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Dry eye

Dry eye

  • About
  • Symptoms
  • Cost
  • FAQ

Dry eye is a chronic condition affecting about one-third of Australian adults and half of those aged over 50.1 Females are at greater risk of developing the condition.

Normally, a film of tears covers the surface of the eye to keep it moist, and meibomian glands in the eyelids secrete oils to slow evaporation of these tears. Dry eye results if there is an insufficient supply of tears or if the tears evaporate too quickly.

Meibomian gland dysfunction (MGD), where the glands don’t function properly either due to blockage or oil deficiency, is a leading cause of dry eye.

Sufferers have difficulty reading, using a computer, watching TV and driving. In its most severe form, dry eye can be accompanied by inflammation of the eye surface, sleep disturbances and depression. The detrimental effects (physical, emotional, financial) can be quite significant. If left untreated, some people may develop corneal ulcers, corneal scars and, rarely, even loss of vision.2

Dry eye is commonly confused with other conditions, in particular allergies. It can be tricky to diagnose because symptoms vary, are subjective and can be described in many different ways (e.g. ‘feels gritty’ vs ‘feels like something in my eye’).

The condition can’t be cured, but available treatments aim to relieve symptoms and improve quality of life. The earlier dry eye is detected and treatment started, the better.

  • Gritty sensation
  • Watery eyes or excessive tearing
  • Redness
  • Itchiness
  • Foreign-body sensation
  • Burning
  • Pain
  • Sensitivity to light
  • Fluctuating vision

Severe, chronic dry eye can become a major financial burden, particularly with the number of products available that claim to treat dry eye and the complex nature of the underlying disease.

Unfortunately, there is no single treatment that works for everyone. It is best to see an ophthalmologist who is experienced in this area. He/she will perform a comprehensive set of diagnostic tests, recommend the most appropriate treatment for your situation and monitor your condition.

Can dry eye be cured?

There is no cure for dry eye, but there are a number of treatments available – e.g. artificial lubricants, warm compresses, omega-3 supplements, maintaining lid hygiene, medications. It may take a bit of experimentation to find the right option for you. At times your condition will improve and you may be tempted to discontinue treatment.

However, dry eye is a chronic condition and it’s important to continue treatment, unless your doctor tells you otherwise.

Do I still need to use lubrication if I'm on prescription medication?

Yes, keep using lubrication as directed by your doctor. However, make sure that you only use a product recommended by your doctor, as some eye preparations can make dry eye worse.

What can I do to prevent dry eye when wearing a mask?

Mask-associated dry eye (MADE) has become common during the COVID-19 pandemic. When air vents from the top of your mask and across the surface of your eyes, it causes your tear fluid to evaporate more quickly, causing (or worsening) dry eye.

A properly fitted mask forces air to vent downwards, away from your eyes. Wearing a mask with nose wire that can be shaped to fit firmly across the bridge of your nose, or taping down the top of your mask with skin-friendly tape, can help. Additionally, try to blink more often while you wear your mask, as this distributes tear fluid across your eye.

Using dry eye treatments, such as lubricating eye drops (artificial tears), warm compresses or heated eye masks, can also help you manage MADE. If your symptoms persist or are severe, consult your optometrist, who can prescribe medications to help.

If wearing contact lenses has become uncomfortable due to MADE, consult your optometrist for alternative contact lens options.

How can I reduce my risk of dry eye?

To reduce the risk of dry eye disease, you can get 7–9 hours of sleep per night, enjoy a nutritious diet rich in omega-3 fatty acids and exercise regularly.

A risk factor for developing dry eye – among other eye conditions – is overusing digital screens, commonly called Digital Eye Strain.

You can lower your risk of developing Digital Eye Strain by:

  • Reducing your screen use where possible
  • Trying to blink often when using a screen
  • Following the 20-20-20 rule (every 20 minutes, take a 20-second break to look at something 20 feet, or 6 metres, away)
  • Considering changes to your workspace setup.

For more information about Digital Eye Strain, including simple suggestions to help prevent it, read our fact sheet.

Does wearing contact lenses increase the risk of dry eye?

Contact lens use can elevate the risk of dry eye disease or worsen existing dry eye disease. As contact lenses are placed on the eye surface, they can disturb the tear film causing dry eye. The tear film acts as a lubricant for the outer surface of the eye and is made of layers of tears and oil.1

To reduce the risk of dry eye while wearing contact lenses, consider:

  • Using daily disposable contact lenses
  • Implementing best-practice contact lens hygiene, such as hand washing before contact lens application or removal and replacing contact lenses regularly
  • Using lubricating eye drops (your optometrist or pharmacist can advise which options are best for you)
  • Applying warm compresses over your closed eyelids
  • Following good eyelid hygiene
  • Preventing Digital Eye Strain.

Medications may be offered to treat dry eye symptoms. To find out if dry eye medications are appropriate for you, you can consult your optometrist or ophthalmologist.

Can dry eye cause blurry vision?

Blurred vision can be a symptom of dry eye disease. While a healthy tear film – the layers of tears and oil that lubricate the surface of your eyes – allows you to see clearly, dry eye can disrupt the tear film causing blurry vision.

Dry eye is not the only cause of blurred vision so it is best to discuss this with your optometrist or ophthalmologist – especially if vision blurriness does not improve after lubricating eye drop use.

Can dry eye cause double vision?

It is rare for dry eye disease to cause double vision.

If you have double vision, please discuss this with your GP or optometrist as soon as possible. Additionally, if you have recently started experiencing double vision, consult a healthcare professional immediately.

Can dry eye cause headaches?

Dry eye disease does not typically cause headaches. However, some conditions – such as Digital Eye Strain – can cause dry eyes and headaches.

Additionally, migraine may be associated with dry eye disease.2 The nature of this association remains uncertain and more research is necessary to determine if there is an association between the two conditions.

Can dry eye cause floaters?

Dry eye disease is not associated with floaters (spots, transparent blobs or tiny worm-like shapes that drift through your visual field).

While floaters can be a normal occurrence, in rare cases new floaters can be a sign of a serious medical condition. If you have a sudden increase in floaters, or you experience other visual symptoms such as flashes or a ‘curtain’ coming down over your field of vision, these could indicate retinal damage. Please seek medical attention urgently.

Are dry eye drops addictive?

Sometimes, patients with dry eye disease can be concerned that eye drop use will cause their eyes to become dependent on eye drops.

Overusing red eye-reducing drops (which cause vasoconstriction) may cause a side-effect called rebound hyperaemia, this describes the dilation of blood vessels in the eye, causing the eye to appear more red. Rebound hyperaemia may cause eye drop dependence.

However, lubricant eye drops, are generally safe to use and form an integral component of dry eye disease care.

If you have been using over-the-counter lubricant eye drops multiple times a day for two weeks or longer without the advice of an optometrist, it is advised to make an appointment. Your optometrist may suggest alternative treatments or refer you to an ophthalmologist if necessary.

Does menopause increase the risk of dry eye disease?

Dry eye disease is common in women over 50 years of age. Recent science has discovered a link between the natural hormone shifts associated with menopause and dry eye disease,3 but further research is necessary.

Sex hormones, including oestrogen, play a key role in the stability of the cornea (the clear window at the front of the eye) by affecting tear production, corneal cell health and the function of the immune system of the eye.

During menopause, sex hormones levels decline and this may increase the risk of dry eye disease in menopausal and post-menopausal women.

References

For a full reference list, visit the dry eye FAQ page.

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Diagnosing dry eye

Ophthalmologists use a combination of tests to diagnose dry eye, including:

  • Schirmer tear test: Determines if the eye produces enough tears to keep it moist
  • Tear-film osmolarity test: Measures the concentration of various components of the tears
  • Tear breakup time: Measures how quickly the tear film evaporates
  • Corneal fluorescein staining: Shows any abrasions or scratches on the cornea
  • Symptom questionnaires: Helps the ophthalmologist determine the severity of your symptoms

Treating dry eye

It’s important to understand that dry eye can’t be cured – ongoing treatment is required. Early diagnosis and treatment may prevent disease progression.

Inflammation of the surface of the eye is commonly associated with dry eye. Untreated cases can result in pain, corneal ulcers, corneal scars and potentially, though rarely, loss of vision.

Treatment may include the following measures to relieve symptoms and prevent complications:3

  • Regular artificial tears: At least three to four times a day
  • Blink more often: Especially when spending long times in front of a computer or other electronic devices
  • Warm compresses: With either a face cloth or heat bag
  • Eyelid hygiene: Keep eyelids clean, especially if they get crusty
  • Omega-3 fatty acids: Include plenty of these in your diet (found in oily fish, linseeds, chia seeds, tofu and walnuts; supplements are also available)
  • Humidify the room: With bowls of water around the room or a good quality humidifier
  • Wear wraparound sunglasses: To stop the tear film from drying out too quickly
  • Minimise exposure to heaters/airconditioners: To stop the tear film from drying out too quickly
  • Topical steroids: Usually reserved for severe or chronic cases, but do carry a small risk of increasing eye pressure – let your ophthalmologist/optometrist know if you have a family history of glaucoma
  • Surgery: To close the ducts draining tears from your eyes into your nose

Newer treatments

These include intense pulsed light and thermal pulsation. However, their effectiveness is yet to be determined. The effect of hormone replacement and anti-ageing therapies on meibomian glands is also being researched, in the hope of discovering new treatments.

  • Intense pulsed light (IPL): This treatment is usually associated with hair removal, but it has also been used to reduce inflammation along the rim of the eyelids to boost meibomian gland function.
  • Thermal pulsation: Special equipment applies heat and light pressure to the meibomian gland to promote the flow of oil.

Reducing the risk of dry eye

To reduce your risk of developing dry eye, you should:

  • Get adequate, good quality sleep (7–9 hours most nights)
  • Eat a nutritious, balanced diet with plenty of omega-3 fatty acids, including oily fish (such as salmon, sardines, mackerel and anchovies), flaxseeds, walnuts and chia seeds
  • Exercise regularly.

Dry eye can also be caused or exacerbated by Digital Eye Strain. This condition results from screen overuse and affects your vision and eye health.

To protect your eyes from Digital Eye Strain, reduce your use of screens where possible, try to blink regularly when using a screen and follow the 20-20-20 rule (take a 20 second break from your screen and look at an object 20 feet, or 6 metres way, around every 20 minutes). You could also modify your workspace to minimise your risk of Digital Eye Strain.

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References

1. Chia EM, Mitchell P, Rochtchina E, Lee AJ, Maroun R, et al. Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study. Clin Exp Ophthalmol. 2003 Jun;31(3):229-32. doi: 10.1046/j.1442-9071.2003.00634.x.
2. Mayo clinic. Dry eyes [Internet]. Scottsdale (Arizona): Mayo Clinic; 2020 [cited 2021 Jan 27]. Available from: https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863
3. American Optometric Association. Dry eye [Internet]. St Louis (Missouri): American Optometric Association;[date unknown] [cited 2021 Jan 27]. Available from: https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/dry-eye?sso=y

Resources

The information on this page is general in nature. All medical and surgical procedures have potential benefits and risks. Consult your ophthalmologist for specific medical advice.

Date last reviewed: 2025-03-17 | Date for next review: 2027-03-17

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