Dry Eye: Gritty, Burning Eyes, Causes and When to Be Seen

What it involves

MedlinePlus explains that tears moisten the eyes and wash away particles, and that a healthy tear film is needed for clear vision. Dry eye syndrome develops when the eye cannot keep a healthy coating of tears, and it is common in otherwise healthy people, particularly as they get older.

Who this is for

• Patients whose eyes burn, itch, or feel gritty or scratchy
• Patients who work at a screen or in air conditioning all day and notice blurred vision
• Patients who wear contact lenses and find their eyes drying out
• Patients with joint pain or a dry mouth in addition to dry eyes

What to expect

• Questions about your symptoms, your work environment, contact lens use, and any eye drops you already use
• A review of medicines, since cold and allergy medicines can dry the eyes
• A talk about simple steps such as artificial tears, blinking, and humidity
• A referral to an eye doctor if the problem is severe, painful, or affects your vision

What dries the eyes out

MedlinePlus lists hormonal changes that make the eyes produce fewer tears, a dry environment or workplace with wind or air conditioning, sun exposure, smoking or second-hand smoke, cold or allergy medicines, and wearing contact lenses. Heat or chemical burns, previous eye surgery, and eye drops used for other eye diseases can also be behind it. A condition called meibomianitis, an oil-gland problem in the eyelids, can change the tear film too.

What it feels like

The symptoms MedlinePlus lists include more than dryness:

• Burning, itching, or redness in the eye
• A gritty or scratchy feeling, as if something is in the eye
• Sensitivity to light
• Blurred vision

Starting with artificial tears

MedlinePlus says the first step is artificial tears, which are sold without a prescription. It suggests using the drops at least 2 to 4 times a day and, if symptoms are not better after a couple of weeks, using them more often, switching to preservative-free drops if the preserved kind bothers you, or trying a different brand. Lubricating ointment at bedtime helps people who sleep with their eyes slightly open, but it can blur vision, so only a small amount is advised.

Changes around the eyes

MedlinePlus recommends not smoking, avoiding second-hand smoke, direct wind, and air conditioning, using a humidifier in winter, blinking more often, resting the eyes now and then, and cleaning the eyelashes with warm compresses. It also suggests limiting allergy and cold medicines that dry you out. The seasonal allergies guide explains how allergies and the medicines for them fit in.

Other treatments an eye doctor may add

For stubborn cases MedlinePlus lists prescription eye drops, fish oil, glasses or goggles that hold moisture in, and tiny plugs placed in the tear drainage ducts. Those are decisions for an eye specialist, and a primary care provider can refer you when basic care is not working. Lid bumps and crusting along the lashes are a separate topic, covered in the stye and eyelid bumps guide.

Signs that need prompt attention

MedlinePlus says to contact a provider right away for red or painful eyes, flaking, discharge, or a sore on the eye or eyelid, an eye injury, a bulging eye or drooping eyelid, or when dry eye comes with joint pain, swelling, or stiffness plus a dry mouth. In severe cases the cornea can be damaged or infected. Red, sticky eyes with discharge are more likely infection, which the pink eye guide covers.

Sources

• MedlinePlus — Dry eye syndrome
• MedlinePlus — Tears