How to ditch dry eyes for good

We put our eyes through a lot each day. So it’s no surprise that everybody deals with dry, irritated eyes now and again. But for about 16 million Americans, this frustrating feeling happens more regularly. And it can have a widespread impact on daily life.

This condition is called dry eye. It occurs when the glands that create tears “don’t produce enough to lubricate and nourish [the eyes],” says Chantal Cousineau-Krieger, MD, an ophthalmologist with the National Eye Institute. “That can make your eye feel uncomfortable and, in some cases, cause vision problems.”

Dry eye often feels like a burning, watering, itching sensation, or like something is stuck in your eye, says Andrew D. Pucker, OD, PhD. He’s an assistant professor and chief of the Myopia Control Clinic at the University of Alabama at Birmingham. Other common dry eye symptoms include having red eyes, sensitivity to light and blurry vision.

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What causes dry eye?

Dry eye happens when you don’t make enough tears, or the tears that you do make can’t properly protect your eyes. This means that they may evaporate too quickly or can’t spread around your eyes.

Causes and risk factors of dry eye include:

• Medications for treating colds, allergies, depression and high blood pressure
• A blockage or some other abnormality of the oil glands that keep your eyes moist
• Surgeries such as laser eye surgery and cataract surgery
• Windy, smoky or dry environments that make tear evaporation more likely
• Blinking less often, such as when you stare at a computer screen for too long

Conditions such as diabetes, thyroid problems and autoimmune disorders (such as lupus or Sjögren’s syndrome) can contribute, too. A 2021 study in Ophthalmology found that facial rosacea, rheumatoid arthritis, peripheral artery disease and smoking also raise your risk for dry eye. Women and people over age 50 experience hormonal changes that may make them more likely to experience dry eye as well.

What are the treatments for dry eye?

Fortunately, dry eye is often very treatable. Methods vary based on what’s causing the dry eye and can range from simple over-the-counter (OTC) remedies to surgery. Here's a look at some of the available treatments.

OTC options

Artificial tears are usually the first line of defense against dry eye, Pucker says. These eyedrops lubricate the eyes. And they’re very effective for most dry eye cases, he says. These drops also come in gel or ointment form.

Prescription medications

If OTC eyedrops or ointments don’t work, your doctor might prescribe a medication, such as lifitegrast (Xiidra®). These drops can help your eyes make more tears, Dr. Cousineau-Krieger says.

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Medical procedures

Advanced cases of dry eye have the potential to damage the surface of your eyes and harm vision. That’s why doctors will sometimes recommend surgery or other procedures, including:

• Tear duct plugs. In cases where tears drain too quickly from your eyes, your doctor might place small plugs in your tear ducts to keep the tears in your eyes longer.
• Eyelid surgery. In rare cases, some people need surgery to address lower eyelid looseness, Dr. Cousineau-Krieger says.
• LipiFlow® Thermal Pulsation System. Your tears need oil to keep them from evaporating. But sometimes the oil glands along the eyelid don’t work as they should. This procedure applies heat to the inside of the eyelids while squeezing the outside of the eyelids to “remove built-up oil and get the glands flowing again,” Pucker says.
• Scleral lenses. These are large, hard contact lenses that “act like a shield for the eyes by trapping in saline applied with these lenses and keeping them lubricated for the whole day,” Pucker says. Soft contact lenses can sometimes cause dry eye by disrupting the tears. Scleral lenses are a good option for people who still want to wear contact lenses because they can treat dry eye while correcting vision, he adds.
• Prokera® Amniotic Membrane. This procedure is for more severe cases and involves placing amniotic tissue over the eye to help heal cornea damage and relieve dry eye for several months.

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Lifestyle changes

You can try several easy day-to-day changes that might help your dry eye. One is applying a warm compress to your eyes for 5 minutes every day, which “can help clear the oil glands in the eye and help tears flow better,” Dr. Cousineau-Krieger says.

She also recommends drinking more water and making sure you get enough sleep. (Are you battling insomnia? Here’s how to find help.)

Be mindful of how your environment is impacting your dry eye, too. You might think about using a humidifier to raise the moisture levels in your home. And whenever possible, don’t sit in front of or under an air conditioning vent, Pucker says. “That’s one simple change that helps people instantly.”

If you often stare at objects such as screens or crafts, that could promote dry eye — or make it worse. The National Eye Institute recommends the 20-20-20 rule: Every 20 minutes, look about 20 feet away for 20 seconds. This will help prevent dry eye and give your peepers a much-needed (and deserved) break.

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