Why Are My Eyes Always Dry? What Causes Dry Eyes and How Can They Be Treated?

Reviewed by Dr Diymitra K Ganasan, Refractive Surgeon of OasisEye Specialists | Last updated: September 2026

What is a Dry Eye?

Dry eye is a common eye surface condition in which the tear layer that normally keeps the eye smooth, comfortable and clear becomes unstable, insufficient or poor in quality, causing irritation, fluctuating vision, watering or discomfort.

Why Dry Eye Matters

Your tears are not just “water.” They form a thin protective layer over the front of the eye so that each blink can spread moisture evenly, keep vision clear and reduce friction between the eyelid and the eye surface. When this layer breaks up too quickly or is not produced well enough, the eye surface can become irritated, inflamed and sensitive.

Dry eye is a common condition. The Tear Film & Ocular Surface Society Dry Eye Workshop II Epidemiology Report 2017 reported that dry eye disease prevalence varies widely, from 5% to 50%, depending on the population and diagnostic method used. The subsequent latest TFOS DEWS III guidelines also reaffirmed that dry eye disease is prevalent globally. In a Malaysian community pharmacy-based study, dry eye disease prevalence was reported at 37.78% among surveyed participants, showing that this is a relevant local issue too.

Dry eye can affect office workers, screen users, contact lens wearers, people exposed to air-conditioning, older adults, patients with autoimmune disease and patients preparing for or recovering from eye procedures such as cataract or refractive surgery. It is usually manageable, but the best treatment depends on the cause.

Causes and risk factors

Dry eye usually happens for one of two simple reasons: either the eyes do not make enough tears or the tears evaporate too quickly. Many patients have a mixture of both. The TFOS DEWS III 2025 guidelines note that people with dry eye often have overlapping causes, including oil gland problems and reduced tear production.

• Blocked or weak eyelid oil glands: Your eyelids contain tiny oil glands that add an oily layer to the tears; when this layer is poor, tears evaporate too quickly. This is called meibomian gland dysfunction.
• Not producing enough watery tears: Some people do not produce enough of the watery part of the tears, so the eye surface is not kept moist enough. This is called aqueous-deficient dry eye.
• Long screen time and reduced blinking: When focusing on screens, reading or driving, people often blink less fully or less often, so the tear layer is not spread evenly.
• Air-conditioning, fans, dry air, smoke, haze, and wind: These conditions can increase tear evaporation. In the Klang Valley study, 76% of dry eye patients felt uncomfortable in air-conditioned or low-humidity areas, and 73% reported discomfort in windy conditions.
• Contact lens wear: Contact lenses sit on the tear layer and may make symptoms worse if the tear film is already unstable.
• Age and hormonal changes: Tear production and oil gland function can change with age; the TFOS DEWS III 2025 guidelines found that dry eye prevalence increases with age and is higher in women, especially with age.
• Certain medications: Some medicines for allergies, mood stabilisers, blood pressure, glaucoma, menopause and pain may contribute to dry eye symptoms.
• Medical conditions: Autoimmune disease, thyroid eye disease, eyelid inflammation and some neurological or endocrine conditions can be associated with dry eye.
• Eye surgery or eye procedures: LASIK, cataract surgery, corneal surgery and other eye procedures can increase dry eye risk in some patients, especially if the eye surface was already borderline before surgery.
• Eyelid inflammation and debris around the lashes: Inflammation along the eyelid margin can block oil flow into the tears and increase evaporation.

Staging and classification

Dry eye is not usually “staged” in the same way as other diseases such as cancer. In a clinic, it is more practical to classify dry eye by severity and by cause.

In the Klang Valley community pharmacy study, the reported distribution was 40.3% mild, 30.5% moderate, and 29.5% severe among participants identified with dry eye, which may reflect the specific group being surveyed.

Mild dry eye usually means symptoms happen mainly during triggers such as screen use, air-conditioning, wind, or contact lens wear. Vision may fluctuate, but symptoms may settle with simple measures and suitable lubricating drops.

Moderate dry eye usually means symptoms are more frequent and may affect reading, night driving, work, contact lens comfort or daily activities. Patients may need treatment for eyelid oil glands, inflammation or tear conservation rather than lubricant drops alone.

Severe dry eye usually means symptoms are frequent, intense or persistent and the eye surface may show more obvious inflammation or damage. Management often requires closer follow-up, prescription treatment and sometimes in-clinic procedures or advanced therapies.

Dry eye can also be classified by cause:

Evaporative dry eye means the tears evaporate too quickly, commonly due to poor eyelid oil gland function.

Aqueous-deficient dry eye means the eye does not produce enough watery tears.

Mixed dry eye means both problems are present, which is common in real patients.

Signs and symptoms

What only a clinician can detect

An eye specialist can look for signs that are not always obvious to patients at home, including:

• A tear layer that breaks up too quickly between blinks
• Reduced tear volume
• Staining on the eye surface, which shows irritated or damaged surface cells
• Inflamed eyelid margins
• Blocked or thickened oil from the eyelid glands
• Poor eyelid closure or incomplete blinking
• Tear film imbalance using clinic-based tests such as tear osmolarity or surface staining

The TFOS DEWS III Diagnostic Methodology Report, 2017, recommends symptom screening followed by clinical tests such as tear breakup assessment, tear osmolarity, and eye surface staining, with further assessment of meibomian gland function, tear volume and lipid layer behaviour to guide classification.

What a patient might notice at home

Patients often describe dry eye in very practical terms:

• A gritty, sandy or foreign-body feeling
• Burning, stinging or soreness
• Redness
• Watery eyes, even though the eyes feel dry
• Blurry vision that clears temporarily after blinking
• Light sensitivity
• Eye tiredness after screen use or reading
• Contact lens discomfort
• Stringy mucus or eyelid crusting
• Symptoms that worsen in air-conditioning, wind, haze or after long screen use

In the Klang Valley study, the most commonly reported symptoms among dry eye patients were sensitivity to light at 74% and blurry vision at 70%; many also reported difficulties with night driving and reading.

Please seek an eye assessment if symptoms are persistent, worsening, associated with pain, light sensitivity, discharge, reduced vision, difficulty opening the eyes or if symptoms occur after eye surgery or eye injury.

Treatment options

Dry eye treatment works best when it is matched to the cause. Some patients need only simple changes and lubricants; others need treatment for eyelid oil glands, inflammation, tear production or tear drainage. The TFOS DEWS III Management and Therapy Report, 2025, describes a stepwise treatment approach because no single treatment works for every patient.

Screening and prevention

Dry eye cannot always be fully prevented, because age, medical conditions, medications, eyelid anatomy and eye surgery history may all play a role. However, many patients can reduce flare-ups and identify problems earlier.

A practical dry eye screening visit may include symptom questions, tear stability assessment, surface staining, eyelid gland evaluation, tear volume assessment and review of medications, contact lens use, screen habits and work environment. The TFOS DEWS III Diagnostic Methodology Report, 2025, supports using symptom screening together with clinical tests because symptoms and signs do not always match perfectly.

Patients may reduce dry eye triggers by avoiding direct air-conditioning or fan airflow to the face, taking breaks during prolonged screen use, blinking fully, managing contact lens wear, removing eye makeup properly, treating eyelid inflammation early and seeking assessment before procedures such as refractive or cataract surgery. These steps are especially relevant in Malaysia, where indoor air-conditioning is common; in the Klang Valley study, 76% of dry eye patients reported discomfort in air-conditioned or low-humidity areas.

For refractive surgery patients, dry eye screening is especially important because an unstable tear layer can affect comfort, measurements and recovery. Your specialist will determine suitability and preparation based on current clinical guidelines and your individual eye surface condition.