Dry Eye Syndrome Types, Causes, Symptoms, and Treatments

Abstract

Dry eye syndrome is a common condition that affects millions of people worldwide. It occurs when the eyes do not produce enough tears or when the tears evaporate too quickly, leading to discomfort and potential vision problems. This article provides a detailed guide on dry eye syndrome, covering its definition, prevalence, types, causes, symptoms, and pathophysiology. Diagnosis and complications are discussed, along with treatment options and strategies for managing the condition in daily life. The goal of this article is to provide clear, well-organized, and easy-to-understand information that helps individuals recognize and address dry eye syndrome effectively.

Cite as: Dry Eye Syndrome: Types, Causes, Symptoms, and Treatments. Brisbane (AU): Exon Publications; 2025. Published on 19 Feb. DOI: https://doi.org/10.36255/dry-eye-syndrome-types-causes-symptoms-treatments

Introduction

The eyes rely on a constant supply of tears to remain lubricated and healthy. Tears protect the surface of the eyes, prevent infections, and ensure clear vision. When tear production is insufficient or tears evaporate too quickly, dry eye syndrome develops. This condition can cause irritation, redness, blurred vision, and a sensation of grittiness. While dry eye syndrome is not usually dangerous, it can significantly affect a person’s quality of life. Understanding its causes, risk factors, and treatment options can help individuals manage their symptoms effectively and prevent complications (1-5).

What is Dry Eye Syndrome?

Dry eye syndrome, also known as keratoconjunctivitis sicca, is a condition where the eyes do not produce enough quality tears to keep them properly lubricated. Tears are essential for eye health as they help remove debris, protect against infections, and maintain a smooth optical surface for clear vision. When tear production is insufficient or their composition is imbalanced, symptoms such as burning, itching, and discomfort may occur. Dry eye syndrome can result from various factors, including aging, medical conditions, and environmental influences.

How Common is Dry Eye Syndrome?

Dry eye syndrome is one of the most common ocular conditions, affecting millions of people worldwide. Studies suggest that its prevalence increases with age, with older adults being more likely to experience symptoms. Women are more susceptible than men, particularly due to hormonal changes associated with menopause. The condition is also more frequently observed in individuals who wear contact lenses, undergo refractive surgery, or have underlying systemic diseases such as diabetes and autoimmune disorders. Geographic and environmental factors, such as exposure to air pollution and prolonged screen use, further contribute to its prevalence.

Types of Dry Eye Syndrome

Dry eye syndrome is classified into two main types: aqueous-deficient dry eye and evaporative dry eye. Aqueous-deficient dry eye occurs when the lacrimal glands do not produce enough tears. This can be associated with conditions such as Sjögren’s syndrome or damage to the lacrimal gland due to inflammation or radiation therapy. Evaporative dry eye results from excessive tear evaporation, often caused by meibomian gland dysfunction, which leads to an unstable tear film. Many individuals experience a combination of both types.

Risk Factors and Causes of Dry Eye Syndrome

Several factors increase the risk of developing dry eye syndrome. Aging is a significant factor, as tear production naturally declines with age. Women, particularly those experiencing hormonal changes during pregnancy, menopause, or while using birth control, are more likely to develop the condition. Certain medical conditions, including rheumatoid arthritis, lupus, diabetes, and thyroid disorders, are also associated with dry eye syndrome. Medications such as antihistamines, antidepressants, and beta-blockers can contribute to reduced tear production. Environmental factors like prolonged screen exposure, air conditioning, and windy or dry climates may also play a role. Contact lens wear and previous eye surgeries, such as LASIK, can further increase the likelihood of developing dry eyes.

Symptoms of Dry Eye Syndrome

Dry eye syndrome presents with a variety of symptoms that can range from mild to severe. Common symptoms include a stinging or burning sensation, redness, and a feeling of grittiness in the eyes. Some individuals experience excessive tearing, which may seem contradictory but occurs as a response to irritation. Blurred vision and difficulty wearing contact lenses are also common complaints. In severe cases, prolonged dryness can lead to damage to the cornea, increasing the risk of infections and vision impairment.

Pathophysiology of Dry Eye Syndrome

The tear film plays a crucial role in maintaining eye health and consists of three layers: the lipid layer, the aqueous layer, and the mucin layer. The lipid layer, produced by the meibomian glands, prevents tear evaporation. The aqueous layer, produced by the lacrimal glands, provides moisture and nutrients to the ocular surface. The mucin layer helps the tears spread evenly across the eye. Disruptions in any of these layers can lead to dry eye syndrome. Meibomian gland dysfunction, decreased lacrimal gland secretion, and inflammation contribute to tear film instability and ocular surface damage.

Diagnosis of Dry Eye Syndrome

A comprehensive eye examination is essential to diagnose dry eye syndrome. The evaluation includes a patient’s medical history, symptom assessment, and specialized tests. The Schirmer test measures tear production by placing a strip of filter paper under the lower eyelid to determine the volume of tears produced. The tear breakup time (TBUT) test assesses the stability of the tear film by measuring how long tears remain intact before breaking apart. Fluorescein and lissamine green staining help detect damage to the cornea and conjunctiva. Imaging techniques, such as meibography, can evaluate the structure of the meibomian glands.

Complications of Dry Eye Syndrome

While dry eye syndrome is usually a manageable condition, severe cases can lead to complications. Persistent dryness can result in damage to the corneal surface, increasing the risk of infections and corneal ulcers. Chronic inflammation can lead to scarring, which may affect vision. Severe cases may also cause light sensitivity, making daily activities challenging. In some instances, individuals with untreated dry eyes may develop secondary infections that require medical intervention.

Treatment and Management of Dry Eye Syndrome

Managing dry eye syndrome involves a combination of lifestyle modifications, artificial tears, medications, and in some cases, surgical interventions. Artificial tears and lubricating eye drops help provide immediate relief by supplementing the natural tear film. Prescription medications such as cyclosporine and lifitegrast help reduce inflammation and improve tear production. Punctal plugs, which are small devices inserted into the tear ducts, can help retain moisture by preventing tear drainage. In cases of meibomian gland dysfunction, warm compresses and eyelid hygiene routines can help restore normal oil production. Omega-3 fatty acid supplements have been shown to improve tear stability and reduce inflammation.

Living with Dry Eye Syndrome

Adopting certain habits can help individuals manage dry eye symptoms and improve eye comfort. Adjusting the environment by using a humidifier, avoiding direct airflow from fans or air conditioning, and taking breaks from screen use can help reduce eye strain. Wearing sunglasses outdoors can protect against wind and sun exposure, preventing excessive tear evaporation. Staying hydrated and consuming a diet rich in omega-3 fatty acids may also support tear production. Individuals who experience persistent symptoms should consult an eye care professional for personalized treatment recommendations.

Conclusion

Dry eye syndrome is a widespread condition that can cause significant discomfort and interfere with daily life. While it is not usually sight-threatening, untreated cases can lead to complications such as corneal damage and infections. Understanding the risk factors, symptoms, and available treatments allows individuals to take proactive steps in managing their condition. With proper care, lifestyle adjustments, and medical interventions, most people with dry eye syndrome can achieve symptom relief and maintain eye health.

References

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2. Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15(3):334-365. https://doi.org/10.1016/j.jtos.2017.05.003


3. Willcox MDP, Argueso P, Georgiev GA, et al. TFOS DEWS II tear film report. Ocul Surf. 2017;15(3):366-403. https://doi.org/10.1016/j.jtos.2017.03.006


4. Baudouin C, Messmer EM, Aragona P, et al. Reconsidering the central role of inflammation in dry eye disease. Acta Ophthalmol. 2016;94(2):e177-e184.


5. Lemp MA, Crews LA, Bron AJ, et al. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012;31(5):472-478. https://doi.org/10.1097/ICO.0b013e318225415a

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