Dry Eye Is on the Rise: Here’s How to Get Relief

If you often experience a stinging, burning, or scratchy feeling in your eyes, chances are you have chronic dry eye. It affects an estimated one in 10 U.S. adults—and research shows that this condition is on the rise.

While experts believe that age and hormone changes are among the most common causes of chronic dry eye, our increasing reliance on smartphones, computers, and other screen-based technologies may explain the recent increase in cases.

“Looking at screens certainly can worsen dry eye symptoms,” says Gargi Khare Vora, MD, a Yale Medicine ophthalmologist. “We don’t blink as much when we are focusing on a screen, and this can worsen dry eye.”

Fortunately, many treatment options—including new ones—are available for chronic dry eye, ranging from mild over-the-counter treatments to prescription medications and medical procedures. “Each step up is a little more aggressive but fortunately, most patients are able to find a treatment that works," Dr. Vora says.

The best treatment for dry eye depends in part on what’s causing the condition. Different problems can lead to chronic dry eye. Doctors divide the condition into three categories based on the underlying source of the discomfort:

• Aqueous deficient: Your eyes don’t produce enough tears to keep them moist and lubricated.

• Evaporative: Your eyes produce tears, but they evaporate too quickly to do their job.

• Mixed dry eye: Your eyes are affected by both issues described above.

“Most patients with dry eye have a low-grade, chronic mixed dry eye that can go through flares every so often,” Dr. Vora says.

Doctors have quite a few tools to treat this chronic condition. “Generally, if we can find the underlying cause of the dry eye, we can target our treatment accordingly,” she says.

Depending on the cause of your dry eye, an ophthalmologist will likely want to start with the mildest treatment that could help you and work their way up the treatment ladder if needed.

Here are the most commonly used dry eye treatments:

Over-the-counter and home remedies

First-line treatments for chronic dry eye include items you can pick up at the local drugstore without a prescription and treatments you can do yourself at home. Your doctor can offer guidance on which products or strategies might work best for you.

“These treatments generally treat low-grade, symptomatic dry eye,” Dr. Vora says. “They’re readily accessible and have minimal risk.”

Artificial tears: These are non-prescription eye drops, usually called “artificial tears” or “lubricating eye drops,” that can help keep your eyes hydrated as needed. “Avoid any drops that target ‘eye redness,’” Vora says. “These are generally not great for the eyes long term and can lead to rebound eye redness.”

Moisturizing ointment: As the name suggests, this is a moisturizer for the surfaces of your eyes. Ointment can bring a lot of relief to chronically dry eyes, but it’s also thick and can blur your vision, so you’d typically reserve this for nighttime use right before bed. To apply the ointment, squeeze a small amount into your lower eyelid and close your eye to spread the lubrication. Don’t use ointment while you’re wearing contact lenses. It will damage the lenses.

Eyelid scrubs: These products are specifically formulated to gently cleanse the eyelids along the lash line. This can wash away bacteria and reduce inflammation to ease dry eye.

Warm compress: A bit of warmth and pressure on the eyelids can help open clogged oil glands and release necessary oils into the eyes. This helps keep the surface of the eye lubricated and prevents tear evaporation.

Prescription medications

If over-the-counter and home remedies don’t provide enough relief, your doctor can offer prescription medications. There are a number of prescription drugs available to address the symptoms and underlying causes of dry eye:

Medicine to reduce eyelid inflammation: Inflammation along your lash line can clog oil glands and keep them from releasing oil. Antibiotics, in the form of pills, eye drops or ointment, can reduce inflammation and get your oil glands working properly again. Your doctor may prescribe them for shorter periods of a few weeks at a time, or you may take them long term.

Eye drops for cornea inflammation: An overactive immune system can cause inflammation on the surface of your eyes (the cornea) that leaves them dry and irritated. Eye drops targeting inflammation, such as cyclosporine (Restasis®) and liftegrast (Xiidra®), help patients produce more tears. Corticosteroids can also be used to reduce this inflammation for short periods of time. Be aware that corticosteroids are used only to relieve temporary flares of dry eye and are not recommended for long-term use.

Tear-stimulating nasal spray: Varenicline (Tyrvaya®) is a twice-daily nasal spray that stimulates tear production.

Custom-made eye drops: Autologous (meaning coming from your own body) blood serum drops can be made using a sample of your blood, minus the red and white blood cells, plus saline. This treatment is reserved for severe cases of dry eye that don’t respond to other treatments.

Medical procedures and devices

If medications don’t bring sufficient relief, you may be a candidate for a medical procedure to treat your chronic dry eye. These corrective procedures include:

Punctal plugs: These are tiny, removable plugs that an ophthalmologist inserts into the tear ducts. These plugs block the tear ducts so that tears stay on the surface of the eyeballs longer, rather than draining out of the eyes.

Thermal cautery: This procedure works the same way as punctal plug insertion, but it’s not reversible. Thermal cautery uses heat to permanently seal the tear ducts closed. Your tear ducts are like drains. After your eyes fill with tears, the tears drain out through the ducts. When the ducts are sealed, the tears stay on the surface of the eyes and keep them lubricated.

Thermal pulsation: This procedure uses one of several different devices approved by the Food and Drug Administration to warm and massage oil glands in order to unblock them. The concept works the same way as using warm compresses to help release oil into the eyes.

Intense pulsed light (IPL) therapy: A longtime treatment for rosacea and skin lesions, IPL can relieve chronic dry eye, too. In 10-minute treatments administered four times a year, the light therapy is applied directly to the eyelids. It can reduce inflammation and clear blocked oil glands.

Amniotic membrane graft: For very difficult cases of dry eye, an amniotic membrane graft can heal the surface of the eye and correct the dysfunction that is causing the symptoms. The tissue used for the graft is derived from the inner lining of the amniotic sac, which holds a fetus during gestation. This tissue is donated by women who’ve delivered a baby by C-section.

Scleral lenses: Doctors resort to this option in patients with end-stage severe dry eye who haven’t gotten relief from any other treatment options. These lenses are placed on the surface of the eyeballs (like contact lenses) to trap moisture and shield the eye from drying air, wind, and dust.

Moisture and lubrication on the surface of the eyes also play important roles for your vision. Your eyes need moisture for their health and function. Ongoing, severe dryness can damage the cornea and even lead to vision loss. That’s yet another reason why it’s important to get your dry eye symptoms under control.