Dry Eye

Dry eye happens when your eyes don't make enough tears to properly wet the surface of the eye, or when your tears don't work correctly.

Overview

Normally, glands around your eyes make tears that keep your eyes wet. Dry eye happens when your tears can’t keep your eyes wet enough. This can occur in three ways: your glands don’t make enough tears, your tears dry up too fast, or your tears just don’t work well enough to keep your eyes wet. Dry eye can be a temporary or chronic (ongoing) condition.

Dry eye can occur at any age and may be more common with the use of certain medicines. If severe dry eye isn’t treated, it can sometimes damage your cornea — the clear outer layer at the front of your eye. Left untreated, dry eye can lead to pain, ulcers, or scars on the cornea.

Dry eye can make your eyes feel uncomfortable, and in some cases, it can also cause vision problems. There are many things you can do to keep your eyes healthy and stay comfortable.

Signs and Symptoms

Dry eye can cause a range of symptoms. Common symptoms include:

  • A scratchy feeling, like there’s something in your eye
  • Eye stinging or burning
  • Red eyes
  • Sensitivity to light
  • Blurry vision
  • Feeling as if sand or grit is in the eye
  • Episodes of excess tears following dry eye periods
  • A stringy discharge from the eye
  • Heavy eyelids
  • Inability to cry when emotionally stressed
  • Uncomfortable contact lenses
  • Decreased tolerance to reading, working on a computer, or any activity that requires prolonged visual attention
  • Eye fatigue

Dry eye can also decrease your tolerance for dry environments, such as the air inside an airplane.

Related Health Effects

If left untreated, it can lead to pain, ulcers, or scars on the cornea, and some loss of vision.

Causes and Risk Factors

Some causes of dry eye include:

  • Medicines: Dry eye can be a side effect of some medicines that treat conditions like colds and allergies, depression, and high blood pressure.
  • Health problems: Some health problems — including diabetes, thyroid problems, and autoimmune disorders like lupus or Sjögren’s disease — can cause dry eye.
  • Nutritional deficiencies: Not getting enough vitamin A (found in foods like carrots, broccoli, and liver) or omega-3 fatty acids (found in fish, walnuts, and vegetable oils) can raise your risk.
  • Laser eye surgery: After some types of laser surgery, your eyes may produce fewer tears
  • Windy, smoky, or dry environments: Spending time in these types of places can cause your tears to dry up faster.
  • Looking at screens for long periods of time: You may blink less when looking at computer or tablet screens, which can lead to dry eye.

Anyone can get dry eye. Several factors raise your risk:

  • People age 50 or older
  • Women: Hormone changes during pregnancy and menopause can make it harder for your body to make tears
  • People who wear contact lenses

Conditions Which Can Lead to Dry Eye

  • Blepharitis and dry eye: Blepharitis, a common condition that makes eyelids red, swollen, irritated, and irritated, can lead to dry eye. Oil and flakes can build up in your tear film (a thin layer of tears across the surface of your eye), making your eyes feel dry. Or your eyes may feel watery because your tears aren’t working correctly.
  • Sjögren’s disease and dry eye: Sjögren’s disease is a chronic autoimmune disorder that happens when the immune system attacks the glands that produce tears and saliva. The main symptoms are dry eyes and dry mouth. Most people are over 50 years old when first diagnosed, and women are more likely to develop Sjogren's disease than men.
  • Inflammation of the eye surface: Inflammation of the surface of the eye may occur along with dry eye.

Prevention Guidance

There are steps you can take to help prevent or reduce dry eye symptoms. These include:

  • Using an air cleaner to filter dust and other particles when indoors
  • Using a humidifier to add moisture to the air
  • Avoiding dry conditions and allowing your eyes to rest when performing activities that require prolonged visual attention
  • Using lubricating eye drops while performing tasks that strain your eyes
  • Avoiding smoke, wind, and air conditioning
  • Limiting screen time and taking breaks from staring at screens
  • Wearing wraparound sunglasses when outside

Diagnosis

Your doctor can check for dry eye as part of a comprehensive eye exam.

Be sure to tell your doctor if you think you might have dry eye. To find out if you have dry eye, your doctor might check:

  • The amount of tears your eyes make
  • How long it takes for your tears to dry up
  • The structure of your eyelids

Your doctor may use several specific tests:

  • Slit lamp test: Your eye doctor will use a microscope called a slit lamp to look at your eye and eyelids with a microscope and see if your eyes are making enough tears.
  • Schirmer's test: A Schirmer's test also tells your eye doctor if your eyes are making enough tears. Your eye doctor will put a small piece of paper on the edge of your eyelid and then see how much moisture is on the paper.
  • Tear break up time: This test checks how long your tear film (layer of tears on your eyes) lasts after you blink.

Treatment and Management

Treatment for dry eye usually depends on what’s causing your symptoms. If another health condition is causing your dry eye, treating that condition may improve your dry eye symptoms. Visit an eye care professional if symptoms continue, to begin treatments and avoid permanent damage.

There are several types of treatment that can ease symptoms and help keep your eyes healthy:

  • Over-the-counter eye drops: The most common treatment for mild dry eye is a type of eye drop called artificial tears. You can get these eye drops without a prescription. There are also over-the-counter moisturizing gels and ointments that may help your eyes feel better.
  • Prescription medicines: If your dry eye is more serious, your eye doctor may give you a prescription for eye drops that can help make your eyes less inflamed.
  • Lifestyle changes: If something in your life or your environment is causing your dry eye, or worsening it, your doctor may suggest changes to help protect your eyes. For example, if a medicine you take for another health condition is causing dry eye, your doctor may suggest that you try a different medicine.
  • Glasses and sunglasses: Wearing glasses or sunglasses that fit close to the face — such as wrap-around shades or ones that have side shields — may also help.
  • Tear duct plugs: If tears are draining too quickly from your eyes, your doctor may suggest putting special plugs (called punctal plugs) in your tear ducts — small holes in the inner corners of your eyes. These plugs can help keep your tears in your eyes.
  • Surgery: In some cases, dry eye can happen because your lower eyelids are too loose, causing tears to drain too quickly out of your eye. If this is the cause of your dry eye, your eye doctor may suggest surgery to fix your eyelids and help your tears stay on your eyes.

Living With Dry Eye

If you have dry eye, there are many things you can do to help keep your eyes healthy. Remember these tips:

  • Follow your doctor’s instructions for using eye drops.
  • Tell your doctor if your dry eye is getting in the way of everyday activities.
  • Use an air cleaner to filter dust and other particles when indoors.
  • Use a humidifier in the rooms where you spend the most time.
  • Avoid dry conditions and allow your eyes to rest when performing activities that require prolonged visual attention.
  • Practice blinking, especially when reading or using a computer.
  • Protect your eyes from drafts, breezes, and wind, which can be drying.
  • Don’t smoke and stay out of smoky rooms.

For people with Sjögren’s disease, using eye drops that don’t irritate your eyes and talking with your doctor to find the best drops for you can help manage dry eye symptoms.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on dry eye.

Find Treatment

Talk to your eye care professional about your symptoms and treatment options. Your eye care professional can tell you how often you need to have a comprehensive dilated eye exam. See the Healthy Vision page for more information on how to find quality and affordable vision care.

Community Support

For more information and to find resources, contact:

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.  

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.  

NIH supports research on the causes dry eye and how to treat it better. It also does research on conditions which lead to dry eye, such as Sjögren’s disease.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.