Persistently dry eyes are extremely common, affecting roughly 35% of adults worldwide. The underlying reason varies from person to person, but it almost always comes down to one of two problems: your eyes aren’t producing enough tears, or the tears you do produce are evaporating too fast. Often, several contributing factors overlap, which is why dryness can feel constant and hard to pin down.
Two Types of Dry Eye
Your tear film has three layers: a watery middle layer, a thin oily outer layer, and a mucus layer closest to the eye’s surface. When the watery layer is insufficient, that’s called aqueous deficiency. When the oily outer layer breaks down, tears evaporate before they can do their job. This second type, evaporative dry eye, is the more common form and is driven by problems with the tiny oil-producing glands (meibomian glands) lining your eyelids.
A useful clue: if your eyes feel driest first thing in the morning, the problem is more likely inadequate tear production. If dryness builds throughout the day and worsens by evening, the oil layer is probably failing and your tears are evaporating too quickly.
Screen Time and Blinking
One of the most widespread triggers is something you’re probably doing right now. When you look at a screen, your blink rate drops to about three to seven times per minute, roughly a third less than normal. Every blink spreads a fresh coat of tears across your eyes, so fewer blinks means your tear film dries out and breaks apart between refreshes. Over hours of sustained screen work, this adds up fast.
The fix is straightforward but easy to forget. The 20-20-20 rule helps: every 20 minutes, look at something 20 feet away for 20 seconds. This naturally triggers more complete blinks. Some people also develop a habit of “half-blinking” during screen use, where the upper lid doesn’t fully close, which leaves the lower portion of the eye exposed. Consciously squeezing your eyes shut a few times per hour can help retrain a fuller blink.
Medications That Dry Your Eyes
If your dry eyes started around the same time as a new prescription, that connection is worth exploring. In older adults, an estimated 62% of dry eye cases can be traced to systemic medications. The most common culprits include antihistamines (both prescription and over-the-counter allergy pills), antidepressants, blood pressure medications, diuretics, anti-anxiety medications, and common pain relievers like ibuprofen and naproxen. Acne medications that reduce oil production can also affect the oil glands in your eyelids.
If you suspect a medication is contributing, don’t stop it on your own. But it’s worth flagging with your prescriber, because alternatives within the same drug class sometimes have a milder drying effect.
Hormonal Changes
Women develop dry eye at significantly higher rates than men, and hormonal shifts are a major reason why. During perimenopause and menopause, declining levels of estrogen, progesterone, and testosterone directly affect the meibomian glands. These glands produce less oil and lower-quality oil, which destabilizes the tear film and causes tears to evaporate too quickly. According to Johns Hopkins Medicine, this hormonal disruption is one of the primary drivers of dry eye in women over 40.
Pregnancy, hormonal contraceptives, and hormone replacement therapy can all shift tear production as well, though the effects vary widely from person to person.
Autoimmune Conditions
Roughly one in ten people with clinically significant dry eye have Sjögren’s syndrome, an autoimmune condition where the immune system attacks the glands that produce moisture in the eyes and mouth. If your dry eyes come with a persistently dry mouth, difficulty swallowing dry foods, or joint pain, Sjögren’s is worth investigating. It’s more common in people who already have rheumatoid arthritis or lupus.
Other autoimmune and inflammatory conditions, including thyroid disease and rosacea, also contribute. Rosacea in particular is closely linked to meibomian gland inflammation and evaporative dry eye, even when the skin symptoms are mild.
Your Environment
Dry indoor air is a constant, invisible aggravator. Forced-air heating in winter and air conditioning in summer both strip moisture from the air and accelerate tear evaporation. Humidity levels of about 45% or higher are best for your eyes. A simple hygrometer (available for a few dollars) can tell you where your home or office stands, and a humidifier can close the gap.
Wind, ceiling fans blowing toward your face, and car air vents pointed at eye level all create the same problem. Even sleeping under a fan can leave you waking up with gritty, irritated eyes. Small adjustments, like redirecting vents or wearing wraparound glasses outdoors on windy days, can make a noticeable difference.
What Helps: Drops, Warm Compresses, and Diet
Artificial tears are the first-line treatment most people reach for, and they work well for mild to moderate dryness. If you’re using them more than a few times a day, switch to preservative-free formulations. The preservatives in standard eye drops can irritate and damage the surface of the eye with repeated use, especially when the surface is already compromised by dryness.
For evaporative dry eye driven by clogged oil glands, warm compresses are one of the most effective home treatments. Hold a warm, damp cloth over your closed eyelids for five to ten minutes, then gently massage along the lash line. This softens and releases the thickened oils blocking your meibomian glands. Doing this daily, especially in the morning, can meaningfully improve tear stability over a few weeks.
Omega-3 fatty acids from fish oil or fatty fish have shown benefits for tear film quality. Some eye doctors recommend starting with about 1 gram of fish oil daily and reassessing after a couple of months. The fatty acids help support the oily layer of the tear film, which is why they tend to help more with the evaporative type of dry eye.
When Dryness Points to Something Deeper
Most chronic dry eye is manageable with lifestyle changes and over-the-counter treatments. But certain patterns suggest something more is going on. Dry eyes paired with a dry mouth, especially if you also have joint pain or fatigue, raises the possibility of Sjögren’s syndrome or another autoimmune condition. Eyes that are not just dry but frequently red, light-sensitive, or producing blurry vision that fluctuates throughout the day may indicate more advanced surface damage. And dry eye that doesn’t respond at all to artificial tears, warm compresses, and environmental changes over several weeks is worth a closer look from an eye care provider, who can evaluate your tear production, oil gland function, and the health of the eye’s surface directly.