Dry eye disease (DED) is more common than many people realise, especially in the digital age where many eyes are glued to screens for hours every day. According to a recent survey:
1
This is bad news to us as optometrists because it means that many people, including rising numbers of young people, 2 are suffering needlessly. Dry eye symptoms may adversely impact quality of life and daily activity choices. Recognising that this issue can and should be mentioned to and managed by a primary eyecare specialist is important. It is also best to deal with initial dry eye symptoms early, before they become a chronic condition or disease. Instead of waiting until your next scheduled appointment, it might be best to schedule an earlier visit if you have early symptoms of dry eye disease. These may include:
- Eyes feeling dry, sore, or irritated
- Tearing or buildup of particles in the eyes
- Sensation of itchiness, grittiness, or eye strain
- There may be light sensitivity, e.g. after prolonged screen use
To draw attention to this public health issue, July has been dubbed Dry Eye Awareness Month by the organisation Prevent Blindness, making it the perfect time to learn more. They provide some informative resources here, listing several risk factors and symptoms.
Besides building your awareness and general knowledge, consulting an optometrist or ophthalmologist will help you to identify the specific type of dry eye you may have, and therefore guide you towards the appropriate options for managing the condition. This is based on an in-clinic diagnosis of your ocular surface, eyelids, and tear composition amongst other relevant measurements taken with specialised equipment. Self-diagnosis is not recommended as symptoms of DED overlap with several other ocular surface diseases.
Article Sections:
What is Dry Eye Disease (DED)?
Besides environmental and physiological factors, dry eye may occur when your eyes either don’t produce enough tears or produce tears of poor quality. Tears are vital because they maintain clear vision and lubrication, as well as protect the eyes from infection.
There are 2 main types of dry eye disease, both of which start as discomfort. It is important to note that modern and digital lifestyles seem to increase vulnerability to developing DED.
1. Aqueous Deficient Dry Eyes (ADDE)
ADDE occurs due to reduced tear production from the lacrimal glands. Symptoms include, burning sensation, sensitivity to light, eye redness and foreign body sensation. Autoimmune conditions like Sjogren’s syndrome often led to ADDE.
2. Evaporative Dry Eyes (EDE)
This is the most prevalent type, resulting from quick evaporation of tears due to poor tear quality, commonly linked to dysfunction of the meibomian glands. Symptoms include gritty or sandy sensation, blurred vision, watery eyes (paradoxical tearing), itchy eyes. According to the Craig et al. (2017), 3 86% of dry eye cases are evaporative due to meibomian gland dysfunction (MGD).
Environmental & Physiological Factors:
Things like air pollution, poor quality or unclean cosmetics, hormonal changes, surgery, stress, and anxiety may increase vulnerability to dry eye symptoms and disease.
Ocular allergies and systemic disease as well as smartphone use were found to be associated with DED in youths (See Stapleton et al., 2024)
Some drugs may cause dry eye, for example several anti-histamines (Penn Medicine, 2025).
People with “evaporative” dry eye often experience what Dr. Singh calls “reflex tearing.” When your tears evaporate too quickly due to poor oil production, your eyes flood themselves with more tears to compensate.
In Varacallo (2025) 4
What can we do?
Several habits and lifestyle changes may help with dry eye symptoms and discomfort.
BLINK! More Frequently
Prolonged screen use significantly reduces your natural blink rate, from an average of 15 to 20 blinks per minute to as few as 4 to 5. This disrupts the tear film and leads to increased tear evaporation, contributing to dry eye symptoms. Making a conscious effort to blink more often, especially during digital device use, helps maintain tear film stability and keeps your eyes well-lubricated.
Break! Follow the 20-20-6.1 Rule
Not everyone can reduce daily screen time, whether due to work requirements or a grievous addiction to games and cat videos. So a good habit to cultivate is that every 20 minutes, you take a 20-second break to look at something 20 feet away. For those of us on imperial measurement systems, that’s 6.1 meters away. This not only reduces digital eye strain but also encourages more frequent blinking. As mentioned above, an increased blink rate helps maintain a healthy tear film.
Nutrition: (e.g. Include Omega-3s and Antioxidants in Your Diet)
Oxidative stress is becoming a target for intervention and therapeutics in a variety of diseases, including DED (See Bu et al., 2024). 5
Omega-3 fatty acids have anti-inflammatory properties that help improve the quality of the tear film and reduce dry eye symptoms. Systemic and localised inflammation are major contributors to DED signs and symptoms as experienced by patients. Omega-3s are able to support the oily layer of the tear film, slowing tear evaporation. Early clinical studies such as Kangari et al. (2013) 6 and Epitropolous (2016) 7 have shown that regular intake of omega-3 from sources like fish, flaxseeds, or supplements can improve tear stability and reduce eye irritation.
Proper nutrition and product selection is important for managing eye health. Regular exposure to toxins, chemical irritants, allergens, and even chronic gut dysbiosis may be involved in a variety of ocular surface diseases, including dry eye (Markoulli et al., 2023). 8
*Please check with your doctor if Omega-3 supplements are compatible with any medications or pre-existing conditions you may have, such as high cholesterol.”
Hydrate! Drink enough water
Adequate hydration from water and even other sources like vegetables is essential for maintaining healthy tear production. The tear film consists of three layers: Lipid, aqueous, and mucin. The aqueous layer is primarily water. When the body is dehydrated, production of this layer may decrease, leading to a thinner tear film and increased evaporation. Beverages like tea, coffee, and sugary juices are not substitutes for your daily water intake.
Several studies have shown a connection between hydration and tear film stability. Research published in Patel et al. (2015) 9 found that individuals with lower water intake reported more dry eye symptoms, but there have been contrasting results in other studies like Nguyen et al. (2018)10 , which indicates a more complex relationship. Willshire et al. (2018) 11 hypothesised that even mild dehydration can affect tear volume and osmolarity.
Humidify! Get outdoors more or use a humidifier
Dry indoor air from air conditioning or heating can speed up tear evaporation and worsen dry eyes. A humidifier can add moisture to the air, helping maintain tear film stability. Studies like Wang et al. (2017) 12 showed that even a USB-powered humidifier can improve comfort of computer users.
You should also try to avoid direct, strong airflow from fans or air conditioning.
Hygiene: Eyelids and Environmental
Natural irritants like smoke, dust, or pollen can lead to inflammation and disruption of the tear film. Wearing proper eye protection in working conditions characterised by lots of small, airborne particles is an option. Patnaik et al. (2024) 13 also found that ocular surface diseases like conjuctivitis and dry eye can be exacerbated by daily levels of ambient particulate matter, which is unavoidable in some contexts.
To minimise irritation and allergies, contact lenses should be kept clean and worn as instructed, and only trustworthy products used. For some people, make-up products may be a source of chemical irritation that could lead to or worsen dry eye. In general, cleanliness is essential for the proper function and microbial state of your eyelids and ocular surface.
What can we use?
Artificial Tears
Artificial tears are the first-line treatment for mild dry eye symptoms. They provide temporary lubrication by supplementing the aqueous layer of the tear film. Regular use of artificial tears can improve comfort and reduce corneal staining in patients with mild dry eye Liu et al. (2000) 14 One downside is that frequent application is required.
Gel Drops or Ointments
For moderate to severe DED, gel formulations or ointments offer longer-lasting relief by forming a protective barrier that reduces tear evaporation. These thicker preparations are particularly effective overnight when tear production naturally decreases. Do note that these may cause temporary blurred vision, however they may significantly improve ocular surface hydration during sleep.
Preservative-Free Drops
Preservatives in eye drops can exacerbate irritation, especially with frequent use or in patients with sensitive eyes or ocular surface disease. Clinical evidence supports the use of preservative-free formulations to minimise toxicity and inflammation (Agarwal et al., 2021)15. These drops are recommended for chronic dry eye sufferers who require multiple daily applications.
Medicated Eyedrops
Prescription eye drops targeting underlying causes such as inflammation (e.g., cyclosporine, lifitegrast) or meibomian gland dysfunction (e.g., lipid-based formulations) have demonstrated efficacy in improving tear quality and reducing dry eye symptoms 16. The majority of participants in the survey recently conducted by Bausch + Lomb generally agreed that prescription drops were more beneficial than their prior OTC options.
Another Route: Meibomian Gland Stimulation
In addition to various types of eyes drops and lifestyle modifications, our clinic offers a non-invasive therapy to suitable patients. Gentle electromagnetic pulses are used to stimulate and therefore improve the function and activity of the meibomian glands, which help to maintain the oily layer of your tear film.
Improving gland activity reduces your rate of tear evaporation and alleviates some of the dryness, irritation, and discomfort. The session is quick, painless, and requires no downtime, making it an effective option for those seeking long-lasting relief beyond conventional eye drops.
What to expect
- Sessions last approximately 20 minutes per eye.
- Most patients undergo four treatments over 4 weeks.
- No anaesthesia or recovery time is required, patients can resume normal activities immediately.
During each session, a specialised applicator rests just above the eyelid surface and emits precise pulses of energy. These pulses penetrate the skin without discomfort and interact with cells in the meibomian glands, encouraging them to clear blockages and resume healthy oil production.
Key benefits
- Improved gland function leading to a more robust oily layer in the tear film
- Reduced tear evaporation and longer-lasting relief from dryness
- Fewer symptoms of burning, irritation, and redness
- Enhanced comfort during extended screen use and in dry environments
We hope you are now slightly better informed about dry eye. Your daily comfort and ocular surface health are important. If you are experiencing irritation or pain or suspect dry eye, it can be worth seeing a professional.
- 1 Report and Campaign Announcement : https://www.bausch.com/newsroom/news/?id=276 Bonavitacola, J. (2025, July 8). Education Surrounding Dry Eye a Persistent Barrier in Treatment. AJMC. https://www.ajmc.com/view/education-surrounding-dry-eye-a-persistent-barrier-in-treatment Bonavitacola, J. (2025, July 8). Dry Eye Awareness Month Highlights Condition Affecting Millions. AJMC. https://www.ajmc.com/view/dry-eye-awareness-month-highlights-condition-affecting-millions
- 2 According to material prepared by Bausch + Lomb (2025), Dry eye can hide in plain sight. Link: https://www.bausch.com/siteassets/pdf/dry-eye-can-hide-in-plain-sight.pdf See also Stapleton, F., Velez, F. G., Lau, C., & Wolffsohn, J. S. (2024). Dry eye disease in the young: A narrative review. The ocular surface, 31, 11-20. https://doi.org/10.1016/j.jtos.2023.12.001
- 3 Craig, J. P., Nichols, K. K., Akpek, E. K., et al. (2017). TFOS DEWS II Definition and Classification Report. The Ocular Surface, 15(3), 276–283. https://doi.org/10.1016/j.jtos.2017.05.008
- 4 Varacallo, P. (2025, July 1). Here’s How You Know You Have Dry Eye: Expert Doctors on the Confusing Symptoms, Causes, and the #1 Mistake Patients Make. The Healthy. https://www.thehealthy.com/eye-care/what-to-know-about-dry-eye-expert-doctor
- 5 Bu, J., Liu, Y., Zhang, R., Lin, S., Zhuang, J., Sun, L., Zhang, L., He, H., Zong, R., Wu, Y., & Li, W. (2024). Potential New Target for Dry Eye Disease—Oxidative Stress. Antioxidants, 13(4), 422. https://doi.org/10.3390/antiox13040422
- 6 Kangari, H., Eftekhari, M. H., Sardari, S., et al. (2013). Short-term Consumption of Oral Omega-3 and Dry Eye Syndrome. Ophthalmology, 120(11), 2191–2196. https://doi.org/10.1016/j.ophtha.2013.04.006
- 7 Epitropoulos, A. T., Donnenfeld, E. D., Shah, Z. A., Holland, E. J., Gross, M., Faulkner, W. J., Matossian, C., Lane, S. S., Toyos, M., Bucci, F. A. Jr., & Perry, H. D. (2016). Effect of Oral Re-esterified Omega-3 Nutritional Supplementation on Dry Eyes. Cornea, 35(9), 1185–1191. https://doi.org/10.1097/ICO.0000000000000940
- 8 Markoulli, M., Ahmad, S., Arcot, J., Arita, R., Benitez-del-Castillo, J., Caffery, B. et al. (2023). TFOS Lifestyle: Impact of nutrition on the ocular surface. Ocul Surf, 29, pp. 226-271. https://doi.org/10.1016/j.jtos.2023.04.003
- 9 Patel, S., Marshall, J., & Fitzke, F. W. (2015). Hydration, fluid regulation and the eye: In health and disease. Clinical & Experimental Ophthalmology, 43(10), 915–924. https://doi.org/10.1111/ceo.12546
- 10 Nguyen, L., Magno, M.S., Utheim, T.P., Jansonius, N.M., Hammond, C.J. & Vehof, J. (2023) The relationship between habitual water intake and dry eye disease. Acta Ophthalmologica, 101, 65–73. https://doi.org/10.1111/aos.15227
- 11 Nguyen, L., Magno, M.S., Utheim, T.P., Jansonius, N.M., Hammond, C.J. & Vehof, J. (2023) The relationship between habitual water intake and dry eye disease. Acta Ophthalmologica, 101, 65–73. https://doi.org/10.1111/aos.15227
- 12 Nguyen, L., Magno, M.S., Utheim, T.P., Jansonius, N.M., Hammond, C.J. & Vehof, J. (2023) The relationship between habitual water intake and dry eye disease. Acta Ophthalmologica, 101, 65–73. https://doi.org/10.1111/aos.15227
- 13 Nguyen, L., Magno, M.S., Utheim, T.P., Jansonius, N.M., Hammond, C.J. & Vehof, J. (2023) The relationship between habitual water intake and dry eye disease. Acta Ophthalmologica, 101, 65–73. https://doi.org/10.1111/aos.15227
- 14 Liu, Z., Xie, Y., Zhang, M., & Pflugfelder, S. C. (2000). [Zhonghua yan ke za zhi] Chinese journal of ophthalmology, 36(2), 131–134. https://pubmed.ncbi.nlm.nih.gov/11853602
- 15 Agarwal, P., Craig, J. P., & Rupenthal, I. D. (2021). Formulation Considerations for the Management of Dry Eye Disease. Pharmaceutics, 13(2), 207. https://doi.org/10.3390/pharmaceutics13020207
- 16 Baudouin, C., de la Maza, M. S., Amrane, M., Garrigue, J.-S., Ismail, D., Figueiredo, F. C., & Leonardi, A. (2017). One-year efficacy and safety of 0.1% cyclosporine A cationic emulsion in the treatment of severe dry eye disease. European Journal of Ophthalmology, 27(6), 678–685. https://doi.org/10.5301/ejo.5001002
