Chronic Dry Eye – What Causes it and How to Get Relief

Did you know that close to 5 million Americans over 50 have chronic dry eye? Although it typically affects older people, most of us will experience the occasional dry eye now and again, but having chronic dry eyes means you’re on a quest for relief every single day. You catch yourself rubbing your eyes constantly, but that stinging feeling of sand in your eyes and the redness just doesn’t go away. You reach for a bottle of artificial tears and finally get some relief, but find yourself having to apply more just a few minutes later. Before you know it that bottle is now empty and you’re eyes are still dry. Are we describing your life right now? If so, keep reading because although you may feel like you’re out of options, there IS effective treatment for chronic dry eyes!

What is Chronic Dry Eye?

A healthy eye produces an adequate amount of tears to keep the eyeball moisturized. Tears are made up of oil, water and mucus. Each of these is an important component in protecting the front of our eyes and keeping them comfortable. An oil layer helps prevent evaporation of water, while the mucin layer spreads the tears evenly over the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to issues with any of the tear layers, you will begin experiencing dry eye symptoms. Most people at some point will experience these symptoms, but people with chronic dry eyes experience symptoms almost daily.

What Causes Chronic Dry Eyes?

Causes of chronic dry eye depend on a variety of factors such as living in a dry climate, exposure to smoke and wind which increase the rate in which tears are evaporated. Women are also more likely to experience chornic dry eyes due to hormonal fluctuations during pregnancy and menopause. Medications such as antidepressants and high blood pressure medications are known to aggravate dry eyes. Age is another cause of dry eyes, most people over the age of 65 experience symptoms.

What are the Symptoms of Chronic Dry eyes?

If you’re experience chronic dry eyes you most likely feel your eyes heavy and out of focus most of the time. Additional symptoms are as follows:

• Difficulty driving at night
• Sore Eyes
• Sensitivity to light
• Itching, burning
• Gritty feeling, like there is sand in your eyes
• Eye redness and eyelid soreness

How is Chronic Dry Eye diagnosed?

The only way to obtain a proper diagnosis is to be evaluated by a reputable eye doctor. It is important to find an eye care provider with the proper technology to make the most accurate diagnosis and match you with the best treatment for your specific condition. At Visual Eyes in Mizner Park, in addition to the standard examination, we carry equipment such as the OCULUS Keratograph® 5M that is specifically made to detect dry eye and determine the best treatment option for you.

What treatments are available?

Once your eye doctor has examined you, the best course of treatment will be determined. Fortunately, you have plenty of options on how to treat Chronic Dry Eye depending on the severity of the discomfort:

Steroid Eye Drops

Inflammation is a big factor when it comes to chronic dry eye. Although it can sometimes cause burning and irritation in the eyes, patients will sometimes have inflammation with no obvious symptoms.

Steroid drops are used to ease this inflammation that comes along with chronic dry eye. For best results, prescription eye drops like Restasis are utilized in conjunction with the steroid drops.

Patients need to be evaluated by their eye doctor before using steroid drops. For the right candidates it is very well tolerated and provides great results.

There are a plethora of steroid types and strengths in the market. We will usually start patients with a lower strength, however, depending on the severity of the condition, more potent drops are prescribed.

It is important to note that steroid eye drops can increase the risk of developing high eye pressure and even cataracts if used for long periods of time. These risks are low when the drops are used only on a short-term basis for dry eye treatment.


Restasis is a “do it all” kind of prescription eye drop. In addition to lubricating the surface of your eye, it has an agent that reduces the inflammation associated with chronic dry eye. It additionally helps your body produce more natural tears to keep your eyes at the perfect moist and comfortable state. All it takes is two daily applications in each eye.

Most people who use Restasis obtain relief, however, the relief is not immediate and you must be consistently using the drops for about 90 days to experience the full extent of relief.

The side effect of Restasis is a burning sensation of the eyes upon application for the first few weeks of treatment. The eyes will adjust and the burning will eventually ease.


This is a new FDA Approved prescription eye drop for the treatment of dry eye. Xiidra was approved in July 2016 and like Restasis, it reduces the inflammation that is associated with chronic dry eye. It tested very well in clinical trials and participants noticed a significant reduction in dry eye symptoms after using Xiidra for two weeks. By week 12, participants were mostly symptomless. The dosage is just like Restasis, two daily applications in each eye.

Side effects of Xiidra reported in the studies were eye irritation and altered taste sensation, which occurred in 5 to 25 percent of participants.

Sometimes drops alone are not enough to resolve the symptoms of chronic dry eye. There are more invasive procedures that although used as a last resort, do prove to be successful in resolving the issue:

Meibomian Gland Expression

An inadequate amount of oil being secreted from the meibomian glands is one of the biggest culprits of dry eye and the majority of people who experience it, have this problem.

These glands are located at the base of the eyelashes. They sometimes get clogged; causing the oil that keeps the tear film from evaporating stuck and unable to be naturally expressed. This problem is called the meibomian gland dysfunction (MGD) and is responsible for evaporative dry eye.

In order to treat this condition, your eye doctor will apply a warm compress to the eyelids, then a small device will be used to squeeze the clogged contents, which usually consist of hardened oil.

This is not the most comfortable of treatments since in order to properly express the contents of the glands, significant pressure must be applied to the eyelids, however, the results are most of the time worth it

Punctal Plugs

This is a great option and resolves dry eyes for a lot of people. It is a simple procedure where small plugs are inserted into the puncta (small openings) of your tear drainage ducts. They are located in the inner corner of the eyelids.

These plugs are very tiny and once inserted, tears can no longer escape from the eye through these openings. This improves dry eyes by making the tear film stay on the surface of the eyes for a longer period of time. Instead of the tears draining through the ducts, they evaporate from the eye surface.

This treatment is mostly comfortable, the usual side effect is watery eyes, but this can be easily corrected by removing one of the plugs.

Chronic dry eye doesn’t have you stop you and you don’t need to live with the symptoms. By obtaining a proper treatment course, you will be on your way to relief in little to no time! At Visual Eyes we offer the latest in eye care technology and can easily help you evaluate your symptoms and recommend the best treatment route.

We are located in beautiful Mizner Park. Schedule a consultation with our board certified optometrists and see just how much Visual Eyes can do for you!

Share this Post