Dry Eye (Keratitis Sicca)

Dry eye can leave your eyes feeling scratchy, burning, and sensitive to light. Dry eye is either caused by not enough tears being produced or the tears that are produced are not of good enough quality to keep the eye's surface moist.

Dry eye can result when glands around the eye produce fewer tears due to age or other reasons, or the makeup of the three layers of tears (oil, water, and mucus) isn't sufficient.

This article will examine the symptoms, causes, and treatments of dry eye.

Young woman putting artificial tears in her dry eyes

Syefanamer / Getty Images

Symptoms of Dry Eye

Dry eye symptoms can include the following:

  • A feeling of having sand in your eyes
  • Experiencing a burning sensation
  • Blurry vision that occurs periodically
  • Feeling that you can't read for very long
  • Inability to wear contact lenses for long
  • Having eye discharge
  • Noticing your eyes are either watery or very dry at times
  • Finding you are unable to cry when you need to
  • Having tired eyes

Types of Dry Eye

Typically, you may have one of two types of dry eye disease, including:

  • Aqueous tear deficiency, in which your eye does not produce enough tears
  • Evaporative dry eye, in which there is not enough lipid (oil) in the tears and that leads to increased evaporation of the tears

Causes of Dry Eye

Dry eye can occur for a couple of reasons. These can include:

  • There aren't enough tears to keep the surface of your eyes moist due to a condition that may inflame the tear ducts, such as Sjögren's syndrome, lupus, or rheumatoid arthritis (these are all autoimmune diseases in which the immune system attacks your own tissues).
  • The makeup of the tears allows them to evaporate too quickly. This may be due to conditions such as blepharitis (inflammation of the eyelids) or meibomian gland dysfunction (problems with the glands that produce oil needed to keep the eyes moist).

What Medications Can Cause Dry Eye?

Certain medications can cause tear-production issues that can lead to dry eye, including:

  • Antihistamines, such as Benadryl (diphenhydramine), Claritin (loratadine), or Zyrtec (cetirizine)
  • Antidepressants, such as Celexa (citalopram) or Prozac (fluoxetine)
  • Blood pressure drugs, such as Lopressor (metoprolol tartrate), Inderal (propranolol) and Toprol-XL (metoprolol succinate)
  • Cold medications containing decongestants

How to Treat Dry Eye

If your case of dry eye is mild enough, treatment may involve nothing more than home remedies or over-the-counter (OTC) treatments. These may include:

Keep in mind, though, that if OTC steps don't work, you should contact an ophthalmologist (eye doctor) for proper treatment.

Complications and Risk Factors

Usually, symptoms of dry eye can be effectively treated so it's not problematic. But if dry eye is not treated, more serious symptoms can emerge. These include:

  • Development of ulcers (sores on the clear corneal dome over the eye)
  • Occurrence of scarring, when an opacity develops, and the normally clear corneal tissue won't let light through
  • Losing some vision

Some people are more vulnerable to this condition, including:

  • People who menstruate: Those who are perimenopausal (around menopause) or menopausal (when 12 months have been reached without a menstrual cycle), can often find themselves contending with dry eye. This group may experience symptoms such as foreign body sensation and burning. Changing levels of hormones (such as estrogen and androgen) may be the underlying cause since these hormones can affect tear film (a thin fluid layer in the eye).
  • Pregnant people: Due to hormonal fluctuations, pregnant people are prone to dry eyes.
  • Refractive surgery patients: Another group that may sometimes contend with dry eye are those who've undergone refractive surgery such as LASIK (laser-assisted in situ keratomileusis), in which a flap is made and tissue is removed beneath it to reshape the clear corneal dome. After being cut to make the flap, this corneal tissue may become less sensitive and, as a result, fewer tears may be produced.
  • Anyone living in a dry environment: Those who live in a dry environment, such as a desert climate, or who are subject to a lot of smoke, may find themselves with dry eye symptoms.

Are There Tests to Diagnose the Cause of Dry Eye?

If you suspect you have dry eye, you will need to visit an ophthalmologist to confirm this. The ophthalmologist can perform some tests that will help to identify if your eyes are dry and why. These tests include:

  • Schirmer's test can alert the ophthalmologist if you are making enough tears. This test involves numbing the eye's surface and leaving a small strip of paper there for about five minutes. The idea is to determine the amount of moisture on the paper.
  • Tear breakup time testing can help the ophthalmologist to determine the quality of your tears. The doctor will put some dye in your eye and have you blink to spread this around. Then, you will be asked to refrain from blinking to see how long the dye in the tear film continues to cover the surface. If the tears evaporate too quickly, that may be the source of your problem.

When to See a Healthcare Provider

Dealing with symptoms of dry eye can be debilitating. You should contact an ophthalmologist immediately if any of the following occurs:

  • Your eye becomes painful or red.
  • The eyelid begins to droop or the eye begins to bulge.
  • You notice discharge, see a sore somewhere on the eye or around it, or find flaking.
  • In addition to dry eyes, you also notice that your mouth is dry and your joints are stiff or painful.
  • The eye has been injured.
  • You're finding that after a few days, home remedies are just not enough to alleviate dry eye symptoms.

Summary

Dry eye can occur when there's either not enough tears being produced or the quality of the tears isn't what it should be. Symptoms include a gritty sensation and periodic blurriness, among others.

Treatments may include OTC remedies such as using artificial tears, applying warm cloths to the lids, and unclogging oil glands along the lashes with scrubs.

People who are prone to this condition include those who are pregnant or menopausal, those who have undergone refractive surgery, and those living in dry environments. If your eyes do not improve with OTC measures or worsen, it's important to consult an ophthalmologist.

Frequently Asked Questions

  • What causes dry eye?

    Dry eye can occur when there are either not enough tears or the quality of tears is poor. Also, dry eye can result from taking medications, undergoing eye procedures, or having conditions like Sjögren's syndrome or lupus.

  • Can dry eye cause corneal scarring?

    Yes. If dry eye is severe enough and appropriate treatment is not given, corneal scarring can result, along with vision loss.

  • How can I get rid of dry eye?

    If your dry eye is mild enough, measures such as adding a humidifier to your home, using artificial tears, or applying warm compresses may be enough. But if these attempts are not sufficient, you should contact an ophthalmologist who can prescribe medication or offer other treatment.

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12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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