Dry eyes happen when your tears can’t keep the surface of your eyes properly lubricated, either because you’re not producing enough tears or because the tears you do produce evaporate too quickly. It’s remarkably common, affecting roughly 35% of the global population, with higher rates in women (about 39%). The cause is rarely one single thing. It’s usually a combination of factors, from how you spend your day to medications you take to changes happening inside your body.
How Your Tear Film Breaks Down
Your tears aren’t just saltwater. They’re a layered film with an oily outer layer, a watery middle layer, and a mucus layer that sits directly on the eye’s surface. Each layer has a job: the mucus helps tears stick to the eye, the watery layer provides moisture and nutrients, and the oil layer on top prevents everything beneath it from evaporating.
The most common breakdown happens in that oil layer. Tiny glands along your eyelid margins, called meibomian glands, produce the lipid material that forms this protective barrier. When these glands get clogged or stop working well, the oil layer thins out and your tears evaporate faster than they should. This is called evaporative dry eye, and it accounts for the majority of cases. The glands can become obstructed on their own, or secondary to skin conditions like rosacea or seborrheic dermatitis. Bacteria on the eyelids can also degrade the oils, producing an unstable tear film and irritating byproducts.
Less commonly, the problem is in the watery layer itself. Your lacrimal glands simply don’t produce enough volume. This can result from aging, autoimmune conditions, or damage to the nerves that signal tear production.
Screens and Your Blink Rate
You normally blink about 15 times per minute. When you’re staring at a screen, reading, or doing any focused near-work activity, that rate drops by roughly half. Fewer blinks means your tear film isn’t being refreshed and spread evenly across the eye, so it breaks apart and dries out between blinks. If you spend several hours a day on a computer or phone, this is one of the most likely contributors to your symptoms.
The fix is straightforward but easy to forget: follow the 20-20-20 rule. Every 20 minutes, look at something 20 feet away for 20 seconds. This gives your eyes a break from intense focus and lets your blink rate return to normal, even briefly. Positioning your screen slightly below eye level also helps, since it reduces the amount of exposed eye surface area between blinks.
Medications That Dry Your Eyes
If your dry eyes started around the same time you began a new medication, that’s worth paying attention to. An estimated 62% of dry eye cases in older adults can be traced to systemic medications. The list of culprits is long: antihistamines (allergy medications), antidepressants and antipsychotics, blood pressure drugs, diuretics (water pills), anti-anxiety medications like benzodiazepines, NSAIDs like ibuprofen, and even some diabetes and heartburn medications.
These drugs reduce tear production through different mechanisms, but the end result is the same. If you suspect a medication is involved, don’t stop taking it on your own. Talk to your prescriber about whether an alternative exists or whether adding a lubricating eye drop could offset the dryness.
Hormonal Changes
Women experience dry eyes at significantly higher rates than men, and hormones are a major reason. During perimenopause and menopause, levels of estrogen, progesterone, and testosterone all decline. These hormones directly influence the meibomian glands. As hormone levels drop, the glands produce less oil and lower-quality oil, which means tears evaporate faster. This is why many women notice dry eye symptoms for the first time in their 40s or 50s, even without any other changes in their health or habits.
Pregnancy and hormonal contraceptives can also shift the balance, though the effects tend to be temporary.
Autoimmune Conditions
Persistently dry eyes, especially when paired with a dry mouth, can signal an autoimmune condition called Sjögren’s syndrome. In Sjögren’s, the immune system attacks the glands responsible for producing moisture in the eyes, mouth, and other tissues. It’s more common in people who already have another autoimmune disease like rheumatoid arthritis or lupus.
If your dry eyes are severe, don’t respond well to over-the-counter drops, and come with other symptoms like joint pain, fatigue, or difficulty swallowing, it’s worth being evaluated for an underlying autoimmune cause. Blood tests and specific eye exams can help distinguish Sjögren’s from ordinary dry eye.
After LASIK or Eye Surgery
Dry eyes are one of the most common side effects of LASIK. During the procedure, creating the corneal flap damages nerves that regulate tear production and blinking. The reshaped cornea can also affect how tears distribute across the surface. For most people, dryness resolves within a few months as the nerves regenerate. But studies suggest that 10 to 40% of people still have symptoms six months after surgery, and a small number experience dryness for over a year.
If you’re considering LASIK and already have dry eyes, this is something to discuss with your surgeon beforehand, since pre-existing dryness can worsen after the procedure.
Your Environment Matters
Dry indoor air is a consistent trigger. Heating systems in winter and air conditioning in summer both strip moisture from the air. Indoor humidity of about 45% or higher is best for your eyes. A simple hygrometer (available for a few dollars) can tell you where your home or office stands. If humidity is low, a humidifier in the rooms where you spend the most time can make a noticeable difference.
Wind, smoke, and high altitudes also accelerate tear evaporation. Wraparound sunglasses or moisture-chamber glasses can help if you’re regularly exposed to wind or dry outdoor conditions.
What You Can Do About It
For mild, occasional dryness, preservative-free artificial tears are the standard first step. They supplement your natural tear film and are safe for frequent use. Avoid drops marketed as “redness relief” since these contain vasoconstrictors that can make dryness worse over time.
Warm compresses held against closed eyelids for 5 to 10 minutes can help unclog meibomian glands and improve oil flow. This is especially useful if your dryness comes with a gritty or burning sensation along the eyelid margins. Gentle lid scrubs with diluted baby shampoo or pre-made lid wipes can also keep the glands clear.
When over-the-counter options aren’t enough, prescription treatments target the inflammation that drives chronic dry eye. Several prescription eye drops work by calming the immune response on the eye’s surface, which allows your tear glands to function more normally over time. These typically take several weeks to reach full effect. There’s also a prescription nasal spray that stimulates tear, oil, and mucin production by activating nerves in the nose, offering a different approach for people who don’t tolerate eye drops well.
Omega-3 fatty acid supplements (from fish oil or flaxseed) have shown mixed results in studies, but some people find them helpful, particularly for oil-layer deficiency. Staying well-hydrated, taking screen breaks, and sleeping enough also support healthy tear production in ways that are easy to underestimate.