Dry Eyes: Symptoms, Causes, Treatment & Relief — Complete Guide
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Dry eye disease is a common condition in which tears cannot adequately lubricate the eyes, because too few or poor-quality tears are produced. This causes surface inflammation, stinging, burning, redness, light sensitivity and even watery eyes. Most people use lifestyle changes and artificial tears, often indefinitely, while persistent cases may need punctal plugs, prescription drops or special contact lenses.
What the research says
Omega-3 supplements did not beat placebo for moderate-to-severe dry eye. In a double-blind trial of 535 patients (349 given 3,000 mg a day of fish-derived omega-3 and 186 given an olive oil placebo), symptom scores (OSDI) improved by 13.9 points with omega-3 versus 12.5 points with placebo (mean difference −1.9 points, 95% CI −5.0 to 1.1; P=0.21), with no significant differences in eye-surface staining, tear break-up time, or Schirmer test results. (Asbell et al., N Engl J Med, 2018) [3]
Punctal plugs are widely used, but the evidence for them is still inconclusive. A Cochrane review of 18 trials (711 participants, 1,249 eyes) judged improvements in symptoms and commonly tested signs inconclusive; in the three trials comparing plugs with no plugs that measured symptoms, there was little or no improvement, although one trial found people with plugs used fewer artificial tear applications (mean difference −2.70, 95% CI −3.11 to −2.29), and very low-certainty evidence suggested side effects such as watery eyes and itching occurred fairly often. (Ervin et al., Cochrane Database Syst Rev, 2017) [4]
At a Glance
Topic | Key Facts |
What it is | Tears can't adequately lubricate the eyes — too few or poor-quality tears |
Hallmark signs | Stinging, burning, redness, light sensitivity, watery eyes, blurred vision |
Two causes | Decreased tear production; increased tear evaporation |
Higher risk | Age over 50, women, low vitamin A/omega-3 diet, contact lenses, eye surgery |
Complications | Eye infections, corneal ulcers, vision loss, reduced quality of life |
Diagnosis | Eye exam plus Schirmer test, dye test, osmolarity and marker tests |
First-line treatment | Nonprescription artificial tears, gels, or ointments |
Ongoing care | Usually needed indefinitely to control symptoms |
What Are Dry Eyes?
Dry eye disease is a common condition that occurs when your tears aren't able to provide adequate lubrication for your eyes. Tears can be inadequate and unstable for many reasons — dry eyes may occur if you don't produce enough tears or if you produce poor-quality tears. This tear instability leads to inflammation and damage of the eye's surface.
Dry eyes feel uncomfortable: your eyes may sting or burn. Many people experience dry eyes only in certain situations — on an airplane, in an air-conditioned room, while riding a bike, or after looking at a computer screen for a few hours.
There is encouraging news in how this is managed: treatments for dry eyes may make you more comfortable, and these treatments can include lifestyle changes and eye drops. Be aware, though, that you'll likely need to take these measures indefinitely to control the symptoms of dry eyes.
Symptoms: The 9 Warning Signs
Signs and symptoms — which usually affect both eyes — may include:
A stinging, burning or scratchy sensation in your eyes.
Stringy mucus in or around your eyes.
Sensitivity to light.
Eye redness.
A sensation of having something in your eyes.
Difficulty wearing contact lenses.
Difficulty with nighttime driving.
Watery eyes — which is the body's response to the irritation of dry eyes.
Blurred vision or eye fatigue.
That eighth point surprises many people: dry eyes can make your eyes water. It seems contradictory, but watery eyes are the body's response to the irritation caused by dry eyes.
When to See a Doctor
See your health care provider if you've had prolonged signs and symptoms of dry eyes — red, irritated, tired, or painful eyes. Your provider can take steps to determine what's bothering your eyes or refer you to a specialist.
Causes: The Healthy Tear Film and How It Fails
Dry eyes are caused by a variety of reasons that disrupt the healthy tear film. Your tear film has three layers: fatty oils, aqueous fluid, and mucus. This combination usually keeps the surface of your eyes lubricated, smooth, and clear — problems with any of these layers can cause dry eyes.
Tear film dysfunction has many reasons behind it, including hormone changes, autoimmune disease, inflamed eyelid glands, or allergic eye disease. For some people, the cause is decreased tear production or increased tear evaporation.
The tear glands located above each eyeball, called the lacrimal glands, continuously supply tear fluid that's wiped across the surface of your eye each time you blink your eyelids. Excess fluid drains through the tear ducts into the nose.
Decreased Tear Production
Dry eyes can occur when you're unable to produce enough liquid tears, also called aqueous fluid. The medical term for this condition is keratoconjunctivitis sicca (ker-uh-toe-kun-junk-tih-VY-tis SIK-uh). Common causes include:
Cause category | Details |
Aging | Tear production naturally diminishes with age |
Medical conditions | Sjogren's syndrome, allergic eye disease, rheumatoid arthritis, lupus, scleroderma, graft vs. host disease, sarcoidosis, thyroid disorders, or vitamin A deficiency |
Medicines | Antihistamines, decongestants, hormone replacement therapy, antidepressants, and medicines for high blood pressure, acne, birth control, and Parkinson's disease |
Corneal nerve desensitivity | Contact lens use, nerve damage, or laser eye surgery — though symptoms related to surgery are usually temporary |
Increased Tear Evaporation
The oil film produced by small glands on the edge of your eyelids — the meibomian glands — might become clogged. Blocked meibomian glands are more common in people with rosacea or other skin disorders. Common causes of increased tear evaporation include:
Posterior blepharitis (meibomian gland dysfunction).
Blinking less often, which tends to occur with conditions such as Parkinson's disease, or when concentrating on activities like reading, driving, or working at a computer.
Eyelid problems, such as lids turning outward (ectropion) or inward (entropion).
Eye allergies.
Preservatives in topical eye drops.
Wind, smoke, or dry air.
Vitamin A deficiency.
Risk Factors
Several factors make it more likely that you'll experience dry eyes.
Risk factor | Why it matters |
Being older than 50 | Tear production tends to diminish as you get older |
Being a woman | Lack of tears is more common in women, especially with hormonal changes from pregnancy, birth control pills, or menopause |
Low vitamin A diet | Vitamin A is found in liver, carrots, and broccoli |
Low omega-3 fatty acids | Found in fish, walnuts, and vegetable oils |
Contact lenses | Wearing them raises risk |
Prior refractive surgery | A history of laser eye surgery raises risk |
Complications
People who have dry eyes may experience these complications:
Eye infections. Your tears protect the surface of your eyes from infection. Without adequate tears, you may have an increased risk of eye infection.
Damage to the surface of your eyes. If left untreated, severe dry eyes may lead to eye inflammation, abrasion of the corneal surface, corneal ulcers, and vision loss.
Decreased quality of life. Dry eyes can make it difficult to perform everyday activities, such as reading.
Prevention: 8 Habits That Protect Your Eyes
If you experience dry eyes, pay attention to the situations most likely to cause your symptoms, then find ways to avoid them. Eight practical steps make a real difference.
Avoid air blowing in your eyes. Don't direct hair dryers, car heaters, air conditioners, or fans toward your eyes.
Add moisture to the air. In winter, a humidifier can add moisture to dry indoor air.
Consider wraparound sunglasses or protective eyewear. Safety shields can be added to the tops and sides of eyeglasses to block wind and dry air — ask about shields where you buy your eyeglasses.
Take eye breaks during long tasks. When reading or doing another visually demanding task, take periodic breaks: close your eyes for a few minutes, or blink repeatedly for a few seconds to spread your tears evenly.
Be aware of your environment. Air at high altitudes, in desert areas, and on airplanes can be extremely dry; close your eyes for a few minutes at a time to minimize tear evaporation.
Position your computer screen below eye level. A screen above eye level makes you open your eyes wider — position it below eye level so you won't open them as wide, which may slow tear evaporation between blinks.
Stop smoking and avoid smoke. If you smoke, ask your provider for help with a quit strategy; if you don't smoke, stay away from people who do.
Use artificial tears regularly. If you have chronic dry eyes, use eye drops even when your eyes feel fine to keep them well lubricated.
How Dry Eyes Are Diagnosed
Tests and procedures that may be used to determine the cause of your dry eyes include five main approaches.
Test | How it works | What it measures |
Comprehensive eye exam | Complete history of your overall health and eye health | Helps the eye care specialist diagnose the cause |
Schirmer tear test | Blotting strips of paper placed under your lower eyelids for five minutes | Volume of tear production |
Phenol red thread test | A thread filled with pH-sensitive dye placed over the lower eyelid, wetted by tears for 15 seconds | Tear volume (alternative method) |
Tear quality test | Special dyes in eye drops applied to the eyes | Surface condition, staining patterns on the corneas, and how long before tears evaporate |
Tear osmolarity test | Measures the composition of particles and water in your tears | Dry eye disease means less water in your tears |
Tear marker analysis | Tear samples examined for specific markers | Elevated matrix metalloproteinase-9 or decreased lactoferrin |
Treatment Options
For most people with occasional or mild dry eye symptoms, it's enough to regularly use nonprescription eye drops, also called artificial tears. If your symptoms are persistent and more serious, you have other options — and what you do depends on what's causing your dry eyes. Some treatments focus on reversing or managing the underlying condition, while others improve tear quality or stop tears from draining away too quickly.
Punctal Plugs
One approach to treating dry eyes is plugging the openings to the tear ducts with tiny silicone plugs (punctal plugs). These plugs close the tiny opening — the punctum — in the inner corner of your upper and lower eyelids. The closure conserves both your own tears and the artificial tears you may have added.
Treating the Underlying Cause
In some cases, treating an underlying health issue can help clear up the signs and symptoms of dry eyes. If a medication is causing your dry eyes, your eye care specialist may recommend a different medicine that doesn't cause that side effect. If you have an eyelid condition such as ectropion, your specialist may refer you to an eye surgeon who specializes in plastic surgery of the eyelids — an oculoplastic surgeon.
Prescription Medications
Medication type | How it works | Examples |
Medicines to reduce eyelid inflammation | Inflammation along the eyelid edge can keep oil glands from secreting oil into tears; usually taken by mouth, some as eye drops or ointments | Antibiotics |
Drops to control cornea inflammation | Prescription eye drops controlling inflammation on the eye surface; corticosteroids are not ideal for long-term use due to possible side effects | Cyclosporine (Restasis), corticosteroids |
Eye inserts that work like artificial tears | A tiny insert, like a clear grain of rice, placed once a day between your lower eyelid and eyeball; dissolves slowly, releasing a lubricating substance | Hydroxypropyl cellulose (Lacrisert) — for moderate to severe symptoms when artificial tears don't help |
Tear-stimulating medicines | Cholinergics that help increase tear production; available as pills, gels, or eye drops; possible side effect is sweating | Pilocarpine, cevimeline |
Eye drops made from your own blood | For severe symptoms unresponsive to other treatment; a blood sample is processed to remove red blood cells, then mixed with a salt solution | Autologous blood serum drops |
Nasal spray to increase tear production | FDA-approved spray for dry eyes; sprayed once into each nostril, twice a day | Varenicline (Tyrvaya) |
Other Procedures
Closing your tear ducts to reduce tear loss can be done by partially or completely closing the tear ducts, which normally drain tears away. Removable silicone punctal plugs are one option; a procedure using heat — called thermal cautery — is a more permanent solution. Special contact lenses are another option: some people with severe dry eyes may opt for scleral lenses or bandage lenses, which protect the surface of the eyes and trap moisture.
For blocked oil glands, warm compresses or eye masks used daily can help, and a thermal pulsation device is another way to unclog them (though it's unclear whether this method provides an advantage over warm compresses). Intense-pulsed light therapy followed by eyelid massage may help people with severe dry eyes.
Self Care at Home
You may be able to manage your dry eyes with frequent eyelid washing and use of nonprescription eye drops or other lubricating products. If your condition is long term (chronic), use eye drops even when your eyes feel fine to keep them well lubricated.
Selecting Nonprescription Products
A variety of nonprescription products are available — eye drops (artificial tears), gels, and ointments — and your eye care specialist can advise on what might be best for you. Artificial tears may be all you need for mild symptoms; some people use drops several times a day, others only once.
Three factors matter when choosing a product. First, preservative vs. nonpreservative drops: preservatives prolong shelf life, and preservative drops can be used up to four times a day — but using them more often can cause eye irritation. Nonpreservative drops come in single-use vials you throw away after use, and they're safe if you need drops more than four times a day. Second, drops vs. ointments: lubricating ointments coat the eyes and provide longer-lasting relief, but they're thicker and can cloud your vision — so they're best used just before bedtime, while drops can be used anytime. Third, avoid drops that reduce redness: they're not the right solution for dry eyes, as prolonged use can cause additional irritation.
Washing Your Eyelids to Control Inflammation
For people with blepharitis and conditions that block the flow of oil to the eye, frequent and gentle eyelid washing may help. Apply a warm washcloth — hold a clean cloth wetted with warm water over your eyes for five minutes, rewetting as it cools, then gently rub it over your eyelids, including the base of the eyelashes, to loosen debris. Next, use a mild soap on your eyelids: put baby shampoo or another mild soap on your fingertips and gently massage your closed eyes near the base of your eyelashes, then rinse completely.
Alternative Approaches
Further study is needed, but some alternative approaches may help relieve dry eye symptoms — discuss benefits and risks with your eye care specialist. Adding omega-3 fatty acids to your diet (supplements, or foods such as flaxseed, salmon, and sardines) may help. Castor oil eye drops may improve symptoms by reducing tear evaporation. And acupuncture has helped some people improve their symptoms, though more research is needed.
Preparing for Your Appointment
You're likely to start by seeing your family health care provider, who may then refer you to an eye specialist (ophthalmologist). Because appointments can be brief, it's a good idea to be well prepared.
What You Can Do
List any symptoms you're experiencing, including any that seem unrelated. List key personal information, including recent life changes. Make a list of all medicines, vitamins, and supplements you're taking. And list questions to ask. Useful questions include:
What's the most likely cause of my dry eyes?
Do I need any tests?
Can dry eyes get better on their own?
What are my treatment options, and their potential side effects?
I have other health conditions — how can I best manage them together?
Is a generic medicine available for what you're prescribing?
Do you have brochures or other printed material? What websites do you recommend?
Do I need to plan for a follow-up visit?
What to Expect From Your Doctor
Your provider is likely to ask: Can you describe your symptoms? When did they first begin? Have they been continuous or occasional? Do other family members have dry eyes? Have you tried nonprescription eye drops, and did they help? Are symptoms worse in the morning or late in the day? What medicines do you take? Have you had any radiation to the head or neck?
In the meantime, to relieve your signs and symptoms while you wait for your appointment, try nonprescription lubricating eye drops (artificial tears) — and avoid the kind that advertise reducing redness, as they can cause additional irritation.
Frequently Asked Questions
What causes dry eyes?
Dry eyes occur when your tears can't provide adequate lubrication, either because you don't produce enough tears or you produce poor-quality tears. The two main pathways are decreased tear production (aging, certain medicines, autoimmune conditions) and increased tear evaporation (blocked eyelid oil glands, less frequent blinking, wind, smoke, and dry air).
What are the symptoms of dry eye disease?
Signs usually affect both eyes and include stinging, burning, or a scratchy sensation, stringy mucus, redness, light sensitivity, feeling like something is in your eye, difficulty wearing contact lenses or driving at night, watery eyes, and blurred vision or eye fatigue.
Why do dry eyes make your eyes water?
It seems contradictory, but watery eyes are the body's response to the irritation caused by dry eyes — the eyes overproduce reflex tears in an attempt to soothe the irritated surface.
Who is at higher risk for dry eyes?
People older than 50, women (especially with hormonal changes from pregnancy, birth control, or menopause), people with diets low in vitamin A or omega-3 fatty acids, contact lens wearers, and anyone with a history of refractive surgery are at higher risk.
How do doctors test for dry eyes?
Diagnosis usually involves a comprehensive eye exam plus tear tests: the Schirmer test or phenol red thread test to measure tear volume, dye tests to assess tear quality and evaporation time, a tear osmolarity test, and tear marker analysis for elevated matrix metalloproteinase-9 or decreased lactoferrin.
What treatments are available for dry eyes?
Mild cases are often managed with regular artificial tears, eyelid washing, and lifestyle changes. More persistent cases may be treated with punctal plugs, prescription eye drops (cyclosporine or corticosteroids), daily eye inserts, tear-stimulating medicines, a varenicline nasal spray, warm compresses, thermal cautery, special scleral or bandage lenses, or — for severe cases — blood serum eye drops.
Can dry eyes be prevented or cured?
There's no cure — chronic dry eyes usually need indefinite management — but symptoms can be well controlled. Avoiding air blowing at the eyes, using a humidifier, taking screen breaks, keeping the screen below eye level, avoiding smoke, and using artificial tears even when eyes feel fine all help protect and lubricate the eyes.
Conclusion
Dry eyes are a tear problem, not just a comfort problem — unstable tears cause inflammation that can damage the eye's surface if ignored.
Nine warning signs matter — stinging, mucus, redness, light sensitivity, the feeling of something in your eye, contact lens trouble, night-driving difficulty, watery eyes, and blurred vision.
Relief is achievable and ongoing — artificial tears, eyelid hygiene, environmental changes, and when needed plugs, prescription drops, or special lenses keep most people comfortable, usually with long-term care.
This guide covered what dry eye disease is, how to recognize its warning signs, what disrupts the tear film, who is at risk, how it's diagnosed, and the full range of treatments and prevention habits. Explore more complete health guides at rinnit.com.
Your Next Steps
Share your thoughts — comment below with your questions or experience.
Stay updated — sign up on rinnit.com for new complete guides and health updates.
This content is provided for general educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Related Reading
Punctal Plugs: Types, Placement and Side Effects explains punctal plugs for dry eye.
Artificial Tears: Types, Uses and How to Use Them explains artificial tears for dry eyes.
LASIK Eye Surgery: Procedure, Recovery and Results explains how LASIK corrects vision.
Slit Lamp Exam: What It Checks, How It's Done and What to Expect explains the microscope eye exam used to check every part of the eye.
References
Mayo Clinic Staff. Dry eyes - Symptoms & causes. Mayo Clinic. September 23, 2022. https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863
Mayo Clinic Staff. Dry eyes - Diagnosis & treatment. Mayo Clinic. September 23, 2022. https://www.mayoclinic.org/diseases-conditions/dry-eyes/diagnosis-treatment/drc-20371869
Dry Eye Assessment and Management Study Research Group, et al. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018;378(18):1681-1690. PMID 29652551. https://doi.org/10.1056/NEJMoa1709691
Ervin AM, et al. Punctal occlusion for dry eye syndrome. Cochrane Database Syst Rev. 2017;6(6):CD006775. PMID 28649802. https://doi.org/10.1002/14651858.CD006775.pub3
Comments