Frequently Asked Questions About Chronic Dry Eye

Whether you are living with chronic dry eye or know someone who is, here is a guide of common questions and things to know.

What are symptoms?

Chronic dry eye (CDE) can have a wide range of symptoms that differ in each person. The symptoms usually occur in both eyes, though 1 eye may have more severe symptoms than the other.

Symptoms can include:

• Painful, sore eyes
• Light sensitivity
• Blurry vision
• Gritty, sandy, or itchy eyes
• Mucus in and around the eyes
• Watery eyes (this may seem like a strange symptom, but it can occur)
• Eye fatigue
• Double vision in 1 eye only (this is known as monocular diplopia)

Who is at risk?

Chronic dry eye is twice as common in women as men. More than 11 million women in the United States have been diagnosed with chronic dry eye, compared to 5.3 million men diagnosed. This gender difference is thought to be due to differences in hormones.^1-3

Older adults, particularly those above the age of 50, are also more at risk. However, the rate of chronic dry eye is increasing among younger adults as well. This may be due to the increased use of technology and screen time.⁴

Other populations at risk may include:

• Those who wear contact lenses
• Anyone who has had laser vision correction
• Those who take certain medicines, such as some decongestants, antihistamines, blood pressure drugs, or drugs used to treat depression
• Those who have certain autoimmune conditions, such as Sjogren’s syndrome and thyroid eye disease
• Anyone who has prolonged use of screen time, such as those who work on the computer daily

Can medicines cause chronic dry eye?

Yes, certain drugs may cause or increase the risk of developing chronic dry eye. Most research focuses on classes or groups of drugs that may cause dry eye.^4,5

Some of the groups include:

• Diuretics and beta-blockers
• Antihistamines and decongestants
• Proton pump inhibitors (PPIs)
• Chemotherapy
• Pain relievers
• Drugs that treat mental illness

How is it diagnosed?

Because of the complex nature of chronic dry eye, there is not a single gold standard for diagnosis, and it is often misdiagnosed and underdiagnosed by doctors.

You can help ensure you receive a correct diagnosis by providing a detailed medical history, including medicines you take, when your symptoms are worst, and what activities make them better or worse.

As part of the diagnosis process, doctors may use the ocular surface disease index (OSDI). This is a 12-question survey that focuses on physical symptoms. Doctors may also use tests and exams such as:

• Slit-lamp examination
• Schirmer test
• Fluorescein, lissamine green, and rose bengal staining
• Phenol red thread test

How is it treated?

The most effective way to manage chronic dry eye is to find the cause of why it is happening. This presents a challenge since many things can lead to or contribute to chronic dry eye.

Treatments can include making lifestyle changes, such as drinking more water, adding supplements or vitamins, or using a humidifier. Some doctors will recommend other treatments, such as using preservative-free artificial tears or prescription eye drops.

In severe cases of chronic dry eye, surgery may be needed. The most common type of surgery is punctal occlusion surgery by cautery, which physically blocks the tear ducts that drain tears and may restore the right balance of tears the eye needs.^6,7

Can it be cured?

No, there is no cure for chronic dry eye. But research is ongoing to find additional treatment options and to better understand the disease.

For example, scientists are working to learn more about the 2 main types of chronic dry eye, aqueous tear-deficient dry eye and evaporative dry eye. Many people with moderate to severe CDE have both types. Understanding how both types begin and affect the eyes can help doctors better treat them and avoid side effects.⁸

Researchers are also exploring how prescription eye drops and other drugs can be used to treat symptoms and flare-ups, as well as how wearable technology products may help treat chronic dry eye.⁹

How much does it cost to treat? Is financial help available?

The average cost of managing chronic dry eye is more than $11,000 per person, or more than $55 billion to the U.S. economy as a whole.¹⁰

There are direct costs in treating the disease, such as drug costs, doctor visits, procedures, and supplements. There are also indirect costs, such as job productivity losses and time away from work.

Potential ways to save on costs related to chronic dry eye include:

• Applying for Social Security disability benefits if chronic dry eye makes it hard for you to maintain or find a job
• Checking both your medical and vision insurance policies for ways to save and seeing if there are benefits you are not using that could help offset the costs of treatment
• Telling your doctor if the costs are too high. There may be a cheaper alternative
• Looking for sales on products you use

Have more questions?

If you do not see answers to other questions you have, you can post your question in our Forums section, where other community members may be able to help and share their experiences.