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Dry eye syndrome

Keratitis sicca; Xerophthalmia; Keratoconjunctivitis sicca

You need tears to moisten the eyes and to wash away particles that have gotten into your eyes. A healthy tear film on the eye is necessary for good vision.

Dry eyes develop when the eye is unable to maintain a healthy coating of tears.

Images

Eye anatomy
Lacrimal gland

Causes

Dry eye commonly occurs in people who are otherwise healthy. It becomes more common with age. This can occur due to hormonal changes that make your eyes produce fewer tears. Dry eye symptom can sometimes be caused or worsened by a condition called meibomianitis, which changes the normal tear film.

Other common causes of dry eyes include:

Dry eye can also be caused by:

Symptoms

Symptoms may include:

Exams and Tests

Tests may include:

Treatment

The first step in treatment is artificial tears. These come as preserved (screw cap bottle) and unpreserved (twist open vial). Preserved tears are more convenient, but some people are sensitive to preservatives. There are many brands available without a prescription.

Start using the drops at least 2 to 4 times per day. If your symptoms are not better after a couple of weeks of regular use:

Other treatments may include:

Other helpful steps include:

Some dry eye symptoms are due to sleeping with the eyes slightly open. Lubricating ointments work best for this problem. You should use them only in small amounts since they can blur your vision. It is best to use them before sleep.

Surgery may be helpful if symptoms are because the eyelids are in an abnormal position.

Outlook (Prognosis)

Most people with dry eye have only discomfort, and no vision loss.

Possible Complications

In severe cases, the clear covering on the eye (cornea) may become damaged or infected.

When to Contact a Medical Professional

Call your provider right away if:

Prevention

Stay away from dry environments and things that irritate your eyes to help prevent symptoms.

Related Information

Conjunctivitis or pink eye
Vitamin A
Sjögren syndrome
Rheumatoid arthritis
Systemic lupus erythematosus

References

Brissette AR, Bohm KJ, Starr CE. Dry eye overview: classification and treatment overview. In: Mannis MJ, Holland EJ, eds. Cornea. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 31.

Goldstein MH, Rao NK. Dry eye disease. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.23.

Margo CE, Harman LE. Dry eye syndrome. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier; 2021:493-495.

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Review Date: 12/14/2020  

Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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