Tears are a mixture of water, mucus, and oil that lubricate the surface of your eyes and protect them from injury and infection.

Since your eyes make tears naturally, you probably don’t give much thought to the amount of tears they produce — unless you have symptoms of chronic dry eye.

Chronic dry eye is when your eyes don’t produce enough tears, or when your tears evaporate too quickly. This condition can be mild, moderate, or severe. Common symptoms include a gritty sensation in the eyes, redness, sensitivity to light, and blurry vision.

Some people are able to treat dry eye with over-the-counter artificial tears and a few simple lifestyle adjustments. Sometimes, though, chronic dry eye requires other medications to prevent complications.

If left untreated, chronic dry eye can affect the quality of your life and even damage your eyes. Here are six signs that it’s time to see a doctor to talk about new treatments.

Dry eye can be a temporary problem caused by environmental factors, and it may resolve quickly with or without treatment.

But dry eye can also become a stubborn, chronic problem. It can affect your eyes every day, all day. And worse, you might be unable to pinpoint an underlying cause.

Since dry eye can lead to complications that impair your vision and quality of life, consider seeing an eye doctor if your symptoms don’t improve.

Prolonged symptoms could indicate a more severe case of dryness. Symptoms may include constant burning or scratchiness, extreme sensitivity to light, eye pain, and redness. It may also feel as if there’s always something in your eye.

An ophthalmologist or optometrist can examine your eyes and diagnose chronic dry eye or another eye condition. For example, you may have a condition that causes inflammation in your eyelids or tear glands.

Your doctor may first ask about your medical history to determine whether medication or an autoimmune disease is at the root of your dryness. Treating the underlying cause can improve tear production.

At first, over-the-counter (OTC) artificial tears may effectively treat your chronic dry eye. But if you have severe dryness, OTC eyedrops might stop working after a while.

If these medications don’t provide sufficient lubrication, you’ll likely need a prescription eye drop. These are stronger than what you can buy in a drugstore. Your doctor can also recommend other treatments for chronic dry eye.

These might include special eye drops to reduce inflammation in your eyes or tear stimulating drugs that are available as a pill or gel.

You may also be a candidate for eye inserts, which are inserted between your lower eyelid and your eyeball. These tiny inserts dissolve and release a substance that helps lubricate your eyes. This type of therapy might be necessary if you have moderate to severe dry eye that doesn’t respond to artificial tears.

Chronic dry eye can be a symptom of another condition, so it’s important to see your doctor if you experience other symptoms along with dry eyes.

For example, some autoimmune diseases can lead to dry eye if the condition affects your tear glands. Autoimmune diseases are conditions where the immune system attacks healthy cells.

Examples include lupus, Sjögren’s syndrome, and rheumatoid arthritis. You may have other symptoms too, like joint pain, fatigue, a low-grade fever, hair loss, a skin rash, or achy muscles.

Discuss these and other symptoms with your ophthalmologist or optometrist. They may refer you to another doctor to determine whether an immune system problem is the root cause of your chronic dry eye.

Your eye doctor may also recommend a prescription eye drop to soothe dryness as you await the results.

Even if you use artificial eye drops, dryness can become so severe that you can’t keep your eyes open. This can make it harder to work, drive, read, and complete many other activities.

Artificial tears may provide some relief, but you might have to apply eye drops several times throughout the day. Stronger prescription eyedrops may be more effective. You may only need to use these eye drops once or twice a day for relief.

Talk with your doctor if you experience any type of emotional distress due to chronic dry eye.

Some people living with chronic conditions experience depression and anxiety, especially when symptoms affect their quality of life or don’t improve. Having chronic dry eye is no exception.

If you’re unable to work or drive, you may feel stressed about your finances or worry about how you’ll care for yourself. Working with your doctor to come up with a treatment plan can ease your symptoms and improve your emotional state.

Keep in mind that some medications used to treat anxiety may also affect tear production. If you take medication for anxiety or depression and your dryness worsens, talk to your doctor about an alternative drug.

While chronic dry eye may improve with OTC remedies, see a doctor if you suspect an eye injury or eye infection.

An example of an eye injury is a corneal ulcer. This can happen if debris or your fingernail scratches your cornea. These types of injuries and infections cause a white bump or scar on your cornea. Other symptoms include redness in the white of your eye, pain, and burning.

Chronic dry eye can affect your vision, mood, and quality of life. If you aren’t getting the treatment you need, your symptoms may continue to progress. Talk to your eye doctor if you develop other symptoms or if you’re unable to improve dryness with OTC treatments.

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