What Really Causes Dry Eye, And What Actually Helps

Are your eyes burning, feel gritty, red or do you have blurry vision that clears when you blink and or eyes that water when you’re outside?

If any of these sound familiar, you may have dry eye disease.

Dry eye is one of the most common conditions affecting the front surface of the eye. But it isn’t simply a problem of not making enough tears. For many people, the real issue is that tears evaporate too quickly or don’t have the right balance of oil, water and mucus to keep the eye comfortable.

Dry eye symptoms are common in Australia. The Australian Blue Mountains Eye Study found that 16.6% of people aged 50 and over reported moderate-to-severe dry eye symptoms, while 57.5% reported at least one dry-eye symptom.

The good news? Dry eye can be managed. The key is understanding what is causing and applying the correct treatment. The first step is to see an experienced optometrist in this field.

What Is Dry Eye?

Every time you blink, you spread a thin layer of tears across the front of your eye. This tear film keeps the eye surface smooth, comfortable and clear.

Your tear film contains three important components:

• Oil (lipid) helps slow evaporation
• Water (aqueous) hydrates and nourishes the eye
• Mucus (mucin) helps tears spread evenly across the eye

When one or more of these components becomes disrupted, the tear film can become unstable. This can lead to irritation, inflammation and damage to the surface of the eye.

This is also why you can have watery eyes and dry eyes at the same time. When the eye becomes irritated, it may respond by producing a sudden burst of watery tears. These reflex tears don’t necessarily contain enough oil to keep the tear film stable.

What Really Causes Dry Eye?

There isn’t one cause of dry eye. Instead, several different factors can contribute.

Meibomian gland dysfunction (MGD)

One of the most important causes of evaporative dry eye is Meibomian Gland Dysfunction, or MGD.

Meibomian glands are tiny oil-producing glands located in your eyelids. Every time you blink, they release an oily substance called meibum onto the surface of your tears.

This oil forms the outer layer of the tear film and helps prevent your tears from evaporating too quickly.

When these glands become blocked, inflamed or stop functioning properly, less healthy oil reaches the tear film. Tears then evaporate faster, leaving the eye surface exposed and irritated.

MGD becomes more common with age and can occur alongside eyelid inflammation, blepharitis and rosacea.

Not producing enough tears

Some people don’t produce enough of the watery component of their tears. This is called aqueous-deficient dry eye.

It can occur with:

• Increasing age
• Hormonal changes
• Certain medications
• Inflammatory conditions
• Autoimmune diseases such as Sjögren’s syndrome
• Previous eye surgery

Many people actually have a combination of evaporative and aqueous-deficient dry eye, rather than fitting neatly into one category.

What Else Can Make Dry Eye Worse?

Often, dry eye isn’t caused by one thing. Several everyday factors can add up.

Screen use

When we’re concentrating on a computer, phone or tablet, we tend to blink less frequently and less completely.

This means the tear film isn’t being refreshed and redistributed as often. Long periods of reading, driving or screen use can therefore make dry-eye symptoms much more noticeable.

Wind, air conditioning and heating

Dry air increases tear evaporation. Air conditioning, heating, fans, windy weather and long flights can all make symptoms worse.

Contact lenses

Contact lenses can alter the tear film and may make dry-eye symptoms more noticeable, particularly with prolonged wear.

Medications

Some medications can contribute to dry eye, including certain antihistamines, antidepressants, blood-pressure medications, acne medications and hormonal treatments.

If your symptoms started after beginning a medication, speak with your doctor or pharmacist before making any changes. Never stop prescribed medication without medical advice.

Age and hormones

Tear production and meibomian gland function can change with age. Hormonal changes can also influence the ocular surface and tear film.

 Other health conditions

Dry eye can occur alongside conditions such as diabetes, thyroid disease, rosacea and autoimmune diseases.

What Does Dry Eye Feel Like?

Dry eye doesn’t always feel “dry.”

Common symptoms include:

• Burning or stinging
• Gritty or scratchy eyes
• A sensation that something is stuck in the eye
• Redness
• Watery eyes
• Light sensitivity
• Blurred or fluctuating vision
• Eye fatigue
• Difficulty wearing contact lenses
• Symptoms that become worse throughout the day

Watery eyes can actually be a symptom of dry eye. Irritation of the eye surface can trigger excess watery tears as a protective response.

What Actually Helps Dry Eye?

The best treatment depends on why your eyes are dry. There is no single eye drop or treatment that works for everyone.

 Artificial tears

Lubricating eye drops can temporarily add moisture and reduce friction across the eye surface.

If you need drops frequently, preservative-free artificial tears are often preferred because repeated exposure to preservatives can irritate the ocular surface.

If MGD is contributing to your symptoms, your optometrist may recommend a lubricant containing lipids to help support the oily layer of the tear film.

Warm compresses and lid hygiene

If MGD is part of the problem, warm compresses can be particularly helpful.

Applying gentle warmth to closed eyelids can soften thickened meibum and support the function of the meibomian glands.

A simple routine is:

Warm compress → gentle lid massage → eyelid cleansing

Consistency is more important than doing it occasionally.

Take blink breaks

If you spend much of your day looking at screens, try the 20-20-20 approach:

Every 20 minutes → look 20 feet away → for 20 seconds.

During your breaks, take several slow, complete blinks to help refresh your tear film.

Positioning your screen slightly below eye level may also reduce the amount of the eye surface exposed to the air.

Change your environment

Small environmental changes can make a difference.

Try to:

• Avoid fans or air conditioning blowing directly toward your eyes
• Use a humidifier in particularly dry environments
• Wear sunglasses outdoors, especially on windy days
• Consider wraparound sunglasses in strong wind

Take regular breaks during prolonged visual tasks

Don’t forget night-time dryness

If your eyes feel particularly dry when you wake up, your eyelids may not be completely closing during sleep.

Depending on the cause, an optometrist may recommend a thicker lubricating gel or ointment before bed, a moisture-chamber sleep mask, environmental humidification or assessment of eyelid closure.

Nighttime symptoms are worth mentioning during an eye examination because they can provide clues about the underlying cause.

What procedures can we offer you?

If dry eye symptoms continue despite lubricating drops and lifestyle changes, it may be time to look at what is causing the problem, rather than simply adding more moisture.

Your optometrist can assess your tear film, eyelids and meibomian glands to determine whether MGD, inflammation or another factor is contributing to your symptoms.

Depending on your individual needs, treatment may include prescription eye drops, eyelid therapy or in-office treatments designed to target the underlying cause of dry eye.

 IPL , Intense Pulsed Light

Intense Pulsed Light (IPL) is an in-office treatment that may be recommended for people with dry eye associated with meibomian gland dysfunction and eyelid inflammation.

IPL uses controlled pulses of light around the eyes to target inflammation and abnormal blood vessels associated with conditions such as MGD and ocular rosacea. It may also help improve meibomian gland function and the quality of the oils they produce.

IPL is generally performed as a series of treatments, with the number and frequency determined by your optometrist based on your individual needs.

IPL isn’t suitable for everyone, so your eyes and skin will be assessed before treatment.

LLLT,  Low-Level Light Therapy

Low-Level Light Therapy (LLLT) is another in-office treatment that may form part of a dry-eye management plan.

LLLT uses low-intensity light to support the management of inflammation around the eyelids and ocular surface. It may be particularly useful when dry eye is associated with MGD, blepharitis or ocular surface inflammation.

LLLT can be used on its own or combined with other treatments, such as IPL, warm compresses and meibomian gland expression.

A tailored approach

Dry eye is rarely caused by just one problem, so a combination approach may be more effective than relying on a single treatment. An experienced optometrist will take you step by step to achieve success in treatment.

Your management plan may include:

Warm compresses + lid hygiene + lubricating drops + IPL/LLLT + meibomian gland management

The aim is not simply to make your eyes feel better temporarily. It is to improve the health and stability of your tear film and address the factors contributing to your dry eye.

What About Omega-3 Supplements?

You may have heard that omega-3 supplements can help dry eye.

The evidence is mixed. Some research suggests omega-3 fatty acids may benefit certain people, but supplements shouldn’t replace treatment of the underlying cause.

Including sources of omega-3 fatty acids as part of a balanced diet can be beneficial for overall health. Speak with your healthcare professional before starting supplements, particularly if you take other medications.

Does Dry Eye Ever Go Away?

Sometimes.

Dry eye caused by a temporary trigger , such as prolonged screen use, a dry environment, contact lens overuse or certain medications , may improve significantly once the trigger is addressed.

However, chronic dry eye caused by conditions such as MGD, ageing or autoimmune disease may require ongoing management.

That doesn’t mean you have to live with uncomfortable eyes.

With the right combination of treatment and lifestyle changes, many people can achieve better comfort and more stable vision.

The goal isn’t always to “cure” dry eye. Often, the goal is to restore the balance of the ocular surface and keep symptoms under control.

Is It Definitely Dry Eye?

Not necessarily.

Several other conditions can cause symptoms that look very similar to dry eye.

Allergies

Itching is particularly characteristic of allergic eye disease. Watery eyes, swelling and seasonal symptoms may also occur.

Blepharitis

Inflammation around the eyelid margins can cause redness, crusting and irritation and commonly occurs alongside MGD.

Digital eye strain

Long periods of screen use can cause fatigue, headaches and blurred vision. Dry eye and digital eye strain can also occur together.

Corneal abrasion or foreign body

Sudden pain, light sensitivity or a strong sensation that something is stuck in the eye may indicate a corneal injury rather than dry eye.

Contact lens-related infection

A red, painful eye in someone who wears contact lenses should never automatically be assumed to be dry eye. Contact lens-related infections can be serious and require prompt assessment.

Autoimmune disease

Persistent, unexplained dry eyes , particularly alongside symptoms such as dry mouth or joint symptoms, can sometimes be associated with an underlying systemic condition.

When Should You See an Optometrist?

Occasional dryness after a long day on your laptop or during a flight is usually not a reason to panic.

However, it’s worth arranging an eye examination if you regularly experience:

• Persistent redness
• Burning or gritty eyes
• Frequent watering
• Fluctuating or blurred vision
• Difficulty wearing contact lenses
• Eye fatigue affecting your day
• Symptoms that aren’t improving with simple measures

Seek prompt eye care for significant pain, marked light sensitivity, sudden vision changes, or a red painful eye, particularly if you wear contact lenses.

A dry-eye assessment can identify whether the main issue is tear production, evaporation, meibomian gland dysfunction, inflammation, eyelid function or another condition altogether.

The Bottom Line

Dry eye isn’t simply a lack of tears.

For many people, the real problem is an unstable tear film, often involving the meibomian glands and excessive tear evaporation.

The most effective treatment starts by finding out why your eyes are dry.

Simple changes such as regular blinking, screen breaks, warm compresses, appropriate lubricating drops and reducing environmental triggers can make a real difference. When symptoms persist, treatments such as IPL and LLLT may provide additional support for people with MGD and ocular surface inflammation.

If your eyes are constantly telling you they’re dry, don’t just keep reaching for another bottle of eye drops. Find out why. See Eyedentity Optometrists today!