Symptoms of Chronic Dry Eye

Reviewed by: HU Medical Review Board | Last reviewed: June 2021

Chronic dry eye is a disease characterized by abnormalities 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

What does chronic dry eye look and feel like?

Symptoms of dry eye disease can cause discomfort. The most common symptoms of dry eye disease include:2-4

  • Painful, sore eyes – This may include stinging, burning, or general discomfort. Those with dry eye disease may also have chronic, long-term pain
  • Light sensitivity – This may range from mild to severe sensitivity and cause pain or discomfort
  • Blurry vision – This may come and go, with normal vision right after you blink
  • Gritty, sandy, or itchy eyes – This may feel like something is on or in your eye
  • Mucus in and around the eyes – This may be stringy or thread-like
  • Watery eyes – This may seem like a strange symptom of dry eye, but this occurs because dryness on the surface of the eye will sometimes cause your glands to react and make too much of the watery component of your tears as a protective mechanism. However, these tears do not stay on the eye long enough to correct the underlying dry eye condition.
  • Eye fatigue – This may cause you to feel like you cannot keep your eyes open
  • Double vision in 1 eye only – This is known as monocular diplopia. Those with dry eye disease often report “double vision,” but this is not truly “double” vision. Instead, it is a shadowing effect from light scattering due to an abnormal tear film or abnormal shape of the cornea. True double vision is usually caused by a misalignment of the 2 eyes and abnormalities of the eye muscles.

Are the symptoms in one or both eyes?

Chronic dry eye symptoms usually occur in both eyes, though one eye may have more severe symptoms than the other.

Could it be something else?

Not all eye dryness and discomfort is chronic dry eye. Many different diseases, conditions, and common medicines can lead to dry eyes. This adds to the confusion and can delay a correct diagnosis.

So are your symptoms chronic dry eye or something else? The answer may not be as simple as you would like. Sometimes, you may have symptoms that are not usually related to dry eye disease. Some eye symptoms are more often caused by other diseases or conditions where dryness of the eye may also be common.

Some symptoms are unusual in chronic dry eye and more common in other conditions, including:5-7

  • Eye twitching – This may occur due to general eye irritation, including dryness of the eye. However, this is not a common symptom of chronic dry eye. Various diseases may cause eye twitching, but it could also be an unknown cause.
  • Seeing spots, floaters, or static – Floaters look like small spots, dots, circles, lines, or cobwebs in your field of vision. While they could be related to abnormal tears on the surface of your eye, more often, they are floating inside the eye. Seeing an occasional floater or spot is not unusual. However, it may be a sign of something more serious. Seeing spots, floaters, or static is not a typical symptom of chronic dry eye.
  • Red or dark circles around or under the eyes – Age, genetics, and seasonal allergies can be related to visible redness or dark shading of the skin around or under the eyes. Dryness of the eye may also lead to this, but this is not a primary symptom of chronic dry eye disease.
  • Astigmatism – The cornea is the clear tissue covering the front of your eye. If this tissue is irregularly shaped, you may be diagnosed with astigmatism. This can cause blurry vision, but it is not a symptom of chronic dry eye alone.
  • Sinus, mouth, or face discomfort – Chronic dry eye disease can cause pain for many people. However, the pain associated with chronic dry eye usually occurs in and directly around the eye or forehead. Pain that extends beyond the mouth or face may be caused by another disease or condition and should be evaluated by a medical professional.

It is important to remember that the signs and symptoms of dry eye disease are different in each person. If you have questions or are concerned about what you are experiencing, talk to your doctor. Only a trained healthcare professional can find the cause of your dry eyes.

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