Chronic Dry Eye: Outcomes and Complications

Reviewed by: HU Medical Review Board

Chronic dry eye is a disease of the surface of the eye that occurs due to a loss of balance in the thin fluid layer that covers the surface of the eye. This fluid layer is known as the tear film. Chronic dry eye may also be called dry eye syndrome (DES), dry eye disease (DED), or keratoconjunctivitis sicca.1

When you are diagnosed with any disease, it is normal to want to know things like whether there is a cure, the prognosis or outcome, and the complications resulting from the disease. Being diagnosed with chronic dry eye can bring up these questions and many more.

Is there a cure?

Dry eye disease is usually a progressive, or relapsing and remitting condition, which means it may get worse over time or recur after periods of relief. There is no permanent cure for chronic dry eye. However, some treatments can help control the condition and manage symptoms.2

What is the typical outcome?

Depending on the disease’s severity, chronic dry eye can often be treated to prevent permanent damage to the eye surface, and symptoms may be controlled to minimize discomfort.2

Can I go blind due to chronic dry eye?

While chronic dry eye does not cause blindness, the disease’s symptoms can be significant enough to interfere with daily activities such as reading, driving, and other vision-related tasks. Complications may happen, especially in those with untreated dry eye. If complications from dry eye become severe, scarring on the surface of the eye and loss of vision may result.3

What are some complications?

Depending on the type and severity of dry eye, complications can range from mild to severe. Less severe complications of dry eye relate to the general discomfort of the disease. Some of these complications may include:4-6

More severe complications include:4-6

  • Corneal abrasion – A scratch on the clear surface of the eye, known as the cornea. This scratch disrupts the layer of the cornea known as the epithelium. Because dry eye affects the tear film, which normally protects the corneal surface, these abrasions may occur. Corneal abrasions can be very painful and may also result in eye redness and sensitivity to light.
  • Corneal ulcer – An open sore on the cornea, or clear surface of the eye. These ulcers are often associated with keratitis, or inflammation of the cornea. Keratitis may be caused by bacteria, viruses, or autoimmune conditions. In particular, a corneal abrasion or scratch due to dry eye may lead to a corneal ulcer if the area becomes infected. Severe chronic dry eye alone, particularly if untreated, may cause this as well. Symptoms may include severe eye pain, redness, and sometimes pus discharge from the eye.
  • Corneal scarring and thinning – This may result after injuries or infections of the cornea heal, such as when a corneal ulcer heals. Severe inflammation of the eye may also result in scar formation. Vision may be impaired, and further treatment or corneal transplantation may be needed to remove or replace the scarred tissue.

How about my mental health?

Several published studies have shown a connection between dry eye disease and depression. Using a variety of self-reporting symptom tools, people with dry eye disease reported higher rates of depression than those without dry eye. Another study showed that anxiety is also more common among those with dry eye.7

As with many chronic diseases, the outcomes and complications may vary among those with the disease. Talk to your doctor about any questions or concerns you have about your condition.

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