Understanding Dry Eye Disease & Its Treatments — According To Experts

There’s nothing like itchy, irritated eyes to throw your day off course. Maybe you’re dealing with seasonal allergies, or you have something stuck in your eye. Or maybe you stayed up way too late reading and your eyes are just plain tired (we’re guilty of that too). Truthfully, it’s normal to experience the occasional eye dryness—but if your eyes constantly feel like parchment, you might have dry eye disease.

Also known as dry eye syndrome, dry eye disease can trigger a variety of irritating symptoms. It’s also super common, affecting about 16 million people in the US. Here, learn everything you need to know about dry eye, plus the best treatment options available.  

Since your tears are meant to hydrate and protect the cornea (the clear part that covers the eye), this lack of tears can cause inflammation and irritation. Over time, if left untreated, it may even damage the eye’s surface.

There are many possible causes of dry eye disease. Here’s a brief rundown:

As we get older, tear production naturally declines2, causing our tear glands to make less tears. Aging also reduces skin elasticity, making the eyelids sag, says Perez. This can prevent the eyelid from closing properly, which is key for spreading tears across the eye’s surface. Plus, aging increases the need for medication, potentially prompting side effects that further worsen dry eye, notes Perez.

The meibomian glands are found along the edge of your eyelids, right along the eyelashes. They release meibum, a type of oil, that prevents tears from evaporating too quickly. Meibomian gland dysfunction3 (MGD) happens when there’s something wrong with these glands, causing tears to dry up too fast.

Menopause causes a natural drop in androgens, male sex hormones that women naturally have. This can lead to dry eye, as androgens support the function4 of meibomian glands. Even the menstrual cycle can contribute to dry eye, as tear production tends to drop during the follicular phase5. This phase is marked by low levels of estrogen and progesterone, two hormones that affect tear production.

In an autoimmune disease, the dysfunctional immune response can cause inflammation in the eye6, triggering dry eye disease. Examples of autoimmune conditions linked to dry eye include Sjögren's syndrome, rheumatoid arthritis, systemic sclerosis, and lupus.

Dry eye disease is a side effect of many medications, including antihistamines, diuretics, beta-blockers, decongestants, oral contraceptives, oral isotretinoin, antidepressants, and anti-anxiety drugs. Depending on the medication, it can cause dry eye by reducing the function7 of the tear gland or meibomian gland (or both).

Living in a dry or windy area can make your tears evaporate quickly. You might also be more prone to dry eyes if you spend a lot of time in air-conditioned rooms, have pollen allergies, or are frequently exposed to secondhand smoke.

Some habits, like prolonged reading, driving, and looking at screens, can dry out your eyes. Regularly wearing contact lenses can also worsen your symptoms.  

Chronic conditions like Bell’s palsy, diabetes, and hepatitis C are associated with dry eye. The risk is especially high with Parkinson disease, as the condition reduces how often you blink.

The most common symptoms of dry eye disease include:

Typically, your eye doctor will perform a comprehensive eye exam, which might include the following tests:

If you think you have a dry eye disease, chat with an eye doctor. They can determine the cause of your symptoms, along with a personalized management plan. After all, there are a lot of treatment options, so following your doc’s recommendations is the best way to find relief. And as always, talk to your healthcare provider before trying a new treatment for dry eye disease. Your eyes will thank you!