with reducing the triggers that make symptoms worse.
When Should You See a Specialist About Dry Eyes?
Occasional mild dryness is common and may improve with simple measures.
However, you should consider arranging an assessment if symptoms are persistent, regularly affect your vision or interfere with your everyday activities.
It is particularly worth seeking advice if you are relying on eye drops frequently without lasting relief or if symptoms are gradually worsening.
Significant eye pain, sudden changes in vision, marked sensitivity to light or a very red eye should be assessed promptly.
Dry Eye Treatment at The Medical Eye Clinic
There are many potential causes of dry eyes, which is why the treatment that works well for one patient may not be appropriate for another.
At The Medical Eye Clinic in Exeter, we take a personalised approach to dry eye care. By assessing your eye health, tear film and eyelids, our specialists can identify the factors contributing to your symptoms and recommend an appropriate treatment plan.
If dry, gritty, watery or uncomfortable eyes are affecting your daily life, contact The Medical Eye Clinic to arrange an assessment and discuss your treatment options.
Frequently Asked Questions
What is the main cause of dry eyes?
There is no single main cause. Dry eye may result from reduced tear production, excessive tear evaporation, problems with the oil glands in the eyelids or a combination of factors.
Can screen time cause dry eyes?
Yes. People tend to blink less frequently while looking at screens, which can increase evaporation from the surface of the eye and make dry eye symptoms worse.
Why are my eyes dry when I wake up?
Dryness in the morning can be associated with tear-film problems, eyelid conditions or the environment in which you sleep. Persistent morning symptoms are worth discussing with an eye-care professional.
Can dry eyes cause blurred vision?
Yes. An unstable tear film can cause vision to fluctuate or become temporarily blurry. Blinking may briefly make vision clearer before it becomes blurred again.
Can dry eyes make your eyes water?
Yes. Irritation from dry eye can trigger reflex tearing, causing the eyes to water excessively even though the underlying problem is dryness.
Are dry eyes permanent?
Dry eye is often a long-term condition, but symptoms can usually be managed effectively. Identifying and treating the underlying causes can make a significant difference to comfort and vision