What Are the Symptoms of Dry Eye Disease?

Understanding Dry Eye Syndrome

Dry eye syndrome, also known as keratoconjunctivitis sicca, occurs when your eyes don't produce enough tears or the quality of your tears isn't quality enough to keep your eyes properly lubricated and protected. Tears are a mix of water, electrolytes, proteins, and lipids that are essential for eye health. The tear film has three layers: the mucous layer, aqueous layer, and lipid layer. Each plays a vital role in nourishing and protecting your eyes, ensuring clear vision and comfort.

The Importance of Tear Composition

Tears are crucial for keeping your eyes healthy and comfortable. The mucous layer, closest to the eye, helps spread tears evenly and allows smooth movement across the cornea. The water layer, mainly water and electrolytes, provides moisture, oxygen, and nutrients and makes up over 90% of all the tear film. The lipid layer, produced by the meibomian glands, prevents tear evaporation and keeps the tear film stable. When any part of this system is off, dry eye symptoms can occur.

Several factors can contribute to dry eye syndrome, including age, gender (women are more susceptible), hormonal changes, environmental conditions (like dry or windy climates), certain medications (such as antihistamines and decongestants), medical conditions (like rheumatoid arthritis and Sjögren's syndrome), and lifestyle factors (like prolonged screen time and not drinking enough water).

Common Symptoms of Dry Eyes

Recognizing the symptoms of dry eyes is key to getting timely treatment. Common signs of dry eye syndrome include: 

• Burning, itching, or scratchy sensation in the eyes 

• A feeling of having something in the eye (foreign body sensation) 

• Redness or inflammation of the eye surface 

• Sensitivity to light (photophobia) 

• Blurred vision, especially during activities requiring prolonged focus 

• Watery eyes

Burning, Itching, or Scratchy Eyes

A persistent feeling of burning, itching, or scratchiness is a common symptom of dry eye syndrome. This discomfort is often made worse by environmental factors such as low humidity, wind, smoke, or extended screen time. People often describe this sensation as gritty or sandy.

Sensation of Foreign Objects in the Eye

Without proper lubrication, your eyes can become swollen, leading to a constant feeling of something being stuck in your eye. Reducing other symptoms of dry eye can help alleviate this sensation.

Redness and Inflammation

When your eyes aren't properly lubricated, they can become irritated and inflamed, leading to redness, swelling, and a gritty feeling. Rubbing your eyes in response to discomfort can make these symptoms worse and potentially damage your eyes.

Sensitivity to Light (Photophobia)

Dry eyes can make you more sensitive to light, making bright environments or fluorescent lighting uncomfortable. This sensitivity often comes with other symptoms such as eye discomfort, glare sensitivity, and difficulty focusing.

Blurry Vision

Tears are vital for keeping your vision clear by maintaining a smooth cornea. Without enough good-quality tears, your vision can become blurry, especially after activities like reading, driving, or using digital devices. Blurred vision might temporarily improve with blinking or artificial tears but can get worse over time if untreated.

Signs of Chronic Dry Eyes

In addition to the common symptoms, dry eye syndrome can show up in other ways that indicate underlying eye conditions, including:

• Excessive tearing (paradoxically) 

• Stringy mucous discharge from the eyes 

• Eye fatigue or discomfort from extended visual tasks

Excessive Tearing (Epiphora)

Some people with dry eye syndrome may experience excessive tearing as their eyes try to compensate for dryness. This reflex tearing doesn't provide the same benefits as normal tears and is often accompanied by irritation, redness, or light sensitivity.

Mucus Discharge

Disruptions in tear composition can lead to stringy mucus discharge from the eyes, indicating underlying issues that need further evaluation by an eye care professional. Mucus discharge may signal chronic dry eye syndrome, ocular surface inflammation, or meibomian gland dysfunction.

Eye Fatigue

Dry eyes can significantly increase visual fatigue. Tasks requiring extended concentration can be more challenging with itchy, blurry eyesight. You may need to focus harder to perform daily activities, tiring your eyes faster.

When to See an Eye Doctor

Persistent or worsening dry eye symptoms should prompt a visit to an eye care professional for a comprehensive evaluation, diagnosis, and management. Delayed treatment can lead to complications such as corneal abrasions, infections, and impaired vision quality.

When to Seek Emergency Eye Care

While dry eye syndrome usually presents with mild to moderate symptoms, certain signs may indicate the need for urgent medical attention:

• Severe eye pain or discomfort 

• Sudden changes in vision clarity or loss of vision 

• Acute eye redness, swelling, or discharge 

• Sensitivity to light accompanied by severe headaches or eye discomfort

Severe Eye Pain or Discomfort

Sharp or persistent eye pain is not typical of dry eye syndrome and may indicate a more serious eye condition that requires immediate evaluation. Severe pain, especially with light sensitivity or vision changes, should be addressed promptly.

Sudden Changes in Vision or Loss of Vision

Rapid changes in vision clarity, particularly if accompanied by halos, double vision, or a shadow across the visual field, may signal serious eye issues like corneal ulceration, retinal detachment, or acute angle-closure glaucoma. Immediate treatment is crucial to prevent permanent vision loss.

Acute Eye Redness, Swelling, or Discharge

Sudden significant eye redness, swelling, or mucus discharge may indicate an acute eye infection, allergic reaction, or inflammation that needs prompt medical attention. Avoid rubbing or touching the eyes to prevent further irritation or infection spread.