Understanding Dry Eye Disease: Symptoms, Causes, and Expert Insights

Dry eye disease (DED), known as keratoconjunctivitis sicca, is a chronic ocular condition affecting millions worldwide. Characterized by insufficient tear production or rapid tear evaporation, it leads to discomfort, visual disturbances, and even damage to the eye’s surface. In this guide, we’ll explore the common symptoms of dry eye and delve into the underlying causes, supported by clinical research and expert insights.

Common Symptoms of Dry Eye Disease

Dry eye symptoms vary in severity but often include:

• Persistent dryness or grittiness (like “sand in the eyes”)
• Redness and irritation
• Watery eyes (paradoxical reflex tearing due to irritation)
• Blurred vision that improves with blinking
• Light sensitivity (photophobia)
• Burning or stinging sensations
• Difficulty wearing contact lenses

These symptoms often worsen in dry, windy environments or after prolonged screen use.

What Causes Dry Eye Disease?

Dry eye is multifactorial, with causes ranging from lifestyle habits to systemic health conditions. Below are key contributors:

1. Aging and Hormonal Changes

Tear production decreases with age, particularly in postmenopausal women due to hormonal shifts (estrogen and androgen fluctuations) [1].

2. Environmental Factors

Low humidity, air conditioning, and pollution disrupt tear film stability.

Prolonged screen time reduces blink rate by up to 60%, accelerating tear evaporation [2].

3. Medical Conditions

Autoimmune diseases like Sjögren’s syndrome, rheumatoid arthritis, or lupus directly impair tear glands.

Diabetes and thyroid disorders are linked to reduced tear secretion.

4. Medications

Antihistamines, antidepressants, blood pressure drugs, and hormonal therapies can suppress tear production.

5. Eyelid Issues

Meibomian gland dysfunction (MGD), where blocked glands fail to produce the oily layer of tears, causes 86% of dry eye cases [3].

Blepharitis (eyelid inflammation) exacerbates symptoms.

6. Lifestyle Factors

Smoking, dehydration, and poor diet (low in omega-3 fatty acids) worsen dry eye.

When to See an Ophthalmologist

Persistent symptoms warrant professional evaluation. Advanced diagnostics, such as tear osmolarity tests or meibography, help identify the root cause and guide treatment. Early intervention prevents complications like corneal abrasions or scarring.

Prevention and Management Tips

• Use preservative-free dry eye ointment for lubrication.
• Incorporate omega-3-rich foods (e.g., salmon, flaxseeds) to support tear quality.
• Follow the 20-20-20 rule during screen use: every 20 minutes, look 20 feet away for 20 seconds.
• Wear wraparound sunglasses outdoors to shield against wind and dust.

References

1. American Academy of Ophthalmology (AAO): Dry Eye Syndrome
2. National Eye Institute (NEI): Causes of Dry Eye
3. Tear Film & Ocular Surface Society (TFOS): Meibomian Gland Dysfunction Report
4. Mayo Clinic: Dry Eyes Diagnosis & Treatment