Dry eye disease is more than simply having dry eyes. It is a common condition that occurs when your eyes do not produce enough tears, your tears evaporate too quickly, or the tear film does not function as well as it should.

Because a healthy tear film is essential for both eye comfort and clear vision, dry eye disease can cause burning, irritation, watering, contact lens discomfort and even fluctuating or blurry vision.

At Reflect Vision Care, our goal is not simply to recommend an eye drop. We evaluate the factors contributing to your symptoms and create a personalized dry eye care plan based on your tear film, eyelids, oil glands, ocular surface, lifestyle and overall eye health.

Experiencing persistent dry eye symptoms? Schedule an eye examination at one of our Asheville, South Asheville, Charlotte or Concord locations.

What Is Dry Eye Disease?

Every time you blink, a thin layer of tears spreads across the surface of your eyes. This tear film lubricates and protects the eye while creating the smooth optical surface necessary for clear vision.

When the quantity or quality of those tears becomes inadequate, the ocular surface can become irritated and inflamed.

Dry eye commonly involves one or both of two underlying mechanisms.

Aqueous Deficient Dry Eye

Aqueous deficient dry eye occurs when the eyes do not produce enough of the watery component of tears.

Evaporative Dry Eye

Evaporative dry eye occurs when tears evaporate too quickly. One of the most common contributors is meibomian gland dysfunction, or MGD.

The meibomian glands are tiny oil producing glands within the eyelids. Their oils help prevent tears from evaporating too quickly. When these glands become blocked or produce poor quality oil, the tear film can become unstable.

Many patients have a combination of aqueous deficient and evaporative dry eye.

Common Symptoms of Dry Eye

Dry eye does not always feel like dryness. Symptoms may include:

• Burning or stinging

• Sandy, gritty or scratchy sensations

• Feeling like something is in your eye

• Eye redness

• Tired or heavy eyes

• Excessive watering

• Sensitivity to light

• Stringy mucus

• Contact lens discomfort

• Difficulty keeping the eyes comfortable during prolonged reading or computer use

• Blurred or fluctuating vision

• Vision that temporarily improves after blinking

Can watery eyes actually be dry eyes?

Yes. When the ocular surface becomes irritated, your eyes may respond by producing reflex tears. These tears can make the eyes water excessively without providing the stable, balanced tear film needed for lasting comfort.

What Causes Dry Eye?

Dry eye disease often has more than one contributing factor.

Meibomian Gland Dysfunction

Meibomian gland dysfunction is one of the most common causes of evaporative dry eye.

When the oil producing glands in the eyelids become blocked or dysfunctional, tears may evaporate too quickly. This is why many patients need treatment directed toward their eyelids and glands rather than simply using more artificial tears.

Screen Time

We tend to blink less frequently and less completely when using computers, phones and tablets.

Reduced blinking allows tears to evaporate more quickly and can make dry eye symptoms worse.

Environmental Factors

Dry or moving air can increase tear evaporation. Common triggers include:

• Ceiling fans

• Car vents

• Air conditioning

• Heaters

• Wind

• Smoke

• Low humidity

Contact Lens Wear

Contact lenses interact directly with your tear film. Dry eye can make lenses less comfortable, while contact lens wear can sometimes make existing dry eye symptoms more noticeable.

Patients experiencing persistent contact lens discomfort may benefit from treatment of the ocular surface or evaluation for a different contact lens material or design.

Age and Hormonal Changes

Dry eye becomes more common with age, and hormonal changes can affect both tear production and meibomian gland function.

Medications

Certain medications may contribute to dry eye symptoms, including some:

• Antihistamines

• Antidepressants

• Blood pressure medications

• Diuretics

• Acne medications

Do not discontinue a prescribed medication because of dry eye symptoms without first speaking with the clinician who prescribed it.

Medical Conditions

Dry eye may also be associated with medical conditions including:

• Sjögren syndrome

• Rheumatoid arthritis

• Lupus

• Thyroid disease

• Diabetes

Eyelid Conditions

Blepharitis, incomplete eyelid closure, abnormal blinking and other eyelid conditions can contribute to dry eye symptoms.

How Is Dry Eye Diagnosed?

Successful dry eye treatment starts with identifying what is contributing to the problem. Your doctor may evaluate:

• Your symptoms and when they occur

• Your medications and medical history

• Your eyelids

• Your blink pattern

• Tear quantity

• Tear stability

• The surface of the cornea and conjunctiva

• The appearance and function of your meibomian glands

Specialized dyes and other diagnostic testing may also be used to evaluate the tear film and ocular surface.

Not every patient needs every dry eye test. Your evaluation and treatment recommendations are based on your individual symptoms and examination findings.

Dry Eye Treatment Options

There is no single treatment that works for everyone. Your doctor may recommend one treatment or several therapies used together. Treatment may also change over time as your ocular surface improves or your symptoms change.

Your personalized plan may include any of the following.

Daily Habits for Dry Eye

Simple changes can reduce tear evaporation and ocular irritation.

Avoid Direct Airflow

Avoid positioning fans, heaters, air conditioners and car vents so that air blows directly toward your eyes.

Use a Humidifier

A humidifier may help increase moisture in dry indoor environments.

Take Regular Screen Breaks

During prolonged screen use, periodically look away from your screen and make a conscious effort to blink completely.

The commonly used 20 20 20 rule can also be helpful: approximately every 20 minutes, look about 20 feet away for at least 20 seconds.

Stay Normally Hydrated

Maintain normal hydration throughout the day. There is no single amount of water that is appropriate for every person.

Get Adequate Sleep

Consistent, adequate sleep supports overall health and may reduce ocular fatigue and irritation.

Protect Your Eyes Outdoors

Wraparound sunglasses can reduce airflow across the eyes, particularly on windy days.

Avoid Smoke and Irritating Environments

Smoke and other airborne irritants can worsen dry eye symptoms.

Preservative Free Artificial Tears

Artificial tears are often one of the first treatments recommended for dry eye.

They supplement the natural tear film and can improve comfort and vision.

At Reflect Vision Care, we generally prefer to recommend trusted brands and the appropriate type of lubricant rather than one specific product for every patient.

Brands we recommend include Refresh, Systane, Blink, TheraTears, OPTASE, and iVIZIA.

We often recommend preservative free artificial tears, especially when drops are being used frequently or when the ocular surface is particularly sensitive.

Some artificial tears are formulated specifically to support the oily portion of the tear film and may be particularly useful for patients with evaporative dry eye or meibomian gland dysfunction.

Your doctor can help determine which type is most appropriate for you.

Should I Use Redness Relief Drops?

Eye drops marketed primarily to “get the red out” are not the same as lubricating artificial tears.

If you must use a redness relief eye drop, we recommend using Lumify, in moderation. However, a preservative free lubricating drop is usually a better starting point when the underlying problem is dry eye.

Gel and Nighttime Lubrication

Some patients benefit from a thicker lubricant, particularly before bedtime. Gels and ointments remain on the surface of the eye longer than standard artificial tears. Because they can temporarily blur vision, they are often best used at night.

Brands we recommend include Refresh, Systane, GenTeal, and Soothe.

Nighttime lubrication may be especially useful for patients who wake with dry or irritated eyes or whose eyelids do not completely close while sleeping.

Warm Compresses for Dry Eye

Warm compresses are an important home treatment for many patients with meibomian gland dysfunction.

Heat helps soften thickened oils within the eyelid glands so they can flow more normally into the tear film.

If your doctor recommends a heated eye mask, we commonly recommend approximately 10 minutes per treatment session.

Follow the manufacturer's heating instructions carefully and avoid overheating the mask. Reusable heated eye masks generally maintain warmth more consistently than a washcloth that cools quickly.

Eyelid Hygiene

Healthy eyelids are an important part of a healthy tear film. Blepharitis, eyelid debris, inflammation and certain microorganisms can contribute to dry eye symptoms.

Eyelid cleanser or spray brands we recommend include OCuSOFT, Avenova, or Cliradex.

Different eyelid hygiene products are designed for different purposes, so use the product and frequency recommended by your doctor.

Some patients may also have Demodex, microscopic mites that can live around the eyelashes and contribute to eyelid inflammation. When clinically significant Demodex is present, additional treatment may be recommended.

Omega 3 Supplements

Omega 3 fatty acids have been studied as a potential treatment for dry eye and meibomian gland dysfunction.

Brands we recommend include, Nordic Naturals, PRN, MacuHealth, and ScienceBased Health.

Research regarding omega 3 supplementation and dry eye has produced mixed results, so supplements are not necessary for every patient.

If your doctor recommends omega 3 supplementation, follow the specific product and dosage guidance provided.

Talk with your healthcare provider before starting a supplement if you take blood thinning medication, have a bleeding disorder or have other medical concerns.

Prescription Dry Eye Medication

Some patients need prescription therapy to improve tear production, reduce inflammation or address other components of dry eye disease. Several prescription medications are available, and they work through different mechanisms.

Your doctor will recommend a medication based on your symptoms, examination findings, medical history and previous treatments.

Some prescription dry eye treatments require consistent use for several weeks or months before reaching their full effect.

Short Term Anti Inflammatory Eye Drops

Inflammation can contribute to the cycle of dry eye disease. For selected patients, your doctor may prescribe a topical anti inflammatory medication for a limited period.

These medications should be used exactly as directed. Some topical corticosteroids can increase eye pressure or cause other complications when used inappropriately or for prolonged periods.

Punctal Plugs

Your natural tears drain through tiny openings near the inner corners of the eyelids called puncta. A punctal plug is a very small device placed into one of these openings to slow tear drainage.

By keeping tears on the eye longer, punctal plugs can improve lubrication in appropriately selected patients. Temporary and longer lasting options are available.

Punctal plugs are not appropriate for every form of dry eye, so your doctor will determine whether they are likely to benefit you.

In Office Dry Eye Treatments

Patients with persistent dry eye or significant meibomian gland dysfunction may benefit from treatments performed in the office.

Depending on your examination findings, available therapies may include.

Thermal Therapy

Controlled heat can help soften thickened material within the meibomian glands.

Meibomian Gland Expression

The glands may be manually or mechanically expressed to help remove obstructed material.

Thermal Pulsation

Some technologies combine controlled heat and pressure to help improve gland function.

Intense Pulsed Light

Intense pulsed light, commonly called IPL, uses controlled light applied around the eyelids and surrounding skin.

IPL may be appropriate for selected patients with meibomian gland dysfunction, ocular rosacea or inflammatory evaporative dry eye.

Not every in office treatment is appropriate for every patient. Your doctor will recommend treatment based on the underlying cause of your dry eye.

Autologous Serum Tears

Patients with more significant ocular surface disease may benefit from autologous serum tears. These eye drops are produced using components of the patient's own blood.

Because serum contains naturally occurring proteins, growth factors and other biological components, it may provide benefits that standard artificial tears cannot.

Autologous serum tears may be considered for patients with severe dry eye, persistent corneal staining or ocular surface disease that has not adequately responded to conventional treatments.

Amniotic Membrane Treatment

An amniotic membrane may be used when the ocular surface requires additional protection and healing support.

Amniotic tissue has biological properties that can help support healing and reduce inflammation. For dry eye patients, this treatment is generally reserved for more significant ocular surface disease rather than routine mild symptoms.

Scleral Contact Lenses for Dry Eye

Scleral lenses are specialty contact lenses that vault over the cornea and rest on the white portion of the eye.

The space beneath the lens is filled with preservative free saline, creating a fluid reservoir over the cornea throughout the day.

For selected patients with moderate to severe dry eye or significant ocular surface disease, scleral lenses can provide both ocular surface protection and improved vision.

Frequently Asked Questions About Dry Eye

Can dry eye cause blurry vision?

Yes. Your tear film forms the first optical surface that light passes through when entering your eye.

When the tear film becomes unstable, vision can fluctuate or become temporarily blurry. If vision improves immediately after blinking, an unstable tear film may be contributing.

Persistent or sudden blurred vision should still be evaluated because many other eye conditions can also affect vision.

Why are my eyes watering if I have dry eye?

Dryness and irritation can trigger reflex tear production. These watery tears may overflow onto the cheeks but still fail to provide the stable lubrication needed for a healthy ocular surface.

Can dry eye be cured?

Dry eye is often a chronic condition, so treatment usually focuses on controlling the underlying causes, improving the health of the ocular surface and reducing symptoms.

Some contributing factors may improve or resolve, while others require ongoing management.

Are preservative free eye drops better?

Preservative free artificial tears are particularly useful when drops are needed frequently or when the ocular surface is sensitive. Your doctor can help determine which formulation is best for you.

How often should I use artificial tears?

It depends on the severity and cause of your symptoms. Follow the frequency recommended by your doctor. If you find yourself needing drops very frequently without adequate relief, it may be time for a more comprehensive dry eye evaluation.

How long should I use a warm compress?

When a heated eye mask is recommended, we commonly recommend approximately 10 minutes per session, unless your doctor provides different instructions.

Can contact lenses make dry eye worse?

They can. Contact lens wear changes the interaction between the ocular surface and tear film. Treating underlying dry eye, adjusting wearing time or switching lens materials or designs can sometimes improve comfort.

Can screen time cause dry eye?

Screen use can contribute to symptoms because people tend to blink less often and less completely while looking at digital devices. Screen use may aggravate dry eye even when it is not the only underlying cause.

When should I see an eye doctor for dry eye?

Schedule an examination if you have persistent burning, irritation, watering, contact lens discomfort or fluctuating vision, particularly when artificial tears are no longer providing adequate relief.

Seek more prompt care for significant pain, marked redness, light sensitivity, discharge, sudden vision changes, injury or rapidly worsening symptoms.

Why Choose Reflect Vision Care for Dry Eye Care?

Dry eye treatment should be based on why your eyes are dry, not simply which eye drop happens to be on the shelf.

At Reflect Vision Care, our doctors evaluate the ocular surface, tear film, eyelids and other contributing factors before recommending an individualized treatment plan.

Schedule a Dry Eye Evaluation

If burning, watering, irritation, fluctuating vision or contact lens discomfort are affecting your day, we are here to help.

Experiencing persistent dry eye symptoms? Schedule an eye examination at one of our Asheville, South Asheville, Charlotte or Concord locations.