Dry Eye Questions & Answers

Get clear, medically reviewed answers to common questions about dry eye symptoms, causes, diagnosis and treatment from Jason Besecker, OD, MS.

Causes and Related Conditions

What Causes Dry Eye?

Dry eye is not simply a shortage of tears. Current TFOS DEWS III guidance defines it as a multifactorial, symptomatic disease involving loss of homeostasis of the tear film and/or ocular surface. Tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities are recognized as etiological factors.

What Is Meibomian Gland Dysfunction?

Meibomian gland dysfunction, commonly called MGD, is a condition in which the oil-producing glands inside the eyelids do not function normally.

What Is Anterior Blepharitis?

Anterior blepharitis is inflammation along the front edge of the eyelids, particularly around the base of the eyelashes and within the eyelash follicles. It can cause redness, crusting, itching, burning, irritation and a gritty sensation.

Can Menopause Cause Dry Eye?

Yes. Dry eye symptoms become more common during and after menopause, and hormonal changes can affect tear production, meibomian gland function and the health of the ocular surface.

Can Sjögren’s Disease Cause Dry Eye?

Yes. Sjögren’s disease is an autoimmune condition in which the immune system attacks moisture producing tissues, including the lacrimal glands that produce the watery portion of the tears.

Can Ocular Rosacea Cause Dry Eye?

Yes. Ocular rosacea can cause or worsen dry eye by creating chronic inflammation of the eyelids, meibomian glands and ocular surface.

Can Medications Cause Dry Eye?

Yes. Some prescription and over the counter medications can contribute to dry eye by reducing tear production, changing meibomian gland secretions, altering blinking or affecting the nerves and tissues that regulate the ocular surface.

Does Screen Time Cause Dry Eye?

Prolonged screen use can contribute to or worsen dry eye symptoms, primarily because people tend to blink less frequently and less completely while concentrating on digital devices.

Can Contact Lenses Cause Dry Eye?

Contact lenses can contribute to dry eye symptoms or make an existing tear film problem more noticeable.

Why Are My Eyes Dry When I Wake Up?

Eyes that feel dry, gritty, painful or blurry upon waking may have been inadequately protected during sleep.

Diagnosis and Testing

What Happens During a Comprehensive Dry Eye Evaluation?

A comprehensive dry eye evaluation is designed to determine whether you have dry eye disease, identify the factors driving the condition and develop a treatment plan based on your individual findings.

Treatment Options

Why Aren’t Artificial Tears Helping My Dry Eyes?

Artificial tears supplement the tear film but may not correct the underlying problem causing it to become unstable.

How Does a Dry-Eye Doctor Choose the Right Treatment?

A dry eye doctor chooses treatment by first confirming the diagnosis and then identifying the specific tear film, eyelid, ocular surface and systemic factors contributing to the condition.

Symptoms

Why Does Dry Eye Cause Blurry or Fluctuating Vision?

An unstable tear film can create an irregular optical surface, causing vision to become blurry or fluctuate between blinks.

Why Are My Eyes Watering If They Are Dry?

Watery eyes can be a symptom of dry eye disease. An unstable tear film can irritate the ocular surface and trigger reflex tears that overflow without correcting the underlying tear film problem.