Understanding Dry Eye Disease: Causes, Symptoms & Treatment

Dry eye disease occurs when your eyes do not make enough tears or the tears evaporate too quickly. Tears normally lubricate and nourish the cornea; without them, the surface of the eye becomes irritated and inflamed. Dry eye can result from reduced tear production or increased tear evaporation and is more common after age 50, in women, and in people who wear contact lenses or spend long hours on screens. Symptoms include a stinging or burning sensation, scratchy or gritty feeling, sensitivity to light, blurred vision, and sometimes excess tearing as your eyes react to dryness.

Dry eye disease can cause a stinging or burning sensation, a gritty or scratchy feeling, stringy mucus in or around your eyes, redness, light sensitivity, blurred vision or eye fatigue. Some people notice their eyes water excessively as the surface tries to compensate for dryness. Common causes include decreased tear production due to aging, hormonal changes or certain medications (like antihistamines and antidepressants); medical conditions such as rheumatoid arthritis, Sjögren’s syndrome, thyroid disorders or diabetes; long hours of reading or screen use that reduce blinking; contact lens wear; and environmental factors like smoke, dry air or wind. Eye surgeries or eyelid problems that prevent proper blinking can also contribute to dry eye.

A comprehensive eye exam is essential to diagnose dry eye disease and identify underlying causes. Your doctor will ask about symptoms, examine your eyelids and cornea with a slit‑lamp microscope, and perform tests like the Schirmer test to measure tear volume and tear break‑up time to assess tear quality. They may also evaluate your meibomian glands for blockages. Risk factors include older age, female sex and hormonal changes, autoimmune disorders such as Sjögren’s syndrome or lupus, thyroid disease, rheumatoid arthritis, diabetes, high screen time or reading, contact lens wear, eyelid problems, and medications such as antihistamines, decongestants, antidepressants, or beta‑blockers. Environmental conditions like dry or windy climates, smoke, and indoor heating or air conditioning can also contribute to dry eye.

Treatment options for dry eye range from over‑the‑counter artificial tears and lubricating ointments to prescription therapies. Anti‑inflammatory drops like cyclosporine (Restasis, Cequa, Vevye) or lifitegrast (Xiidra) can reduce inflammation, while Miebo helps stabilize the tear film and Tyrvaya is a nasal spray that stimulates tear production. Lacrifill gel plugs or punctal plugs conserve tears. XDEMVY treats Demodex blepharitis, and short‑term steroids like Eysuvis can calm flares. Advanced options include thermal pulsation or intense pulsed light therapy and lid hygiene procedures.

Healthy habits can help prevent or reduce dry eye episodes. Avoid dry or windy environments or wear wraparound sunglasses to protect your eyes. Use a humidifier indoors, take regular breaks from screens, and consciously blink when reading or using digital devices. Stay hydrated by drinking plenty of water, eat a diet rich in omega‑3 fatty acids, and practice daily eyelid hygiene to keep your meibomian glands functioning. Treating allergies and managing conditions like diabetes or thyroid disease can also improve tear quality.

At Mainland Eye, Dr. Pastore and our dedicated team are committed to helping you manage dry eye disease with personalized care. We perform thorough evaluations to identify the underlying causes of your symptoms, use advanced diagnostics like tear osmolarity and meibography, and tailor treatment plans using the latest therapies. We provide ongoing support and education to help you improve your ocular surface health and quality of life.