7 common causes of dry eye — and what to do about them

If you work on a computer all day, you may be used to your eyes burning, stinging and tearing by 3 p.m. You may also notice that the screen starts to look a little blurry and your eyes feel irritated.

Those are some of the symptoms of dry eye, according to the American Optometric Association.¹ The condition affects millions of Americans annually.² “If you have dry eye, your eyes are either not making enough tears or they’re not making good quality tears,” explains Bridget Anderson, O.D., an optometrist in Tulsa, Oklahoma. This affects not only your eye comfort, but the quality of your vision too.

It’s important to identify the cause of your dry eye because it may help you make the lifestyle changes needed to help improve symptoms. Here are 7 causes — some of which may surprise you — and what to do about each.

If your eyes are glued to a screen — computer, tablet, smartphone — you’ll naturally blink less often. And those blinks tend to be incomplete.³

“If you’re not blinking, it’s like driving down the road with a dirty windshield,” says Dr. Anderson. “Using the windshield wipers and spray will clean it. Blinking will do the same for your eyes. It replenishes the lubricating tear film.”

The best advice is to practice the 20-20-20 rule. Take a 20-second break every 20 minutes to look at something 20 feet away. If that’s too frequent, try every 30 minutes or every hour, she says. Can’t remember to break throughout the day? Download an app on your phone that will deliver regular reminders.

When you wash your face at night, spend some time caring for your lids. The oil glands in your eyelids make the lipids in your tears. If the glands become clogged, you can develop an inflammatory condition called blepharitis, which can contribute to dry eye.

An overabundance of microscopic mites that live on eyelids, as well as bacteria, can also contribute to irritation and inflammation, explains Dr. Anderson.

“There’s been a big push to practice lid hygiene, which is something we should all do 1 to 2 times per day,” she explains. After brushing your teeth and washing your face, clean your eyelids with an eyelid wipe, available at your local drugstore.

Big, fluttering eyelashes are beautiful, but they play into dry eye, says Dr. Anderson. Lash extensions provide more real estate for bacteria and mites to proliferate. That causes lid irritation, which affects tear quality.

What’s more, extra-long eyelashes affect the way you blink and can also be difficult to clean. The glues — even those designed for sensitive skin — tend to trigger skin reactions, explains Dr. Anderson. If you’re struggling with dry eye, consider giving up the lash extensions.

The majority of people who have diabetes — 54%, to be exact — deal with dry eye, according to the American Diabetes Association (ADA).4 As the ADA notes, diabetes affects your tear quality and production and increases inflammation.

You can have healthy eyes with diabetes. Work with your health care provider to ensure that your blood sugar is well controlled through lifestyle and/or medication. And be sure to see your eye doctor for regular eye exams.

During menopause, your body makes less estrogen and testosterone. That also decreases the amount of tears your eyes make, as well as the quality of those tears.⁵

One study of nearly 2,000 women between ages 45 and 79 found that 79% of them reported symptoms of dry eye disease, something that was associated with poorer quality of life.⁶

Talk to your gynecologist and your eye doctor if you’re experiencing dry eye. Treatments like artificial tears, applying warm compresses and taking screen breaks can all help.

Sleeping in contacts doesn’t just increase your risk of infection — the habit can also disrupt tear film and cause inflammation, setting the stage for dry eye. “Taking them out at night gives your eyes time to rest and recover,” Dr. Anderson says.

Make sure that you’re cleaning your contacts appropriately. Extended wear contacts — which can be worn for days or up to a month — can accumulate bacteria that you then put on your eyes, she explains. Better yet, wear daily disposable lenses and pop in a fresh pair every morning.

Dry-eye is known to be associated with several systemic autoimmune diseases including rheumatoid arthritis, scleroderma, Sjögren’s syndrome and systemic lupus erythematosus.

Autoimmune diseases are conditions where the immune system attacks healthy tissue in your body and then causes inflammation, which may lead to pain and swelling. This inflammation can occur anywhere in the body, including the tear glands of the eyes.

One study showed that dry eye made up 85% of eye complications seen in patients with rheumatoid arthritis⁷. It is common for there to be delays in diagnosing underlying autoimmune diseases related to dry eye, therefore it is important to discuss signs and symptoms with your eye doctor.

Dry eye can be diagnosed during a comprehensive dilated eye exam.² Be sure to bring up your symptoms and ask about dry eye. The eye doctor can check your tear production and examine your eyes and eyelids.¹

There are 2 major types of dry eye disease. It’s important that your optometrist learns which one you have, so that they can prescribe the right treatment. They can also confirm that the problem is dry eye and not something else, such as indoor or seasonal allergies.

The most common treatment for mild dry eye is over-the-counter eye drops. Choose preservative-free artificial tears, Dr. Anderson recommends. If you wear contacts, choose artificial tears that are specifically formulated for contacts.

Stay away from eye drops labeled “redness relief,” as often those do not add lubrication to the eyes and may disrupt tear film, causing more long-term problems. Other treatments include prescription eye drops; in-office procedures, such as meibomian (oil) gland expression; and laser treatments, Dr. Anderson adds.

Dry eye is often a chronic condition, so you may need to stick with your lifestyle changes and medications. “The earlier you can stop the inflammatory process, the better,” says Dr. Anderson. Less inflammation means clearer, more comfortable eyes.