Burning, scratchy, watery eyes? It might not just be a long day — it could be dry eye disease, also known as dry eye syndrome. This common condition affects millions of people and can turn simple tasks like working at a computer or being outdoors into a daily annoyance.

Dr. Andreoli explains what's behind dry eye, what symptoms to watch for and how to feel better.

What Is Dry Eye Syndrome?

Dry eye isn't just about not producing enough tears. In fact, one of the most important concepts to understand is that tears are more complex than they seem.

The eye depends on a delicate tear film, which is a balanced mixture of water, oil and mucus. This film coats the cornea (the clear front surface of the eye) and keeps it smooth and healthy.

“The cornea needs a healthy tear film to stay healthy,” says Dr. Andreoli. “This film should be balanced with mucus, oil and salt water. If there's too little of one of those things, or too much of one, the surface of the eye can suffer.”

Problems with the tear film can come from issues in different parts of the eye, including the:

• Lacrimal glands, which make the watery portion of tears
• Meibomian glands, which produce oil that prevents tears from evaporating too quickly

Dysfunction of these oil-producing glands — known as meibomian gland dysfunction — is a common cause of dry eye.

Common Symptoms

The symptoms of dry eyes can vary widely and may even change throughout the day. People may experience:

• Stinging or burning
• A scratchy or gritty sensation
• Redness
• Itching
• Excess tearing
• Light sensitivity
• Blurred vision
• A mucus-like film covering the eye or collecting in the corner of the eye
• Discomfort when wearing contact lenses

It may seem surprising, but watery eyes are often linked to dry eye.

“Some people make lots and lots of fluid — it's just not a very good quality,” says Dr. Andreoli. “The brain gets a message that the eye is dry, so we make another tear, but the fluid doesn't lubricate, and the tears pour down our cheek.”

What Causes Dry Eye?

Dry eye can affect anyone, but certain factors increase your risk.

“Women are typically drier than men, especially perimenopausal and postmenopausal women,” says Dr. Andreoli. “But there are a lot of risk factors, including certain medical conditions and medications.”

Risk factors include:

• Autoimmune diseases, such as lupus and rheumatoid arthritis
• Thyroid conditions
• Diabetes
• Certain skin conditions
• Environmental exposure, such as wind, dry air and smoke
• Medications, such as antihistamines, antidepressants, diuretics, hormone replacement therapy and birth control pills, as well as medications for high blood pressure and acne
• Wearing contact lenses

If you suspect your medications are contributing, Dr. Andreoli recommends discussing your full medication list with an ophthalmologist.

How Is Dry Eye Diagnosed?

Your clinician will review your medical history to identify any underlying causes of dry eye. In addition, these tests may be used:

• Schirmer test: Blotting strips are used to measure your tear production
• Corneal staining: Special eye drops containing dyes are used to examine your cornea's condition and measure how quickly the drops evaporate

Why Modern Life Makes Dry Eye Worse

Everyday habits can significantly contribute to dry eye disease, especially prolonged screen use.

“We know that when we use our computers or phones, we don't blink as often as we should,” says Dr. Andreoli. “You should blink about once every four seconds, and when you don't blink, your eye doesn't stay lubricated.”

Environmental factors also play a role. Indoor heating, air conditioning and low humidity can all accelerate tear evaporation.

Dr. Andreoli recommends the 20-20-20 rule: Every 20 minutes, take a 20-second break and look at something 20 feet away. This encourages blinking and helps rehydrate the eye surface.

When To Try Eye Drops

For occasional dryness, over-the-counter eye drops can help — but choosing the right product matters.

“What we're looking for is something that says artificial tears,” says Dr. Andreoli. “We strongly discourage using redness-relief drops, because they can actually make your eyes drier.”

If you use drops frequently, opt for preservative-free options to avoid irritation.

When To See a Specialist

“If someone is using artificial tears more than a couple times a week, it may be time to see an eye doctor,” says Dr. Andreoli. “There are lots of things that can cause dry eye syndrome, and often we can offer more targeted treatment.”

Left untreated, chronic dry eye can damage the cornea and lead to lasting vision problems. “If you scar the cornea, you are looking through a clouded structure, and that may not be repairable,” she adds.

Treatment Options for Dry Eye

Dry eye treatment isn't one-size-fits-all. Relief depends on identifying and addressing the root cause. Here are some treatment options your eye doctor may recommend:

Lifestyle changes

To support healthy eyes, Dr. Andreoli often starts with simple adjustments:

• Stay hydrated.
• Limit caffeine and avoid alcohol (both can dehydrate).
• Use a humidifier.
• Avoid direct airflow from fans.
• Consider supplements, such as omega-3 fatty acids.
• Try placing warm compresses, such as a warm washcloth, over your eyes.

Over-the-counter relief

Lubricating eye drops and gels are often the first line of treatment. These include artificial tears, which typically last a few hours.

Nighttime ointments

For more severe dryness, ointments can provide longer-lasting relief.

“Nothing really lubricates as long as a petroleum-based product,” says Dr. Andreoli. “An ointment can last six to eight hours.”

These are especially helpful for people who wear contact lenses, as overnight use can improve comfort the next day.

Prescription treatments

Prescription eye drops may be recommended when over-the-counter options aren't providing enough relief. These medications are designed to address underlying inflammation or stimulate natural tear production, helping improve eye comfort over time. The American Academy of Ophthalmology offers an overview of prescription options commonly used to treat dry eye.

“The idea is not that the drops make you feel better right away,” she explains. “But if you use them over time, they can sometimes raise your baseline tear production.”

In-office procedures

For certain patients, procedures may help retain moisture in the eye. One option is punctal plugs, which block tear drainage.

“Some patients find that a punctal plug works great for them, and that's a one-minute procedure that can be done in an ophthalmologist's office,” says Dr. Andreoli. “Others don't think it helps much at all. The most important thing is finding out what's causing dry eye syndrome, and the symptoms that go along with it, and treating it as specifically as possible.”

Other treatments, such as manual gland expression and thermal therapies, target meibomian gland dysfunction, addressing oil imbalances in the tear film.

Say Goodbye to Dry Eye

While dry eye becomes more common with age, it doesn't have to interfere with your daily life.

“As we age, we may get more dry eye symptoms. But it does not have to affect us day to day,” says Dr. Andreoli. “We can do many things to help patients improve their quality of life.”

If you're experiencing persistent irritation, redness, blurred vision or watery eyes, don't ignore it. With the right diagnosis and treatment plan, it's possible to ease your symptoms — and keep your eyes comfortable and healthy.