Do your eyes feel like there are grains of sand in them? Better keep the symptoms in check. What might start as mild dry eyes can advance to a moderate or even severe case.
That’s because dry eye syndrome is generally chronic and progressive. It tends to worsen over time and interfere with your day-to-day activities.
In this post, we cover the length and breadth of mild vs moderate vs severe dry eyes. Understanding the subtle differences between each will help you effectively overcome the condition.
What Is Mild Dry Eye Disease?
Mild dry eyes is the early onset of dry eye disease. It comes with mild symptoms that generally go away on their own.
The first signs of mild dry eyes include occasional dryness and discomfort. While these signs aren’t serious, it’s best to monitor and treat them before they worsen over time.
Symptoms of Mild Dry Eyes
Dry eye symptoms during the initial stage are mild and temporary. You may experience all or most of the following:
- Occasional eye dryness
- Mild discomfort in the eyes
- Burning or stinging sensations
- Itchy eyes
- Excessive tearing
Causes of Mild Dry Eyes
Temporary and easily fixable factors, like environmental exposure and contact lens wear, are often to blame for mild dry eyes.
- Environmental factors: If you’re exposed to dry or windy conditions 24/7, be prepared to experience occasional eye dryness and discomfort. Air-conditioned or heated environments are no better.
- Eye surgery: LASIK or cataract surgery can sometimes disrupt tear film stability, leading to mild and temporary dry eye.
- Contact lenses: Wearing contact lenses for extended periods is also associated with an increased risk of mild dry eye disease. That’s because contact lenses absorb your tears to maintain their shape.
- Medications: Some medications, including antihistamines, decongestants, and certain blood pressure medications, can contribute to mild dry eye as a side effect.
What Is Moderate Dry Eye Disease?
As your mild dry eye symptoms progress, they reach the second stage: moderate dry eyes. In this, you will experience more pronounced dryness. You will also have inflammation on the surface of your eyes, resulting in eye pain.
Moderate dry eyes comes with significant changes in your tear film stability leading to insufficient or poor quality tears. Poor quality tears evaporate quickly, leaving the surface of your eyes feeling dried out.
Symptoms of Moderate Dry Eyes
In addition to the worsening of dry, burning, and watering of the eyes, you will experience a range of other symptoms. Most noticeably, when you have moderate dry eyes, your eyes will become inflamed and your vision will turn blurry.
- Eye inflammation
- Persistent grittiness
- Sensitivity to light
- Difficulty wearing contact lenses
- Blurred vision
Causes of Moderate Dry Eyes
Most causes of moderate dry eyes are the same as mild dry eyes. But there are also certain chronic causes, such as autoimmune conditions and hormonal changes, that may lead to moderate dry eyes.
- Age: Moderate dry eye is often associated with aging. The reason is that tear production tends to decrease as you get older.
- Nutritional deficiencies: If your diet is lacking in certain nutrients, like vitamin A and omega-3 fatty acids, your eyes may feel dried out.
- Autoimmune diseases: Conditions like Sjögren’s syndrome, rheumatoid arthritis, and lupus can also lead to moderate dry eye. In these, your immune system attacks your tear-producing glands.
- Hormonal changes: Hormonal fluctuations, such as those occurring during menopause or pregnancy, are often associated with moderate dry eye symptoms.
- Medical conditions: Conditions like diabetes and thyroid disorders can affect the quality and quantity of your tears. The result? Moderate eye dryness and inflammation.
What Is Severe Dry Eye Disease?
This is the third stage of dry eyes and comes with the most constant and severe symptoms. This is also the stage when you can’t afford to overlook your dry eyes any longer. Further delays might lead to vision-related issues.
Severe dry eyes can also impact your eye comfort and quality of life. You may have difficulty performing daily tasks such as reading and driving.
Symptoms of Severe Dry Eyes
Severe dry eye symptoms take on an intense form. They are more painful than those in mild and moderate stages and also appear more frequently.
- Corneal ulcers
- Scarring of the cornea
- Severe pain and discomfort in the eyes
- Extreme light sensitivity, or photophobia
- Foreign body sensation in the eyes
- Difficulty keeping your eyes open
- Vision loss
Causes of Severe Dry Eyes
Severe dry eye syndrome is generally a result of neglected mild and moderate dry eyes. But there are also some causes, like surgical complications and neurological issues, that may trigger severe dry eyes directly.
- Screen use – Prolonged use of digital screens, like computers, smartphones, and tablets, reduces your blink rates. This causes dry eyes and can lead to severe symptoms over time, a 2021 study shows.
- Surgical complications – In some cases, complications from eye surgeries, such as corneal scarring, can result in severe dry eye.
- Neurological disorders – Severe eye dryness can result from neurological conditions, like optic neuritis and Parkinson’s disease. These conditions affect the nerves controlling tear production and blinking.
- Eyelid problems – Eyelids help spread your tear film and lubricate your eyes. But issues like eyelid malposition and nocturnal lagophthalmos can cause severe dry eyes over time.
Mild Dry Eye vs Moderate Dry Eye vs Severe Dry Eye: Key Differences
Let’s now understand the key difference between mild, moderate, and severe dry eyes, based on the duration of symptoms, diagnosis, impact on vision, treatment approach, and more.
Duration of Symptoms
In mild dry eye cases, your symptoms are intermittent, and may come and go based on factors that exacerbate dryness. These symptoms last anywhere from a couple of hours to days.
Symptoms of moderate dry eye tend to be persistent. They may last for more extended periods, ranging from a few days to weeks.
Severe dry eye symptoms are typically constant. Without your intervention, they can persist for days, weeks, or even months.
Tests and Diagnosis
Diagnosis for dry eye disease typically involves a combination of symptom assessment and clinical tests.
- Tear break-up time – This test measures the time it takes for your tear film to break up after a blink. For mild dry eyes, this is less than 5 seconds. With moderate dry eyes and severe dry eyes, the tear break-up time may be even shorter.
- Corneal staining – During this test, your cornea is examined for signs of damage or staining using special dyes. Mild dry eyes shows minimal or no staining. Moderate dry eyes shows staining in specific areas of the cornea. Finally, severe dry eyes shows extensive staining, including central corneal staining.
- Schirmer’s test – This helps measure your tear production by placing small strips of paper under your lower eyelids. Mild symptoms score less than 5-10 mm of wetting in 5 minutes. Severe dry eyes score less than 5.5 mm.
Impact on Vision
Mild dry eyes typically have a minimal impact on vision. So, you may experience only slight changes in vision after prolonged visual activities.
Moderate dry eyes can have a more noticeable impact on your vision. You may experience frequent and persistent blurriness. This can cause discomfort with tasks like reading, driving, or watching TV.
Severe dry eyes can significantly impact your vision. As the corneal scars and ulcers get worse, they can cause persistent blurriness. In extreme cases, research shows that the condition can also lead to vision loss.
Ease of Treatment
It goes without saying that it’s easier to treat dry eyes during the initial stages than in the later stages. Mild and moderate dry eyes can be kept in check with a few home remedies and lifestyle changes.
Severe dry eye require a more aggressive treatment plan. You need a combination of home remedies and in-office procedures. You also need to address the underlying cause of your eye dryness to fully recover.
The treatment approach for dry eyes varies, depending on its severity and frequency.
Mild dry eye symptoms can be treated by applying a warm compress and massaging your eyelids to increase tear production. You can also avoid dry eye triggers like dry environments, overuse of contacts, and smoke.
Moderate dry eyes also benefit from the above treatment approach. In addition, you may need prescription eye drops or ointments. These will work to improve your tear film stability.
Severe dry eyes is a completely different case. You may require in-office procedures, like punctal plug application, device-based therapies, or surgery to remove blocked oil glands.
Keeping Your Eyes Healthy and Happy
Dry eye syndrome is only as bad as you make it. Start addressing the condition when the first symptoms appear and you will have nothing to worry about. But ignore the symptoms and you will wreak havoc on your vision and eye health.
The reason is that dry eye syndrome is progressive and gets worse over time. So, before it advances to moderate and severe stages, fix it when it’s still mild and temporary.
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