Dry, itchy eyes are no fun. You rub and you rub, but the feeling like you’ve got rocks in your eyes won’t go away. Nothing helps until you buy a bottle of artificial tears and pour them in. The relief is wonderful, but soon you have to apply more. Eventually you realize that the four doses allowed per day isn’t enough.

If this sounds familiar, you may have chronic dry eyes. This condition is known to millions of Americans, yet chronic dry eyes are treatable. Knowing what leads to dry eyes can help you reduce symptoms and treat the underlying cause.

Dry eyes occur in many Americans each year, but chronic dry eyes persist past a change in environment or habit. This is called Dry Eye Syndrome or DES. It’s an ongoing condition that lasts weeks or months at a time. The symptoms may improve but then return after some time.

The problem occurs in the tear film. The cornea, or eye’s surface, has a tear film made of water, mucus, and oil layers. Each layer must produce enough moisture to keep the eye’s surface in balance. When one element reduces its production, dry eye results.

Some people get dry eyes from lack of tears. This occurs when the watery layer of the tear film malfunctions. People with low tear production can boost it with artificial tear eye drops.

Other people get dry eyes from poor quality tears. This occurs when the oily layer malfunctions, allowing tears to evaporate too quickly. People with poor quality tears should take measures to keep tears in their eyes.

There are environmental and medical solutions for both types of chronic dry eyes. Sometimes, however, dry eyes are caused by underlying conditions, such as diabetes and herpes zoster. In these cases, dry eyes can only be resolved by treating the underlying cause.

Dry eyes are a common condition in the United States. Most often, people who have dry eyes are middle-aged or older. An estimated 4.88 million Americans age 50 and older have dry eyes. Of these, over 3 million are women and 1.68 million are men.

There are several reasons why more women have dry eyes than men. For one, dry eyes can occur as a side effect of estrogen fluctuations. Women who are pregnant, taking birth control pills, or in menopause may also have dry eyes.

Many people who have dry eyes can find relief simply by changing their environment. Others, however, have real medical conditions that prevent them from living with moist eyes. Here’s a look at the different symptoms, causes, and treatments for chronic dry eyes.

Symptoms

If you have chronic dry eyes, your eyes likely feel heavy and dry. You may have trouble focusing on everyday tasks, and things may get cloudy now and then. Symptoms of dry eyes also include:

  • night driving problems
  • discomfort when wearing contacts
  • burning, itching, or stinging
    sensations
  • light sensitivity
  • eyes that are watery at times,
    then completely dry at others
  • red and sore eyelids
  • mucus secreting from the eye in a
    string-like texture

Causes

It’s important to understand the causes of dry eyes. Sometimes the cause is a medical condition that, when treated, can improve dry eyes. Treating the root cause can help you find a permanent solution to the problem.

Dry eyes can be caused by:

  • medications for high blood
    pressure, like beta-blockers or diuretics
  • sleeping pills
  • medications to lower anxiety
  • antihistamines
  • being in a dry or smoky
    environment on a long-term basis
  • diabetes
  • herpes zoster
  • wearing contact lens
  • eye surgeries like laser surgery
  • autoimmune diseases like lupus,
    rheumatoid arthritis, and Sjögren’s syndrome

All of these causes impact the oil glands, tear ducts, or corneas in some way.

Diagnosis

An eye doctor often confirms a dry eye diagnosis. In general, your eye doctor will:

  • ask about your medical history
  • perform an eye exam to inspect the
    exterior of your eye, including the eyelids, tear ducts and how you blink
  • examine your cornea and the
    interior of your eye
  • measure the quality of your tear
    film

Once your eye doctor knows these things, it’s easier to pursue a course of treatment. Measuring the quality of your tears is important, for instance. One thing that is common in all people with dry eyes is abnormal tear quality.

Treatments

After confirming a case of dry eyes and evaluating your tears, your doctor can pursue treatment. The basic treatments break down into four categories:

  • increasing tears
  • maintaining tears
  • triggering tear production
  • healing inflammation

If your dry eyes are mild, you may only need artificial tears. They can be applied as needed less than four times per day.

However, if your eyes don’t change with artificial tears, you may need help keeping tears in your eyes. You can get your tears ducts blocked so tears can’t drain.

Prescription eye drops or inserts can stimulate tear production. Increasing your intake of omega-3 fatty acids can also help with certain causes of dry eyes.

To reduce inflammation of the eyelids or glands, you may have to take an anti-inflammatory drug. Massage, warm compresses, or ointments may also help.

Chronic dry eyes can be painful and distracting, but they’re also treatable. If you’re one of the nearly five million Americans with dry eyes, talk to your doctor. You can get treatment to relieve your symptoms, perhaps even long-term. Your eyes are worth taking care of, no matter how old you are.