Dry eye
Dry eye: a common problem that can be treated
Grittiness, burning, tired eyes at the screen or, paradoxically, watery eyes. Dry eye is very common and many people spend years trying drops without a clear plan.
By Dr Idaira Sánchez Santos, ophthalmologist · Nº 390905425
Last reviewed: · Patient information. It does not replace a medical consultation.
What dry eye is
It is a disorder of the tear film and the surface of the eye. Tears have an oily layer that stops them evaporating; when the meibomian glands in the eyelids do not work well, tears evaporate too fast. This "evaporative" form is the most common. In other people the problem is that too few tears are produced.
Symptoms and contributing factors
- Gritty or foreign-body sensation, stinging, burning.
- Vision that fluctuates and clears when you blink.
- Watering, especially in wind or cold.
- Worse with screens, air conditioning or heating.
Age, menopause, contact lenses, some medicines (antihistamines, antidepressants, anxiolytics…), refractive surgery and conditions such as Sjögren's syndrome or rosacea all play a part.
Step-by-step treatment
- Preservative-free artificial tears and changes to your environment (screen breaks, a humidifier).
- Eyelid hygiene: warmth and massage so the meibomian glands work better.
- Anti-inflammatory treatment prescribed by an ophthalmologist: ciclosporin, short courses of steroids or others.
- Punctal plugs, intense pulsed light (IPL) or autologous serum drops in selected cases.
The benefit of omega-3 supplements is debated: studies are not conclusive.
When an online consultation helps
- You have had symptoms for a long time and tried several drops without a clear plan.
- You want to know whether your dry eye is evaporative or due to low tear production and which treatment suits you.
- You wear contact lenses or spend many hours at screens.
- You have an autoimmune condition (Sjögren's, arthritis, lupus…) and want to coordinate your eye care.
Which tests to send the doctor
- Previous eye reports and treatments you have tried
- Photos of your eyelids taken with your phone in good light
- List of medicines you take
- Rheumatology reports if you have an autoimmune condition
Severe pain, strong sensitivity to light, reduced vision or a red eye with discharge, especially if you wear contact lenses, may mean a corneal infection. It needs urgent in-person assessment.
Frequently asked questions
Why do my eyes water if I have dry eye?
Because the irritated surface triggers reflex tearing. Those tears are of poorer quality and do not protect the eye well.
Can I use artificial tears as often as I like?
Preservative-free ones can be used frequently. If you need them many times a day, it is worth reviewing your treatment with an ophthalmologist.
Is an online consultation useful for dry eye?
Yes. Much of the diagnosis is based on your symptoms, habits and medication, and treatment is step by step. If a slit-lamp examination is needed, the doctor will tell you.