Do I have dry eyes?

Patients with dry eye experience sandy-gritty irritation or burning in the eyes that generally gets worse as the day goes on.

Eyes can become dry either from not making enough tears, or from rapid tear-film evaporation.

Tear production can go down from conditions like rheumatoid arthritis or Sjögren's syndrome, contact lens wear, surgery (such as LASIK or blepharoplasty), injuries that damage important muscles or nerves, or simply from aging.




Tear evaporation can increase from long-standing eyelid inflammation or blepharitis, or from increased eye exposure, commonly caused by illnes such as thyroid eye disease or Bell’s Palsy. Blepharitis (specifically posterior blepharitis) may be associated with ocular rosacea, and the inflammation causes sandy-gritty eye irritation that is worse in the morning. Long-standing posterior blepharitis results in decreased function of the oil glands in the eyelid. This is important because the oil produced by these glands enters the tear film and coats it, slowing evaporation. With large eyes and with thyroid eye disease the eye surface area exposed to air increases.


How Is Dry Eye Diagnosed?

An ophthalmologist is usually able to diagnose dry eye by examining the eyes. Sometimes tests that measure tear production are necessary. One test, called the Schirmer tear test, involves placing filter-paper strips under the lower eyelids to measure the rate of tear production under various conditions. Another test uses a diagnostic drops to look for certain patterns of dryness on the surface of the eye.

How Is Dry Eye Treated?

Adding Tears

Eyedrops called artificial tears are similar to your own tears. They lubricate the eyes and help maintain moisture. Artificial tears are available without a prescription. There are many brands on the market, so you may want to try several to find the one you like best. Preservative-free eyedrops are available for people who are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you.

Conserving Your Tears

Conserving your eyes' own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry). Your ophthalmologist may close these channels either temporarily or permanently. The closure conserves your own tears and makes artificial tears last longer. There are also medications that can allow your eyes to make more and better quality tears.

Other Methods

Tears evaporate like any other liquid. You can take steps to prevent evaporation. In winter, when indoor heating is in use, a humidifier or a pan of water on the radiator adds moisture to dry air. Wrap-around glasses may reduce the drying effect of the wind, but you should note that they are illegal to wear while driving in some states. A person with dry eye should avoid anything that may cause dryness, such as an overly warm room, hair dryers, or wind. Smoking is especially bothersome. Some people with dry eye complain of "scratchy eyes" when they wake up. This symptom can be treated by using an artificial tear ointment or thick eyedrops at bedtime. Use the smallest amount of ointment necessary for comfort, since the ointment can cause your vision to blur.