Dry Eye Syndrome: Causes and Treatment

Dry eye syndrome is one of the most common reasons for an eye-doctor visit — and one of those conditions whose scale is systematically underestimated, because many people treat burning, tired eyes as an unavoidable side effect of screen work. In reality there are far more causes, from natural aging to autoimmune diseases like Sjögren's syndrome, and treatment success depends heavily on correctly identifying the cause, not just relieving symptoms with artificial tears.

Redakcja VitMode — Serce i układ krążeniathe VitMode editorial team, no individual bylinesPublishedSeptember 16, 202613 min readAbout 13 min left

How this article was made

Author: Redakcja VitMode — Serce i układ krążenia — the VitMode editorial team, no individual bylines
Method: Prepared from primary sources: clinical trials, meta-analyses and guidelines. We describe study findings separately from our interpretation.
Source verification: Cited PubMed papers are automatically checked for a matching identifier, title and publication year.
Medical review: none — this article has not been reviewed by a physician
Last updated: September 16, 2026

The content is educational and does not replace medical advice. Read the full editorial process

Table of contents

TL;DR — key takeaways

→A widespread condition, rarely taken seriously
→Why there are more causes than just "not enough tears"
→Screen time — what the research actually shows
→Sjögren's syndrome — when dry eye is a symptom of autoimmune disease
→Artificial tears — the foundation of treatment, but not always enough
→Cyclosporine — what the registration trials showed
→Other treatment options when response is insufficient
→When to see an eye doctor
→Our editorial recommendation

A widespread condition, rarely taken seriously

Dry eye disease (DED) is a chronic disease of the ocular surface resulting from an insufficient amount or improper quality of the tear film, leading to its instability, irritation of the eye's surface, and symptoms such as burning, a gritty feeling under the eyelids, redness, sensitivity to light, and, paradoxically, sometimes even excessive tearing as a defensive reaction to irritation.

The scale of the problem is larger than the number of actual diagnoses in eye clinics might suggest — many people with mild or moderate symptoms never seek help, treating dry eyes as an unavoidable consequence of working at a computer, aging, or simply "tired eyes," rather than as a condition that can and should be diagnosed and treated.

What does the research say?

TFOS DEWS II Epidemiology Report

Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F et al. · The Ocular Surface · 2017

Study findings

This epidemiology report, prepared by an international expert panel as part of the second Tear Film & Ocular Surface Society Dry Eye Workshop (TFOS DEWS II) report, summarized data from numerous population-based studies worldwide. The prevalence of dry eye disease ranged from 5% to 50% depending on the diagnostic criteria used and the population studied, with the prevalence of both symptoms and objective clinical signs clearly increasing with age, and women showing a higher prevalence than men, especially after menopause.

Strong evidenceView the study on PubMed

This describes what the study found. Editorial interpretation follows in the text below.

Why there are more causes than just "not enough tears"

Dry eye disease is traditionally divided into two main, partly overlapping types: aqueous-deficient dry eye, resulting from insufficient tear production by the lacrimal glands, and evaporative dry eye, most often caused by dysfunction of the meibomian glands responsible for producing the lipid layer that, under normal conditions, prevents the tear film from evaporating too quickly. In clinical practice, many patients have elements of both mechanisms.

What you can do

The most common causes and risk factors for dry eye syndrome

Natural aging — tear production and tear-film quality decline with age, and hormonal changes after menopause further intensify this process in women
Prolonged use of digital screens — computers, smartphones, tablets — associated with significantly less frequent and incomplete blinking
Autoimmune diseases, primarily Sjögren's syndrome, but also rheumatoid arthritis and systemic lupus erythematosus
Certain medications — antihistamines, antidepressants, beta-blockers, isotretinoin, some hormonal drugs — which can reduce tear production as a side effect
Meibomian gland dysfunction, often associated with chronic inflammation of the eyelid margins
Long-term contact-lens wear, especially with improper hygiene or excessively long wearing time
Dry, air-conditioned or heated rooms, wind, and tobacco smoke as environmental factors intensifying tear evaporation
Corneal eye surgery, including some vision-correction procedures, which can temporarily or permanently disrupt corneal innervation affecting tear production

Screen time — what the research actually shows

The link between time spent in front of screens and dry-eye symptoms is one of the most frequently repeated, but also relatively well-supported, risk factors found in observational research, particularly relevant in the context of remote and office work.

What does the research say?

Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis

Courtin R, Pereira B, Naughton G, Chamoux A, Chiambaretta F, Lanhers C, Dutheil F · BMJ Open · 2016

Study findings

A meta-analysis covering 16 studies and a total of 11,365 people working with display screens found an overall prevalence of dry-eye symptoms of 49.5% (95% CI 47.5-50.6%), with large variation between studies (from 9.5% to 87.5%) mainly due to inconsistent diagnostic criteria used across the primary studies. The authors emphasized that because of this heterogeneity, the single figure (49.5%) should be treated as indicative rather than a precise epidemiological measure.

Moderate evidenceView the study on PubMed

This describes what the study found. Editorial interpretation follows in the text below.

The mechanism linking screens with dry eyes is mainly associated with reduced blink frequency and incomplete eyelid closure during focused visual work — blinking can decrease several-fold relative to resting values, which shortens the time in which the tear film is renewed on the eye's surface and promotes its faster evaporation.

Sjögren's syndrome — when dry eye is a symptom of autoimmune disease

In some patients, chronic dry eyes aren't an isolated ophthalmological problem but one of the symptoms of Sjögren's syndrome — a chronic autoimmune disease in which the immune system attacks the exocrine glands, primarily the lacrimal and salivary glands, leading to dryness of the eyes and mouth as the main symptoms (so-called sicca syndrome).

Artificial tears — the foundation of treatment, but not always enough

Artificial-tear preparations (lubricating drops) remain the first-line treatment for mild and moderate cases of dry eye syndrome, regardless of the exact cause — they relieve symptoms by supplementing and stabilizing the tear film. Preservative-free formulations are generally preferred for frequent use (more than 4-6 times a day), since preservatives in drops can themselves further irritate the eye's surface over time.

Myth

Artificial tears are an effective treatment for dry eye syndrome for every patient — you just need to find the right formulation and use it regularly.

Fact

In patients with moderate to severe disease, especially when chronic inflammation of the eye's surface plays a significant role (typical, for example, in Sjögren's syndrome), artificial tears alone often merely mask the symptoms without addressing the underlying inflammatory mechanism. In such cases, anti-inflammatory medications like topical cyclosporine may be needed, and the decision to start such treatment is best made by an ophthalmologist after assessing the severity and type of disease.

Check your profile

Not sure which supplements actually make sense for you?

Answer a few short questions about your lifestyle, diet, sleep, and goals. VitMode will build your profile and show supplements worth considering — with reasoning and evidence strength.

Takes about 2 minutesBased on scientific evidence

Find supplements for me

Recommendations take your answers and the strength of the scientific evidence into account. A supplement's popularity has no bearing on whether it gets recommended.

Cyclosporine — what the registration trials showed

What does the research say?

Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease

Sall K, Stevenson OD, Mundorf TK, Reis BL (CsA Phase 3 Study Group) · Ophthalmology · 2000

Study findings

Two multicenter, randomized, double-blind, vehicle-controlled trials enrolled a total of 877 patients with moderate to severe dry eye disease, comparing cyclosporine A ophthalmic emulsion (0.05% and 0.1%) with vehicle alone over 6 months. Groups treated with cyclosporine showed statistically significant improvement in objective ophthalmological parameters (including corneal fluorescein staining and Schirmer test) compared with the control group, leading to the drug's approval for treating chronic dry eye disease associated with inflammation-related suppression of tear production.

Strong evidenceView the study on PubMed

This describes what the study found. Editorial interpretation follows in the text below.

Other treatment options when response is insufficient

A separate category worth mentioning is omega-3 fatty acid supplementation, whose effectiveness in treating dry eye was the subject of a separate, large randomized trial — we cover it in more depth in our article on omega-3 and dry eye syndrome, where we discuss, among other things, the DREAM trial and its surprisingly null result. It's worth treating as a supplement to this text if you're specifically interested in the supplementation question rather than the general clinical picture of the disease.

When to see an eye doctor

Question	Short answer
How common is dry eye syndrome?	Very — from 5% to 50% depending on criteria and population, according to the TFOS DEWS II report
Do screens really matter?	Yes — a meta-analysis found roughly 49.5% symptom prevalence among screen workers
Is it always a mild condition?	Not always — in some patients it's a symptom of Sjögren's syndrome or another autoimmune disease
Are artificial tears always enough?	Not in moderate and severe cases with an inflammatory component — cyclosporine can help there
When should I see a doctor?	When symptoms don't improve after several weeks of self-treatment, or are accompanied by pain, strong redness, or dry mouth

Dry eye syndrome at a glance

Our editorial recommendation

Dry eye syndrome is a good example of a condition that's both widely minimized and genuinely underdiagnosed — many people accept chronic discomfort as an unavoidable cost of computer work, instead of considering whether the cause might lie elsewhere, including in a systemic disease requiring entirely different treatment than eye drops.

A stepwise approach — from modifying screen and environmental habits, through artificial tears, to anti-inflammatory medication in persistent cases — remains a reasonable path, as long as it's accompanied by vigilance for symptoms suggesting something more than ordinary eye fatigue, such as dry mouth or joint pain.

Dry eye is rarely a problem of the eyes alone — more often it's a signal the body is sending, and the doctor's role is to recognize when that signal calls for just drops, and when it calls for much broader diagnostic workup.

VitMode editorial team

Frequently asked questions

It depends on the cause — dryness related to reversible environmental factors (e.g., excessive screen time) often responds well to habit modification, while chronic forms related to age or autoimmune disease usually require long-term symptom-control treatment rather than a one-time cure.

Not necessarily, but with pronounced symptoms it's worth consulting an eye doctor about switching to a different type of lens (e.g., with higher oxygen permeability or a different material), shortening wear time, or a temporary break from lenses during more intensive treatment.

In registration trials, significant improvement in objective parameters was visible after several weeks to a few months of regular use — the effect isn't immediate, which is important information for patients starting therapy, so they don't stop it prematurely because of a lack of quick improvement.

No — most dry-eye cases aren't related to Sjögren's syndrome. Available data suggest this applies to about 1 in 10 patients with clinically significant, aqueous-deficient dry eye, though it's worth considering this possibility when there's coexisting dry mouth, joint pain, or chronic fatigue.

With occasional use they're usually not a problem, but with frequent use (more than a few times a day) preservatives, especially benzalkonium chloride, can further irritate the eye's surface over time. If frequent use is necessary, it's worth choosing preservative-free formulations.

This is a topic we cover in more depth in a separate article on omega-3 and dry eye syndrome — in short, results from the large DREAM trial were surprisingly negative relative to placebo, which shows that even a well-reasoned mechanistic hypothesis doesn't always hold up in a rigorous clinical trial.

Yes, though prevalence clearly rises with age. In younger people, the most common cause is intensive use of digital screens and the associated less frequent, incomplete blinking, rather than the chronic diseases typical of older patients.

Sources (4)

Sources are numbered. PubMed items are automatically verified (identifier, title, year).

1Stapleton et al. 2017 — The Ocular Surface (TFOS DEWS II)PubMed
2Courtin et al. 2016 — BMJ OpenPubMed
3Akpek, Bunya, Saldanha 2019 — CorneaPubMed
4Sall et al. 2000 — OphthalmologyPubMed

Redakcja VitMode — Serce i układ krążenia

VitMode editorial team — no individual bylines; content based on primary sources

VitMode Editorial — Heart and Circulation is the VitMode editorial team responsible for: the heart, blood pressure, lipids and cardiovascular prevention. The team has no individual bylines — texts are prepared by VitMode editors from primary sources (clinical trials, meta-analyses, guidelines). Every cited PubMed paper is automatically checked for a matching identifier, title and publication year. The content is educational and does not replace medical advice. Factual errors can be reported in a comment under the post or through the contact form; corrections are made by the editorial team.

Explore the topic further

Related topics from the VitMode knowledge base — pick the area you care about.

This article

Dry Eye Syndrome: Causes and Treatment

Diagnosis 2

Treatment 4

Nutrition and lifestyle 1

SleepEntry

Biological mechanisms 1

Metabolic SyndromeEntry

Research 4

Prevention 1

Glaucoma — Risk Factors and PreventionArticle

Path: Dry Eye Syndrome

0 of 7 read0%

Learn the basics
- Dry Eye Syndrome: Causes and Treatment (You are here)
Understand possible causes
Related topics
- Astaxanthin for Skin and Eye Health: What Do Clinical Trials Show?
- Stye vs Chalazion on the Eyelid: How They Differ and How to Treat Them

Progress is saved in this browser only.

Start the path

Tools for this topic

Your entries stay in your browser and are never sent anywhere. This is a notebook, not a diagnostic tool — it does not diagnose or recommend treatment. Discuss results with your doctor.

Questions readers often ask

Short answers from related articles — click to read more.

What's the difference between primary and secondary Sjögren's syndrome?

Primary Sjögren's syndrome occurs on its own, without another coexisting autoimmune connective tissue disease. Secondary Sjögren's syndrome occurs alongside another diagnosed disease, most often rheumatoid arthritis, systemic…

From the article: Sjögren's Syndrome: Symptoms, Diagnosis, and Treatment

What dose of astaxanthin was used in the skin and eye trials?

The skin UV-protection trial used 4 mg daily for 9 weeks. The visual-acuity-after-screen-work trial used 9 mg daily for 6 weeks. The systematic review of skin studies covered doses in the 3-6 mg daily range.

From the article: Astaxanthin for Skin and Eye Health: What Do Clinical Trials Show?

How does a stye differ from a chalazion?

A stye is an acute, painful, red lump on the edge of the eyelid, usually from a bacterial infection of a gland; it develops within 1-2 days and usually lasts a few days to two weeks. A chalazion is a slower-growing, hard, usually…

From the article: Stye vs Chalazion on the Eyelid: How They Differ and How to Treat Them

What does light sensitivity mean?

Light sensitivity (photophobia) is an abnormal, painful intolerance of light. It is a symptom, not a separate disease. Most often it accompanies migraine, blepharospasm, head injury, dry eye and corneal disease, but it can also…

From the article: Light Sensitivity (Photophobia): Causes (Migraine, Dry Eye, Inflammation) and When to See a Doctor

Did not find your answer? Write to us — we do not give individual advice, but we can point to reliable sources. Ask the editors

Related knowledge base entries

Omega-3 Fatty Acids

The polyunsaturated fatty acids EPA and DHA have one of the strongest evidence bases among cardiometabolic supplements — but the effect depends heavily on baseline blood levels, not just the dose on the label.

SuplementyStrong evidence

Sleep

Sleep isn't a passive shutdown of the body — it's an active, highly organized biological process. Its shortfall (and, counterintuitively, its excess too) is linked to a measurably higher risk of death from any cause.

SenStrong evidence