Chronic Dry Eye

Elderly people frequently experience dryness of the eyes, but chronic dry eye can occur at any age.  Nearly five million Americans 50 years of age and older are estimated to have dry eye.  Of these, more than three million are women and more than one and a half million are men.  Tens of millions more have less severe symptoms.  Chronic dry eye is more common after menopause and women who experience menopause prematurely are more likely to have eye surface damage from dry eye.

Chronic dry eye can make it more difficult to perform some activities, such as using a computer or reading for an extended period of time, and it can decrease tolerance for dry environments, such as the air inside an airplane.

There are two main types of chronic dry eye, Aqueous tear-deficient dryness and Evaporative dryness.  Aqueous tear-deficient dryness is a disorder in which the lacrimal glands fail to produce enough of the watery component of tears to maintain a healthy eye surface.  Evaporative dry eye may result from inflammation of the meibomian glands, located along the eyelid margins.  These glands make the lipid or oily part of tears that slows evaporation and keeps the tears stable.

Tears, made by the lacrimal gland, are necessary for overall eye health and clear vision. Tears bathe the surface of the eye, keeping it moist, and wash away dust and debris. They also help protect the eye from bacterial and other types of infections.

Tears are composed of three major components:

  1. An outer, oily, lipid layer produced by the meibomian glands
  2. A middle, watery, lacrimal layer produced by the lacrimal glands
  3. An inner, mucous or mucin layer produced by goblet cells located within a thin transparent layer over the white part of the eye and covering the inner surface of the eyelids

Chronic dry eye can manifest as:Red Eye

  • Stinging or burning of the eyes
  • A sandy gritty feeling
  • Episodes of excess tearing following very dry periods
  • A stringy discharge from the eye
  • Pain and redness
  • Episodes of blurry vision
  • Heavy eyelids
  • Inability to cry
  • Uncomfortable contact lenses
  • Decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention
  • Eye fatigue or headaches


Potential treatments for Chronic Dry Eye Disease include:fish-oil-pills2

  • Cyclosporine, or Restasis, an anti-inflammatory medication, is the only prescription drug available to increase natural tear production
  • Punctal plugs (temporary or semi-permanent) to keep the tears from draining off the eye as quickly
  • Punctal cautery surgery to permanently close the tear drainage system
  • Dietary Omega-3 fatty acids especially DHA and EPA (from tuna and salmon)
  • Artificial tears, gels, and ointments may help but only offer temporary relief
  • Humidifier in your home or office will help increase the moisture content in the air
  • Take frequent breaks from prolonged computer or digital device use

If contact lens wear is the problem, your eye care practitioner may recommend another type of lens or reducing the number of hours you wear your lenses.  In the case of severe dry eye, your eye care professional may advise you not to wear contact lenses at all.


At Chapel Hill Eyecare, we are members of the Triangle Dry Eye Network whose main office is located off of Executive Drive in Raleigh.

Learn more about Chronic Dry Eye Disease here

*All information and images courtesy of the National Eye Institute.