Dry Eyes

Causes, Symptoms, and Care

The human eye is one of the most delicate organs of the body, and its smooth functioning depends greatly on being kept moist at all times. A continuous layer of tears spreads over the front of the eye, forming a protective and nourishing coat. Without this natural moisture film, the eyes quickly become irritated, red, and even vulnerable to infections.

Normal anatomy and tear production

The tear system consists of the lacrimal glands, accessory glands, ducts, and drainage passages. The main lacrimal glands, located above the outer corner of each eye, secrete the watery component of tears. Smaller accessory glands present inside the eyelids also contribute to tear production. These secretions pass into the tiny lacrimal ducts and spread evenly over the surface of the eye each time we blink.

The tear film is more than just water. It has three layers:

1️⃣An outer oily layer produced by the meibomian glands in the eyelids, which prevents tears from evaporating too quickly.

2️⃣A middle watery layer from the lacrimal glands, which provides oxygen, nutrients, and antibacterial enzymes.

3️⃣An inner mucin layer secreted by special conjunctival cells, which helps the watery part of tears stick smoothly to the eyeball.

Together, these layers create a clear optical surface and form a small reservoir of fluid inside the cavity made by the conjunctiva and the inner surface of the eyelids. Every blink spreads this fluid evenly, keeping the cornea and conjunctiva moist. Excess tears normally drain through two tiny openings in the eyelids (puncta) into the nasolacrimal duct, which finally empties into the nose.

Why do tears dry out?

Dry eyes occur when there is either inadequate tear production or excessive tear evaporation. Common reasons include:

✔️ Mechanical factors: Constant rubbing of the eyes disrupts the tear film and can damage the surface epithelium.

✔️ Environmental factors: Wind, smoke, low humidity, or prolonged exposure to air conditioning can accelerate tear evaporation. 

✔️ Dehydration: Insufficient body fluids reduce tear formation.

✔️ Blockage of tear drainage: Surprisingly, a blocked nasolacrimal duct can also cause irritation. Though this usually leads to watery eyes, the stagnant fluid is of poor quality, leaving the surface inadequately protected.

✔️ Medical conditions: Autoimmune disorders like Sjögren’s syndrome, eyelid malpositions, or side effects of certain medications (antihistamines, antidepressants) can reduce tear quantity or quality.

✔️ Ageing: Natural tear production tends to decline with age, particularly in post-menopausal women.

Symptoms of dry eyes

Patients may notice:

✔️ A gritty or sandy feeling inside the eyes.

✔️ Burning, itching, or stinging sensations.

✔️ Redness and fatigue, especially after reading or working on screens like TV, phones, or PCs.

✔️ Blurred or fluctuating vision that improves with blinking.

✔️ Difficulty wearing contact lenses.

✔️ Excessive tears due to a reflex response to dryness.

Complications if Dry Eyes are left untreated

When the surface of the eye remains dry for long periods, the thin membranes of the conjunctiva and the transparent cornea suffer. Without adequate lubrication, microscopic breaks develop, making the eye prone to infections and scarring. Persistent dryness may cause ulcers on the cornea, thinning of tissues, or permanent loss of transparency. Severe damage can even threaten vision.

How to keep eyes naturally moist

Several simple measures can help maintain eye moisture:

✔️ Blink regularly, especially while viewing screens of the mobile phone, computer, or TV.

✔️ Stay well hydrated throughout the day.

✔️ Use protective glasses when outdoors in the wind or the sun.

✔️ Avoid smoke, dust, and prolonged exposure to direct air from fans or AC vents.

✔️ Ensure adequate dietary intake of omega-3 fatty acids, which support tear quality.

✔️ Omega-3 fatty acids are found in nuts, seeds, and plant oils. Flax seeds, chia seeds, and walnuts are good sources.

When to consult an eye specialist

Mild, occasional dryness often improves with lifestyle adjustments. However, you should seek professional advice if symptoms persist beyond a few days, if vision becomes blurred, or if there is constant redness and discomfort. Those with autoimmune diseases, thyroid problems, or eyelid abnormalities should be particularly cautious.

Treatment of dry eyes

Eye specialists usually begin with non-surgical options:

✔️ Artificial tears or lubricating eye drops to supplement natural tears.

✔️ Gels or ointments for night use to provide longer lubrication.

✔️ Anti-inflammatory drops (such as cyclosporine or lifitegrast) when inflammations reduce tear production.

✔️ Punctal plugs to block tear drainage and retain moisture on the surface.

✔️ Warm compresses and eyelid massage to improve oil secretion from meibomian glands.

Surgical Treatment

In rare and severe cases, surgical procedures may be considered. These include permanent punctal closure or corrective surgery for eyelid malposition that interferes with normal tear spreading.

Prevention and long-term care

The best strategy against dry eyes is prevention. Regular eye rest during screen time, keeping indoor air humidified, and adopting a balanced diet go a long way. Regular eye check-ups also help detect early signs of dryness, particularly in older adults or those on long-term medication.

Conclusion

Dry eyes may sound like a minor nuisance, but they can significantly affect comfort, vision, and quality of life. Understanding the normal anatomy of the tear system helps us appreciate how delicate the balance is between tear production, evaporation, and drainage. By protecting this balance with good habits, early medical care, and appropriate treatment, the eyes can remain healthy, moist, and clear for a lifetime.