Dry Eye Syndrome: Symptoms, Causes and Treatment Options

If your eyes feel gritty, burn by mid-afternoon, or blur after a long stretch at the computer, you may be dealing with dry eye syndrome. It’s one of the most common reasons people visit an eye doctor, and it’s easy to dismiss as a minor annoyance until it starts affecting your reading, driving, screen work or contact lens wear.

The good news is that dry eye is very treatable once you know what’s causing it. This guide explains what dry eye is, why it happens, what you can do at home, and what an eye doctor can offer when drops from the drugstore aren’t enough.

The Short Answer

Dry eye syndrome happens when your eyes don’t make enough tears, or when your tears evaporate too quickly, so the surface of the eye isn’t kept smooth and moist. It commonly causes burning, grittiness, redness, blurry vision that comes and goes, and, surprisingly, watery eyes. For most people it’s a long-term condition that is managed rather than cured, starting with good habits and artificial tears and moving to prescription or in-office treatment when needed.

What Is Dry Eye Syndrome?

Every time you blink, a thin tear film spreads across the front of your eye. That film has three layers that work together:

• An oil layer on the outside, made by small glands along the edges of your eyelids (the meibomian glands), which slows evaporation
• A watery layer in the middle, made by the tear glands, which keeps the eye moist and washes away debris
• A mucus layer closest to the eye, which helps tears stick evenly to the surface

When any of these layers isn’t working properly, the tear film breaks down and the surface of the eye becomes irritated. Eye doctors generally describe two main types of dry eye, and many people have some of both:

• Evaporative dry eye (the more common type): You make enough tears, but the oil glands in your eyelids are blocked or not producing healthy oil, so tears evaporate too fast. This is often called meibomian gland dysfunction.
• Aqueous-deficient dry eye: The tear glands don’t produce enough of the watery part of your tears.

Knowing which type you have matters, because the treatments are different. Artificial tears alone often don’t solve evaporative dry eye, so if drops haven’t helped you, that’s useful information rather than a sign that nothing will.

What Are the Symptoms of Dry Eye?

Dry eye can feel different from person to person, and symptoms often get worse as the day goes on. Common signs include:

• A gritty or sandy feeling, or the sense that something is in your eye
• Stinging, burning or scratchiness
• Redness and irritation
• Blurry vision that clears when you blink, especially while reading or using a screen
• Tired, heavy-feeling eyes
• Sensitivity to light
• Difficulty wearing contact lenses comfortably
• Stringy mucus in or around the eyes

Why Dry Eyes Can Be Watery

Excess tearing is one of the most confusing dry eye symptoms. When the eye’s surface gets irritated from dryness, it can trigger a burst of reflex tears. These tears are mostly water and drain away without fixing the unstable tear film underneath. If your eyes water often but still feel irritated, dry eye is worth considering.

What Causes Dry Eye?

Dry eye usually has more than one contributing factor. Common causes and risk factors include:

• Screen time: People blink less often, and less completely, while focusing on phones, computers and tablets, which lets tears evaporate. Our post on screens and eye health covers habits that help.
• Age: Tear production tends to decrease with age, and dry eye becomes more common after 50.
• Hormonal changes: Women are more likely to develop dry eye, especially during menopause and sometimes during pregnancy or with hormone changes.
• Medications: Antihistamines, decongestants, some blood pressure medications, antidepressants and other drugs can reduce tear production. Never stop a prescribed medication on your own; talk with the prescribing doctor if you suspect it’s a factor.
• Contact lenses: Long-term lens wear can affect the tear film and make dryness more noticeable.
• Eyelid and oil gland problems: Blocked meibomian glands, eyelid inflammation (blepharitis), or eyelids that don’t close fully can all lead to dry eye.
• Health conditions: Diabetes, thyroid disease, rheumatoid arthritis, Sjögren’s syndrome and other autoimmune conditions can contribute. Severe or sudden dry eye is worth investigating rather than simply managing.
• Environment: Wind, smoke, ceiling fans, air conditioning and dry indoor air all increase evaporation.

Dry Eye and East Tennessee Seasons

Our region can be hard on dry eyes. Spring and fall allergy seasons in the Tennessee Valley bring pollen that inflames the eye’s surface and makes dryness worse, and many allergy medications dry the eyes further. Then winter heating dries indoor air for months. If your symptoms follow the calendar, mention that at your visit. Our guide to East Tennessee allergies and your eyes explains how to tell allergy symptoms from dry eye and how to manage both.

What Can You Do at Home for Dry Eyes?

For mild dry eye, simple changes often make a real difference:

• Use artificial tears regularly, not just when your eyes feel bad.
• Follow the 20-20-20 rule: every 20 minutes of screen time, look at something about 20 feet away for 20 seconds, and make a point of blinking fully.
• Add a humidifier at home or at work, especially during winter.
• Point fans and car vents away from your face.
• Wear wraparound sunglasses outdoors to block wind and pollen.
• Apply warm compresses to closed eyelids for a few minutes, then gently clean the lid margins. This can help loosen thickened oil in the glands.
• Follow your lens care routine and replace contacts on schedule. See our tips on taking care of your contact lenses.

Some people find that omega-3 fatty acids, from food or supplements, help their symptoms, though research results have been mixed. Ask your doctor before starting a supplement.

Which Eye Drops Are Best for Gritty Eyes?

For most people, a lubricating artificial tear is the right first step. A few practical tips:

• Preservative-free drops are generally a better choice if you use drops more than a few times a day.
• Thicker gels or ointments can help overnight, but they blur vision for a while, so they’re usually used at bedtime.
• Avoid redness-relief drops for dryness. They shrink blood vessels to make eyes look whiter but don’t add moisture, and regular use can lead to rebound redness.

There isn’t a single best drop for everyone. If you’ve tried artificial tears consistently for a few weeks and still feel gritty or blurry, it’s time for an exam.

How Do Eye Doctors Treat Dry Eye?

An eye doctor starts by finding out which type of dry eye you have and what’s driving it. The exam usually includes looking closely at your eyelids and oil glands, checking the surface of the eye with special dye drops, and measuring how much tear fluid you make and how quickly your tears break up.

From there, treatment is tailored to you and often combines several approaches:

• Artificial tears, warm compresses and lid hygiene to supplement your tears and improve oil gland function.
• Prescription anti-inflammatory eye drops that calm inflammation on the eye’s surface and help the eye produce healthier tears over time. Some are used long term; others are used briefly to settle a flare.
• Punctal plugs: tiny devices placed in the tear drainage openings of the eyelids so your natural tears stay on the eye longer. Placement is quick and done in the office.
• In-office treatments for blocked oil glands, which use heat or other methods to help clear the glands and improve oil flow. Your doctor can explain whether these make sense for you.
• Treating contributing factors, such as adjusting contact lenses, managing eyelid inflammation or allergies, or coordinating with your other doctors about medications or health conditions.
• Scleral lenses for severe dry eye that doesn’t respond to other treatment. These large contact lenses hold a reservoir of fluid against the eye all day. Learn more in our post on scleral lenses for keratoconus and dry eye.

Finding the right combination often takes a few adjustments over several weeks or months, so follow-up visits are a normal part of dry eye care. Our dry eye services page describes the evaluation and treatments available at our clinics.

Can Dry Eye Be Cured?

It depends on the cause. If dry eye is triggered by something temporary, such as a medication, a stretch of dry weather or a change in contact lenses, it may improve once that cause is addressed. For most people with chronic dry eye, though, the condition is managed rather than cured. With a plan that fits your type of dry eye, many people reach the point where symptoms rarely interfere with daily life. Be cautious of any product that promises a permanent cure.

When Should You See an Eye Doctor for Dry Eyes?

Make an appointment if:

• Symptoms last more than a few weeks despite artificial tears and home measures
• Dry eye makes it hard to read, drive, work at a screen or wear contacts
• You need drops many times a day just to stay comfortable
• Your symptoms flare every allergy season or every winter

Get prompt care, the same day if possible, if you have significant eye pain, a sudden change in vision, strong light sensitivity, thick discharge, or a red, painful eye while wearing contact lenses. These can be signs of an infection or injury that needs treatment right away rather than dry eye.

Dry Eye Care Across East Tennessee

Dry eye doesn’t have to be something you just put up with. Our eye doctors evaluate and treat dry eye at all five of our clinics in Harriman, Knoxville, Lenoir City, Morristown and Powell, so follow-up visits can happen close to home. Find a location and schedule a dry eye evaluation to start working toward more comfortable eyes.