Dry eyes can happen to anyone, but severe dry eye, or even dry eye disease, is a more complex problem.

Our eyes are coated with fluid — tears — that keep them hydrated, clean away debris, and lubricate eye movement.

Anyone can develop dry eyes from wind, a dry climate, dehydration, and more. Dry eye disease is considered severe when it’s long lasting and doesn’t respond to typical treatment options.

Severe dry eye isn’t an official diagnosis. Severe, chronic dry eye, or dry eye disease (DED), is different than having sporadic dry eyes.

When you have dry eye disease, some part of the system that produces or excretes your tears doesn’t work properly. The lack of tear production or a blockage in the flow of tears is what causes the dryness.

Learn more about dry eye syndrome.

You likely have experienced dry eyes on a windy day, alongside allergies, or even when you are tired. Symptoms of dry eye can include:

  • a scratchy feeling
  • the sensation that there is something in your eye
  • redness
  • sensitivity to light
  • blurred vision

More severe cases of chronic dry eye or dry eye disease can also cause pain, significant vision problems, or leave you completely unable to produce tears.

Your healthcare team will begin to diagnose your eye condition with a routine eye examination, usually with the help of lights and magnification.

This exam may also include a vision screening but will mostly focus on checking the structure and anatomy of your eye and eyelid.

You may be asked to blink or move your eye in different directions, and measurement and testing of your tears is possible.

An official diagnosis of dry eye disease is usually only made if a healthcare professional identifies a structural or functional problem with how your eyes make and use tears.

Some tests that analyze your tear production and how your eye uses tears might include:

The treatment for your dry eyes will depend on the underlying cause. If environmental factors like wind, dust, or irritants are the cause of your dry eye, avoiding these irritants or protecting your eyes when you are outside can help.

Dry eyes that are caused by medications, chronic health problems like Sjögren syndrome, or issues with tear production are usually treated with things like:

  • over-the-counter lubricating eye drops, gels, or ointments
  • prescription medications to increase tear production, like cyclosporine (Restasis) or lifitegrast (Xiidra)
  • tear duct plug (punctal plug) placement
  • surgery that targets eyelid structure or tear duct function

Beyond irritation, untreated dry eyes can cause damage to the outer layer of your eye and may rarely lead to permanent vision damage or loss. Abrasions can develop on your cornea — the outer layer of your eye — with severe dry eyes.

Some people with these symptoms have significant discomfort and report experiencing depression over their symptoms.

Anyone may experience dry eye from time to time, but there are certain people at risk for more chronic or serious forms of this condition.

Risk factors for severe dry eye problems include:

Millions of Americans experience dry eye each year, but for most people, it’s a manageable problem. You may need to use eye protection, avoid triggers, or use eye drops regularly to avoid flare-ups and severe complications. However, there are a lot of options for treating dryness in your eyes.

If your dry eye symptoms are caused by a problem with your tear ducts, tear composition, or glands around your eyes, treatment is feasible but also a bit more complicated.

For structural and functional problems in your eyes that are causing dry eye, your healthcare team may need to use intensive treatments like laser therapy or surgery.

You can’t prevent every kind of dry eye. If a structural problem or systemic disease is causing your dry eye, those underlying issues must be treated for you to find relief.

For more general forms of dry eye, though, there are some steps you can take to help prevent dryness and irritation. These include:

  • drinking plenty of water
  • using a humidifier
  • protecting your eyes from wind and irritants
  • treating allergies
  • getting plenty of sleep
  • limiting your screen time

What can I do for my extremely dry eyes?

There are many ways to treat dry eyes. Finding the right treatment will depend on what’s causing your dry eye. You can try over-the-counter lubricating drops to start, but if this doesn’t help, you may need to see a healthcare professional for a more in-depth examination.

What’s considered severe dry eye?

Severe dry eye or dry eye disease (DED) is usually diagnosed when the dryness is the result of poor tear quality or problems with the parts of your eye that produce tears. These problems may also be referred to as dysfunctional tear syndrome.

Can dry eyes be a symptom of something serious?

Dry eye disease (DED) is usually only diagnosed when a structural or functional problem in the way your eye makes or uses tears is identified.

Without evidence of problems with tear production, your healthcare team may look to other causes of your dry eye. This can include other diseases or medical conditions — often autoimmune diseases such as Sjögren syndrome or connective tissue diseases like lupus.

How long does it take to recover from severe dry eye?

If the environment around you is contributing to your dry eye problem, the dryness is likely to continue until you make changes to your habits and lifestyle.

Regular use of eye drops can help, but if you have dry eye disease, a full recovery may require prescription medications or medical procedures that repair or support your tear production.

Dry eye is a problem that many people face. Lubricating eye drops can provide relief in many cases, but your dry eye could be caused by a problem with your tears or tear production. Dry eye is considered severe when it doesn’t respond to typical treatment options and is long lasting.

If you’ve taken steps to stay hydrated, protect your eyes, or tried over-the-counter products and your dry eye isn’t getting any better, make an appointment for an eye exam to rule out more serious issues like tear duct dysfunction.