What Are Dry Eyes? Causes, Symptoms & How to Treat Them

Feeling like you have sand in your eyes that you just can’t blink away? You probably have dry eyes.

Screens, environmental factors, and nutritional deficiencies may upset the delicate balance of your tear film and cause this increasingly common condition.

Learn more about dry eyes symptoms, causes, and treatments so you can restore your eyes to health and prevent long-term damage to your vision.

Symptoms of Dry Eyes

Dry eyes often feel tired and sandy. You may experience a host of other symptoms, which usually affect both eyes.

• Soreness, burning, or stinging in the eyes
• Scratchy or gritty eyes
• Feeling like having something in the eyes that you can’t blink away
• Redness in the conjunctiva
• Tearing or watery eyes
• Light sensitivity
• Eye fatigue when reading or performing activities requiring sustained visual attention
• Blurry or filmy vision, which generally occurs later in the day
• Mucus in or around the eyes
• Sticky eyelids in the morning
• Discomfort when wearing contact lenses
• Difficulties driving at night
• Double vision

Dry eye symptoms can be unpleasant and interfere with everyday tasks. They may make it difficult for you to work on your computer, read in the evening, or enjoy a bright sunrise. More than affecting your performance at work, they may lower your mood and impact your sense of well-being.

Left untreated, dry eyes can affect your quality of life and may cause permanent damage to your eyes.

What Causes Dry Eyes?

Dry eyes are caused by imbalances in the tear mixture, reduced tear production, environmental factors, nutritional deficiencies, medication, or problems with the eyelids.

Tear glands above your eyes produce tears that normally lubricate your eyes. Dry eyes occur when your tear glands don’t make enough tears, the tears don’t work well, or the tears dry too quickly.

Tear Film Imbalances

Tear glands produce tears all the time, not only when we cry. Tears keep the surface of the eyes smooth and clear. They contain more than water: fatty oils, essential minerals, protein, and antimicrobial compounds that protect the eyes against bacteria.

The tear film consists of three layers:

• Oily layer at the top contains fatty acids, which are lipids secreted by the Meibomian glands that line the edge of the eyelids. This layer smooths the tear surface and reduces its evaporation rate.
• Watery layer in the middle contains essential salts produced by the tear glands. This layer washes away irritants and cleanses the eyes.
• Mucus layer at the bottom contains mucins made by cells in the conjunctiva. This layer enables tears to spread evenly over the surface of the eyes. It also keeps them attached to the cornea.

Each layer is important for clear vision and healthy eyes. Imbalances in any of these layers may lead to dry eyes and other eye health problems.

Here are some of the most common problems resulting from tear film imbalances:

• Not enough mucus in the bottom layer can lead to dry areas on the cornea.
• When there are not enough lipids in the oily layer, the watery layer may evaporate too quickly.
• If the middle watery layer is unstable, the oily and mucus layers may touch, leading to a stringy discharge.

Insufficient Tear Production

Tear production decreases with age. Hormonal changes during pregnancy and menopause can also affect the activity of the tear glands, which is why dry eyes tend to be more common in women.

Tear production may also be affected by:

• Diabetes
• Vitamin A deficiency
• Autoimmune diseases such as rheumatoid arthritis or lupus
• LASIK and other refractive eye surgeries
• Radiation treatment

Environmental Factors

Environmental factors can interfere with the balance of the tear film. They may cause dry eyes in conjunction with other factors or on their own.

• Facing dry air or hot air such as from an air conditioning system at home, work, or in the car
• Living in a dry climate
• Being exposed to intense sun or wind
• Living or working in a room with a low humidity
• Living at a high altitude

Medication

Certain medications can cause dry eyes, including some antidepressants, acne drugs, sleeping pills, birth control pills, decongestants, and diuretics.

Activities That Require Visual Concentration

We normally blink around five times every minute. But when the eyes focus on a visual task, we blink less, which affects the spread of the tear film over the surface of the eyes.

Using a computer or looking at a screen for several hours every day can contribute to dry eyes. Reading for extended periods, performing manual work requiring precise focus, and driving a vehicle may also increase the risk. All these activities slow down your blinking rate.

Dry Eyes and Nutritional Deficiencies

Vitamin and nutrient deficiencies can also be responsible for dry eyes. They may occur alongside the factors mentioned above or be the main culprits.

Not all vitamin deficiencies cause immediate symptoms, which makes them difficult to recognize sometimes. When your eyes feel try, your body could be sending you a signal that you need more of certain nutrients.

Vitamin A

Vitamin A is crucial for eye health. Deficiencies may affect the tear gland’s ability to make tears. They may also reduce the tear film’s ability to lubricate the eyes. The eyes need this vitamin to maintain a smooth tear film.

A study noted quick improvements in the tear film of participants taking a Vitamin A 5000 IU supplement for three days.

Omega-3 Fatty Acids

The US NIH National Eye Institute notes that not getting enough omega-3 fatty acids from your diet increases the risk for dry eyes.

Fatty acids are a crucial component of the tear film. Without them, the watery layer of the film evaporates, leading to dry eye symptoms.

Getting enough omega-3 fatty acids helps reduce the rate at which the tear film evaporates. Rich sources of omega-3 fatty acids include flax seeds, walnuts, olive oil, pumpkin seeds, and oily fish such as salmon.

Vitamin D

Vitamin D improves the stability of the tear film. A Korean survey concluded that it may directly affect the activity of the lacrimal glands.

Another study found a link between vitamin D deficiency and symptoms associated with dry eyes.

Not getting enough sunlight in the colder months or having a vitamin D deficiency could predispose you to this condition.

Vitamin B12

Research has found an association between severe dry eyes symptoms and Vitamin B12 deficiency. A more recent study found that vitamin B12 supplements helped contribute to treating dry eyes.

Vegetarians and vegans have a higher risk of vitamin B12 deficiency as they may not get enough of this vitamin from non-meat sources. For them, B12 supplements are especially important.

Lutein & Zeaxanthin

Lutein and zeaxanthin are carotenoids found in berries and other fruits, most notably in goji berries. A study found that lutein supplementation can help alleviate dry eyes symptoms.

Other research suggests that zeaxanthin may also help treat dry eyes, especially when used alongside lutein.

Are You at Risk?

Age, gender, environment, diet, work, and lifestyle factors can increase your risk of suffering from dry eyes. You are more likely to develop this condition if you:

• Are 50 or older
• Are female
• Don’t get enough vitamin A and omega-3 fatty acids from your diet
• Have vitamin D deficiency
• Have diabetes
• Suffer from eye allergies
• Use topical eyedrops with preservatives
• Have problems with your thyroid, which may lead to hormonal imbalances
• Spend several hours every day in front of a screen
• Are exposed to smoke
• Live or work in a dry or windy environment
• Travel often on a plane
• Perform regularly activities that require sustained visual concentration, and which slow down your blinking rate, such as reading, working on a computer, or driving a vehicle (especially at night)
• Suffer from an autoimmune disease
• Wear contact lenses

Some risk factors for dry eye disease are beyond your control. But there's a lot you can do to safeguard your vision in the years to come. Check out our post on how to age-proof your vision.

How to Treat Dry Eyes

Dry eye symptoms that are mild to moderate can be treated at home by reducing environmental factors, resting your eyes, and supplementing your diet with the right vitamins and nutrients.

• Reduce environmental factors that may cause dry eyes as much as possible.
• Supplement your dietary intake of vitamins A, D, B12, and omega-3 fatty acids.
• Choose a supplement for eye health that includes lutein and zeaxanthin.
• Limit your screen time and take regular breaks when working on your computer, using a screen for long periods, or reading—close your eyes for a few minutes to rest them.
• Place your computer below eye level to minimize strain and slow tear evaporation.
• When performing activities requiring visual concentration, remind yourself to blink constantly to renew the tear film.
• Use a humidifier to add moisture to your room or office in winter when the heating system dries the air.
• Avoid exposing your eyes to direct sources of air such as an air conditioner, fan, car heater, or blow-drier.
• Avoid smoke entering your eyes.
• Drink at least 8 glasses of water every day.
• Get good sleep every night to help your eyes rest and recover—aim for 7 to 8 hours.
• Wash your eyelids with clean, warm water. You can massage them gently as you do this.
• Wear wraparound glasses when traveling through a windy or dry environment.

Important: If you experience severe symptoms, take medication that may cause dry eyes, or suffer from a disease that may trigger the condition, don’t hesitate to consult a doctor. Dry eyes can be a serious condition that requires medical treatment.

Take the Dry Eye Test

Today, when screens surround you everywhere and eating healthy, unhurried meals can be challenging, the risk for dry eyes is higher than ever before.

More than discomfort and unpleasant symptoms, dry eyes can take their toll on your vision over time. They can lead to corneal scars which cause permanent vision loss.

Do you experience symptoms of dry eyes? Take the Dry Eye Test now—the first step to addressing the condition.