Dry Eyes: Causes, Symptoms and What Actually Helps

By Nizam Diveli, registered optometrist and founder of BlinkBetter

Dry eye means your tears aren't keeping the front of your eye properly covered, so it feels gritty, sore, tired or itchy, and your vision can blur until you blink. It's very common, especially over 50 and with long hours on screens. Most dry eye is caused by tears evaporating too fast, usually because the oil glands in the eyelids aren't working well. That's why eyelid care, not just eye drops, is often the missing piece.

Not sure what's causing your symptoms? Try our free eyelid symptom checker. It takes about a minute.

Dry eye symptoms

According to the NHS, dry eyes can feel (NHS):

• itchy, sore or gritty, like there's sand in them
• red
• blurry, often clearing when you blink
• sensitive to light
• watery. Yes, really: irritated eyes produce extra, thin, watery tears that run off rather than protecting the surface

Symptoms are often worse at the end of the day, after screen work, in air-conditioned or heated rooms, in wind, or when driving with the vents on.

Why does it happen? Your tear film explained

Every blink spreads a thin film of tears over the eye. That film has three parts working together: a thin oily layer on top, a watery layer in the middle and a mucus layer that helps it cling to the eye.

Eye experts describe two main types of dry eye, which often overlap (TFOS DEWS II):

	Evaporative dry eye	Aqueous-deficient dry eye
What goes wrong	Too little oil on the tears, so they evaporate too fast	The tear gland makes too little water
How common	The most common type	Less common; often linked to conditions like Sjögren's
Usual cause	Meibomian gland dysfunction (MGD)	Age, some medicines, autoimmune conditions
What helps most	Warmth, lid massage, lid cleaning, plus drops	Lubricating drops, plus specialist care

The international TFOS DEWS II report concluded that most dry eye is evaporative, and that the most common cause of evaporative dry eye is meibomian gland dysfunction (TFOS, Craig et al. 2017). In plain terms: for a lot of people with "dry eyes", the problem starts in the eyelids.

What causes dry eye?

The NHS lists these as making dry eyes more likely (NHS):

• being over 50
• wearing contact lenses
• using screens for long periods without breaks
• air-conditioned or heated rooms, wind, dust or dry air
• smoking, being around smoke, or drinking alcohol
• some medicines, such as certain antidepressants and blood pressure tablets
• conditions like blepharitis, Sjögren's syndrome or lupus

Hormonal changes, including the menopause, can play a part too. Demodex eyelash mites can also aggravate blocked oil glands and an unstable tear film.

Dry eye treatment at home

The NHS recommends cleaning your eyelids every day: a warm (not hot) flannel over the eyes, a gentle massage of the lids, then wiping them clean (NHS). This targets the oil glands, which is why it often helps where drops alone haven't.

1. Warm, massage, clean: daily

1. Warm your closed eyes for 5 to 10 minutes. A flannel cools fast, so re-warm it, or use a heat mask that holds its warmth.
2. Massage gently towards the lashes to help the softened oil flow.
3. Clean along the lash line. Our lid cleaning guide shows exactly how.

2. Use lubricating drops properly

Lubricating eye drops (artificial tears), gels and night-time ointments are available from pharmacies, and a pharmacist can help you choose (NHS). A few tips:

• If you use drops more than a few times a day, preservative-free drops are usually gentler on the eye.
• Thicker gels last longer but blur vision briefly, so they're useful before bed.
• Drops ease symptoms, but if your oil glands are blocked, they won't fix the cause on their own.

3. Change your environment and habits

• Take screen breaks and consciously blink fully. Concentrating on a screen cuts how often and how completely we blink.
• Place your screen just below eye level, so your eyes are slightly less open (NHS).
• Use a humidifier in dry, heated rooms, and keep car and desk fans off your face.
• Wear wraparound glasses outdoors on windy days.
• If you wear contact lenses, give your eyes regular days in glasses.
• Don't stop a prescribed medicine without speaking to your GP, even if you think it's making your eyes dry.

What helps

• For the warm step: our SelfHeat eye mask is designed to give steady warmth for a full session, with no microwave.
• For the clean step: our BetterScrub eyelid wipes are a UKCA-registered medical device for eyelid hygiene. Prefer the sink? Our Eyelid Cleansing Foam is designed to gently cleanse the lids and lashes.
• For comfort overnight: our BetterLids eyelid ointment is a UKCA-registered medical device that keeps dry, sore lid edges comfortable while you sleep.
• For a refresh during the day: our HypoMist spray is designed for no-touch eyelid freshening over closed eyes.

Browse the full routine in our dry eye collection.

What your optometrist can do

If your eyes are still dry after a few weeks of home care, see an optometrist (NHS). They can look at your tear film and eyelids under magnification, check how quickly your tears break up, and work out whether it's mainly evaporative, mainly aqueous-deficient, or both. Depending on the cause, options include:

• targeted advice on the right drops, gels or sprays
• treating blepharitis, MGD or Demodex if those are driving it
• in-clinic gland treatments or intense pulsed light in some practices
• referral to an eye specialist if they suspect an underlying condition. Specialists can offer prescription anti-inflammatory drops, small plugs to keep tears on the eye, and more

When to get help

See an optician or GP if your eyes are still dry after a few weeks of home treatment, or the shape of your eyelid has changed (NHS).

Get an urgent GP appointment or call NHS 111 if you have a painful red eye, or a red eye while wearing contact lenses, which could mean an infection (NHS).

Go to A&E or call 999 if you have sudden changes in vision (such as flashing, wavy lines or vision loss), pain when looking at light, a red eye with a severe headache and feeling sick, or an eye injury (NHS).

Frequently asked questions

Why are my eyes watery if they're dry?

When the surface dries out, it gets irritated and the tear gland floods it with thin, watery tears. Without enough oil, these don't stay put, so they run down your cheeks while your eyes still feel dry.

Can dry eye be cured?

It's often long-term, but very manageable. Many people get big improvements once they fix the cause, often the oil glands, rather than relying only on drops.

Do screens cause dry eye?

They don't damage the eyes, but we blink less and less fully when we concentrate, which lets tears evaporate. Regular breaks and deliberate full blinks help.

Which eye drops are best?

It depends on the type of dry eye. If you need drops often, preservative-free versions are usually kinder. Ask a pharmacist or optometrist; for evaporative dry eye, drops designed to support the oil layer may suit you better.

Is dry eye worse in winter?

For many people, yes. Central heating, cold wind and car heaters all speed up tear evaporation.

Does the menopause cause dry eyes?

Hormonal changes can affect both the tear and oil glands, so dry eye symptoms are common around the menopause. The same routine applies, and it's worth mentioning to your optometrist or GP.

The short version

Dry eye is common and usually down to tears evaporating too fast, often because the eyelid oil glands are blocked. Warm, massage and clean your lids daily, use preservative-free drops if you need them often, take screen breaks, and see an optometrist if it isn't settling. A painful red eye or a sudden change in vision needs urgent help.

This guide is general information, not a diagnosis. If you're worried about your eyes, see an optometrist.