Dry Eye
Why Your Eyes Burn, Water, Sting or Feel Tired — And What You Can Do About It
Dry eye disease is a chronic condition where the surface of the eye does not stay properly lubricated and protected. This can happen because the eyes do not produce enough tears, the tears evaporate too quickly, or the oil glands in the eyelids are not functioning normally.
Many people assume dry eye simply means “not enough tears,” but in reality it is usually an inflammatory condition involving the tear film, eyelids, meibomian glands, skin, and ocular surface.
Dry eye can range from mild irritation to severe pain and visual fluctuation, and for many people it significantly affects daily life.
Common Symptoms of Dry Eye
Dry eye symptoms are often inconsistent and can fluctuate throughout the day. Common symptoms include:
Burning or stinging eyes
Redness or irritation
Watery eyes
Gritty or sandy sensation
Fluctuating or blurry vision
Sensitivity to light
Eye fatigue or heaviness
Difficulty wearing contact lenses
Sore eyelids or crusting around the lashes
Tired eyes when reading or using screens
One of the most confusing symptoms for patients is excessive watering. This is often a reflex response to irritation, this means that watery eyes can actually be a sign of dry eye disease.
The Most Common Cause: Meibomian Gland Dysfunction (MGD)
For many patients, dry eye is caused by dysfunction of the meibomian glands. These tiny oil glands are located within the eyelids and produce meibum. Meibum ois the oily layer of your tear film which prevents your tears form evaporating off the front surafce of your eye too quckly. When these glands become blocked, your tears evaporate too quickly causeing blurred and fluctuating vision, dry, sore and gritty eyes.
This is known as evaporative dry eye and is one of the most common forms of dry eye disease.
The Link Between Rosacea and Dry Eye
Facial rosacea and ocular rosacea are strongly linked to chronic dry eye disease.
Inflammation from rosacea can affect the eyelids and meibomian glands, leading to:
Red, irritated eyelid margins
Recurrent styes or chalazion
Burning and light sensitivity
Poor quality tears
Chronic inflammation of the ocular surface
Many patients with ocular rosacea have been told for years they simply have “sensitive eyes” or “allergies” when the underlying inflammatory condition has never been properly identified.
Why Eye Drops Alone Often Aren’t Enough
Artificial tears can help temporarily soothe symptoms, but they do not address the underlying cause of dry eye disease.
If inflammation, gland blockage, bacterial overgrowth, demodex, or ocular rosacea are contributing to symptoms, treatment usually needs to go beyond lubricating drops alone.
A comprehensive dry eye assessment can help identify:
Tear film instability
Meibomian gland dysfunction
Eyelid inflammation
Demodex infestation
Reduced tear production
Ocular rosacea
Corneal surface damage
Modern Dry Eye Treatment Options
Dry eye management has changed significantly in recent years, with treatment now focused on addressing the underlying drivers of disease rather than simply masking symptoms.
Depending on the cause and severity of your dry eye, treatment may include:
Eyelid deep cleaning
IPL (Intense Pulsed Light) therapy
Heat and gland expression treatments
Prescription anti-inflammatory therapy
Punctal plugs
Scleral lenses for severe ocular surface disease
Long-term eyelid and skin care strategies
Dry Eye Is Often Chronic — But It Can Be Managed
Dry eye disease is usually a chronic condition, meaning management is often ongoing rather than a one-time fix. However, with the right diagnosis and treatment plan, many patients experience significant improvement in comfort, vision, and quality of life.
If your eyes constantly feel irritated, tired, watery, or uncomfortable despite using drops, it may be worth investigating whether an underlying dry eye condition is being missed.
Brianna Caldow is an optometrist with a clinical focus on dry eye disease, ocular rosacea, and complex ocular surface conditions in Perth, Western Australia.