What is dry eye syndrome?
Dry eye syndrome (or dry eye disease) is a condition that happens when your eyes don’t produce enough tears or if the quality of your tears isn’t quite right. When the tear supply is reduced or of poor quality, your eyes can feel itchy and uncomfortable as they won't be able to moisten your cornea.
Dry eye syndrome symptoms
Both eyes are usually affected, with symptoms including:
Uncomfortable, gritty or itchy feeling in your eyes
Burning or sore sensation
Temporary or fluctuating blurred vision (that improves when you blink)
Contact lens discomfort, especially at the end of the day
Watery eyes (despite the name, watery eyes can be a common symptom of dry eye syndrome)
More severe complications of dry eye can lead to symptoms which may include extreme sensitivity to light (photophobia), very red and painful eyes, and a change in your vision.
If you have any of these symptoms, contact your optometrist, GP or NHS 111 as soon as possible, as it could be a sign of a more serious complication.
Dry eye syndrome causes
Dry eye syndrome happens when your eyes stop making tears as they usually would. Tears are an important part of your eye health as they help to keep your eyes moisturised, protect them against infections, clear away any debris from the surface of your eyes and keep your vision clear.
A normal tear film is made up of three main layers:
Mucin layer – which lines the surface of the eye (the cornea) and makes the tears stick to the eye
Aqueous (water) layer – this nourishes and protects the eye
Lipid (oily) layer – this sits on the outer surface of the tear film and prevents the tears from evaporating.
A breakdown in the production of any of these layers will lead to an imbalance in the tear film, which reduces the quality or quantity of tears. For example, if the lipid layer is reduced, the tears may evaporate too quickly as there is nothing to hold the aqueous layer in place. If there is a reduced aqueous layer, not enough tears are being produced.
Dry eye syndrome can happen for many reasons, including any or a combination of the following:
A blockage in the glands of the eyelid that supply the important oily layer of tears (known as meibomian gland dysfunction (MGD)) – without this layer (the lipid layer), the tears evaporate quicker, causing the eyes to dry out.
Blepharitis – inflammation of the eyelid and around the eyelashes, which can also disrupt the glands responsible for producing the parts of the tear film
Age – as we get older, our eyelids don’t spread tears across the eyes as well when blinking and the glands which supply the components of our tears can become less efficient (similar to when our skin dries more with age)
Wearing contact lenses
Working in an office or air‑conditioned environment
Eye strain – staring at a screen for a prolonged time means that we don’t blink as efficiently
Some eye surgeries
Being in a hot or windy environment
Certain underlying medical conditions, like diabetes, rheumatoid arthritis or Sjögren's syndrome.
Side effects of certain medications, such as some antihistamines
Alcohol usage – alcohol can dehydrate the body and therefore reduce the volume of tears your eyes produce
Hormonal changes — recent research found that 86% of women were unaware of the link between eye health and menopause1. Fluctuations in oestrogen can cause hormonal dry eye. Discover our best eye drops for menopause dry eyes here.
How are dry eyes and headaches linked?
Even though dry eyes and headaches often happen at the same time, it’s not clear yet whether one causes the other or if they’re both just symptoms of the same condition.
Some studies have investigated a potential link between the two2,3,4, suggesting that people with headaches or migraines are more likely to have dry eye, but there is still plenty of research to be done into the nature of their relationship.
The most likely link between the two is that they’re both common symptoms of computer or digital eye strain. And because so many of us now use screens as part of our normal daily lives, it’s likely that a lot of us will experience dry eyes and headaches at some point.
So what part do screens play?
Screens do seem to play some sort of role in dry eyes and headaches. A 2017 survey showed that 9 in 10 UK optometrists had seen patients in the last month who reported problems as a result of screen use – including dry eyes, headaches or eye strain.5
So what is it about screens that has this effect on the eyes? To start with, when concentrating on screens for extended periods of time, your blink rate reduces by over 60%, or you don’t blink fully. This means that the eye’s surface isn’t regularly being replenished and moisturised with tears, and they’re exposed longer to the air, evaporating the tears quicker. Coupled with the air conditioning of an office environment, this can further dry out the eyes.
Headaches associated with screen usage are more related to the muscles in the eyes working too hard when concentrating on the screen. They might also be battling with glare or reflections from screens, which puts extra pressure on the eyes to get a clear image.
Dry eye treatment
It’s fairly straightforward to treat dry eye syndrome and make your eyes feel more comfortable.
Applying a heated eye mask to closed eyelids, twice a day for 5 minutes, can help to soften and loosen any blocked oil in the glands along the eyelid that supply oil into your tears. After you take off the eye mask, use a clean finger to gently massage your eyelids towards your lashes – this helps to get the oil flowing from the glands.
Cleaning your eyelids each day with lid scrubs, wipes or foams can help to remove bacteria, debris and oil that can lead to blockage of the glands and dry eye syndrome.
Using preservative‑free dry eye drops (lubricants) can ease the symptoms. These drops can be used as often as needed, depending on your symptoms. Usually, you’d start using them two or three times a day. Dry eye drops will help with the symptoms, but it’s important to target the underlying causes of dry eye by carrying out steps one and two.
If it’s thought that dry eye syndrome is caused by a medication you’re taking or an underlying medical condition, you should discuss this with your GP. If medication is aggravating symptoms, your GP may try switching you to an alternative. If your dry eye is thought to be caused by an underlying condition, then treating that condition will usually help to relieve the symptoms.
If you’re a contact lens wearer, it can sometimes help to take a break from wearing your lenses or change to a different lens material. You could also use contact lens‑friendly dry eye drops onto your lenses before you apply them each day, and then apply them during the day while you’re wearing your lenses.
In more severe cases, surgery might be an option to prevent tears from draining away too easily, by plugging the tear duct which drains the tears.
It has now been recognised that having a diet rich in Omega‑3 fatty acids can help to manage dry eye syndrome. Omega‑3 nutritional supplements can be effective as well.
Maintaining a good intake of fluid and making sure you don’t become dehydrated can help reduce the severity of dry eye syndrome.
Avoiding smoky or very dry air‑conditioned environments as much as possible can help with the symptoms of dry eye syndrome.
Specsavers antibacterial dry eye compress
Specsavers Antibacterial Dry Eye Compress can be used hot or cold to alleviate symptoms of dry eye, meibomian gland dysfunction (MGD), and blepharitis. It is available to purchase from your local store.
Key features:
Use hot to relieve symptoms of blepharitis, dry eye disease and eyelid cysts.
Use cold to relieve symptoms of hay fever, inflammation, headaches, and migraines.
Or use in conjunction with Specsavers dry eye drops to manage dry eyes.
Dry eye drops
Dry eye drops provide some welcome relief from dry eyes as well as some extra comfort for contact lens wearers.
Types of eye drops available at Specsavers
Specsavers Mild to Intensive Dry Eye Drops
Thealoz Duo Dry Eye Drops
Hycosan Original to Plus Dry Eye Drops
View our accessories page to see all available eye drops.
Features and benefits of dry eye drops
As well as helping with dry eye symptoms, our range of dry eye drops doesn’t contain any preservatives, so as not to interfere with the delicate structure of your tear film. They’re also contact lens‑friendly, so you can use them while you’re wearing your lenses.
Which dry eye drop is right for me?
There are different types of dry eye drops to suit different levels of dry eye. Have a chat with our team in‑store, or with your pharmacist, who will be able to recommend the right type for you.
If you have any concerns about your eye health, get in touch with your local store, even if you don’t have an appointment.
How often should you use eye drops?
Although the recommended use is once or twice a day, this may not be sufficient. You should use them as frequently as you feel is required.
Alongside eye drops, It's also worth bathing your closed eyes with a hot compress, like a face flannel rinsed under hot water and do this three or four times a day. This will help stimulate the secretory glands under your eyelids and help improve the quality of your tears.
What's the best treatment for dry eyes that feel gritty and make it difficult to concentrate?
Buying eye drops is one of the best treatments for dry eyes; a simple and cheap one is Hypermellose, but it contains preservatives that you might be sensitive to and it doesn't stay in the eye for very long.
The latest generation of 'artificial tears' is an advanced formula that tends to condition the cornea and stay in the eye for longer, giving more relief with little risk of sensitivity.
Recommended brands include the range stocked at Specsavers (Specsavers, Thealoz Duo and Hycosan), Systane Ultra, Hyabak, Ocusan, Lubristil, Hydromor, Clinitas and Blink — your optician is the best person to go to for recommendations. Find your local store here to get in contact with your nearest optician.
FAQs
Dry eye can be temporary or chronic, but if you’ve had it once it’s likely you’ll get it again at some point. Often it can come and go in certain situations and throughout your life.
When you’re dehydrated, your body tries to keep as much fluid in the body – so you won’t go to the loo and your eyes and mouth can feel dry. So it’s important you try to keep hydrated so that your body can properly produce the tears your eyes need to stay healthy.
Consuming alcohol can dehydrate your body and may therefore reduce the volume of tears your eyes produce. When there is not enough fluid to lubricate the eye, you might experience symptoms of dry eye as a result. Alongside lubricating your eyes, tears help protect eyes against infection and foreign objects, such as dust particles.
The difficulty in opening your eye might be a separate problem from your dry eyes. For dry eyes, we would recommend using eye drops during the day, and a thicker, gel‑like drop before you go to bed to help keep the cornea as moist as possible while you sleep.
The problem with your eyelid is possibly due to a weakness in the muscle that elevates the lid. The cause may be difficult to determine but it may be due to a growth in the eyelid, such as a stye, a medical problem, a nerve injury or part of the normal ageing process.
Although it's a nuisance, it's not usually a serious problem and should be evaluated by your GP or optician. Book your appointment here.
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Kimberley Young (2022) Eye Health UK launches #VisionAndMenopause campaign Available at: https://www.aop.org.uk/ot/industry/charity/2022/10/18/eye‑health‑uk‑launch‑visionandmenopause‑campaign
Asuman Celikbilek, Mehmet Adam (2015) NCBI. The relationship between dry eye and migraine [Online] Available at: https://pubmed.ncbi.nlm.nih.gov/25231463/
(Accessed: 6 November 2019)Bengu E Koktekir, Guner Celik, Aylin Karalezli, Ali Kal (2012) NCBI. Dry eyes and migraines: is there really a correlation? [Online] Available at: https://pubmed.ncbi.nlm.nih.gov/22710496/
(Accessed: 6 November 2019)(2015) NCBI. Chronic migraine is associated with reduced corneal nerve fiber density and symptoms of dry eye. [Online] Available at: https://pubmed.ncbi.nlm.nih.gov/25828778/
(Accessed: 6 November 2019)Association of Optometrists (no date). AOP position: visible blue light [Online] Available at: https://www.aop.org.uk/our‑voice/policy/position‑statements/visible‑blue‑light
(Accessed: 5 November 2019)