Dry eye symptoms include dry, itchy, red, burning, or sore eyes. Dry eye irritation can also include excessive tearing, a gritty feeling under the eyelid, and temporary instances of blurred vision. Persistently dry eyes can potentially lead to rare but serious complications such as cornea inflammation or infection in the eye, so it is important to report dry eye symptoms to an ophthalmologist or physician.
Symptoms of Dry Eye Irritation
Over time, dry eye irritation can become a circular pattern in which dry, itchy eyes trigger reactions such as rubbing, excessive tearing, or use of poor-quality eye drops, all of which only intensify the symptoms of dry eye. It is important to recognize dry eye symptoms and get proper treatment to avoid making them worse.
Dry, Itchy Eyes
People with dry eye irritation often liken the sensation to having allergies without the runny nose. Dry, itchy eyes can be uncomfortable and distracting. It may feel as if there is something in the eye, when in fact there is not.
Dry, Red Eyes
Dry, red eyes can make a person look tired or ill. Eye drops designed to remove redness work by constricting blood vessels in the eyes, but over time become less and less effective. They also worsen the other dry eye symptoms, such as dry, itchy eyes and irritation, so dry, red eyes should be examined by an ophthalmologist.
Dry, Burning Eyes
As dry eye symptoms worsen, the surface of the eye can potentially become damaged. Dry, burning eyes may be a sign that the lack of moisture is taking its toll on the delicate tissues of the eye. This painful sensation can trigger heavy blinking, but without adequate tear production or retention, this will only cause further irritation.
Dry, Sore Eyes
People with dry eye irritation that rub their eyes, blink repetitively, or squint will often have dry, sore eyes. The muscles surrounding the eyes become tired and achy, or the eye itself hurts due to increased blood pressure or rubbing.
It may seem odd that a condition caused by a lack of tears can often produce excessive tearing, but it is important to understand that there are different types of tears. The tears that normally keep the eyes comfortably moisturized are a mixture of water, oils, and mucus. These components are produced in different areas and mixed on the surface of the eye itself. The heavy, flowing tears that are triggered by emotion or dry eye irritation are mostly water. They lack lubricating properties provided by the oil and mucus, and can therefore make eyes feel even drier.
Gritty Sensation in the Eyes
In addition to dry, itchy, red, burning, or sore eyes, dry eye symptoms may include a gritty feeling in the eyes, as if very fine sand were under the eyelids.
Dry Eye Testing and Diagnosis
When symptoms of dry eye become apparent, ophthalmologists may use several dry eye testing methods to find the root of the problem and prescribe effective treatment. It is possible that the eye produces too few tears, but in many cases the problem is not a lack of tear production but rather the composition of the tear film.
- Measuring Tear Production: Two tests which have been developed to test tear production and tear film are the Schirmer test and dye testing. The Schirmer test measures the rate of tear production. Dye testing measures the strength of your tear film. Tear film with an abnormal composition will break up more rapidly, resulting in a dry feeling. Your dry eye specialist will be able to make a dry eye diagnosis from the results of one or both of these tests.
- Schirmer Test: One way a dry eye diagnosis can be made is by measuring the amount of tears the eyes produce. For a Schirmer test, your doctor uses a paper filter to measure the quantity of your tears to determine if your tear production is abnormally low. A tiny strip of paper is placed beneath your eye for five minutes while you look forward and blink normally. If few tears are produced, you may have severe dry eyes. If enough tears are produced, yet you still feel your eyes are uncomfortable and dry, it is likely you have a mild case of dry eyes. The Schirmer method of dry eye testing is more effective in the diagnosis of severe dry eyes rather than mild or moderate dry eyes.
- Dye Testing: Sometimes chronic dry eye syndrome is not caused by a lack of tears, but by faulty tear film that evaporates and breaks up instead of holding together to lubricate the eye, as healthy tears do. This kind of dry eye is measured with dye testing. Fluorescein and Rose Bengal are two types of dye commonly used. In fluorescein dry eye testing, a strip of fluorescein is applied to the lower eyelid and removed. The doctor will ask you to blink so that the fluorescein disperses, coloring the tear film on the outside of your eye blue. A cobalt blue filtered light enables the doctor to see how quickly the tear film breaks up. From this data, the doctor will discern whether your dry eye symptoms are mild or severe. Rose Bengal is another safe dye doctors typically use to diagnose dry eye disease. Rose Bengal temporarily stains cells on the eye that are inadequately covered by tear film. This test reveals the degree of dry eye and is especially useful for testing mild dry eyes.
Mild vs. Severe Dry Eyes
Those who suffer from dry eye disease may have mild or serious symptoms. The wide range of symptom severity can be attributed to the multiple causes of dry eyes. It is important to determine if you have mild or severe dry eyes because treatment is based on the nature of your symptoms.
Contact lenses and other eye irritants can disrupt tear film production in the eye and result in mild dry eyes. You might have mild dry eyes if your eyes are frequently irritated by smoke, wind, or contact lenses. You may find that your eyes are sensitive to light and quickly become fatigued while reading. Treatment may be as simple as changing your contact lens cleaning solution. For most patients, demulcent drops (artificial tears) are used to lubricate the eyes throughout the day and effectively relieve the symptoms of dry eye disease.
If your persistent dry eye symptoms do not respond to artificial tears, you may have chronic dry eye syndrome, also commonly known as serious or severe dry eye. A serious dry eye condition may cause your eyes to burn, sting, and itch, affecting your ability to see. Left untreated, severe dry eyes can result in an inability to keep the eyes open, eye inflammation, corneal infection, and scarring. It is important to treat a serious dry eye condition as soon as possible. A prescription dry eye medication and even dry eye surgery may be necessary to prevent the eyes from becoming permanently damaged.
Find an Eye Care Specialist in Your Region
If you have persistently dry, itchy, red, burning, or sore eyes, or are concerned about the damage your dry eye irritation might be causing to the structures of your eyes, it is important to speak with a qualified eye care specialist. Use DocShop to locate an ophthalmologist in your area. Discussing your dry eye symptoms with a specialist is the first step toward alleviating your eye discomfort.