Hi everyone, this is Dr. Diab, board-certified ophthalmologist.

Most of the patients who come to see me have some degree of dryness of the eyes. It is one of the most common eye problems I see, and it is also one of the most misunderstood.

Patients often say: “My eyes burn, or feel gritty, like there is sand in them. But sometimes they water so much, how can they be dry?”

That is a very good question, and the answer starts with what tears actually are.

Tears are not just water. They have layers: a watery layer, a mucus layer that helps tears stick to the eye, and an oily layer on the outside that keeps tears from evaporating too quickly. That oil comes from tiny glands in your eyelids, called meibomian glands.

Dry eye disease happens when you do not make enough tears, or when your tears evaporate too fast, or when those layers are out of balance. If the oily layer is weak, tears can evaporate quickly, the surface of the eye gets irritated, and the eye responds by making a flood of watery, reflex tears. That is why dry eyes can water.

Common symptoms include burning, stinging, gritty or scratchy feeling, redness, tired eyes, and vision that blurs and then clears when you blink. Many people notice it more with prolonged computer use and screen time, because we blink less when we are staring at a screen. It can also be worse in dry, windy, or air-conditioned environments, and with certain medications, contact lens wear, and after some eye surgeries.

So what helps? I usually start with the basics, because they help a lot of people:

• Blink on purpose and take screen breaks. Try to look away from the screen regularly, and blink fully a few times. It sounds simple, but it helps spread a fresh tear layer over the eye.
• Warm compresses. Warmth helps loosen the oil in those eyelid glands so it can flow more easily. A clean, warm washcloth works, and so does a reusable dry compress — I have a simple rice-sock method I shared in an earlier video.
• Lid hygiene. Gentle cleaning of the eyelid edges can help if there is debris or crusting, especially if you also have blepharitis, which is inflammation of the eyelids.
• Artificial tears. Over-the-counter lubricating drops can add moisture during the day. Use them as directed, and let your eye doctor know if you are needing them very often.

If those steps are not enough, there are other treatments we can discuss in the office, including prescription drops and in-office treatments for the eyelid glands. The right plan depends on what type of dry eye you have, so it is worth getting checked rather than just trying drop after drop.

Dry eye is usually a long-term condition to manage, not something we cure in one visit. The goal is comfort, clearer vision, and protecting the surface of the eye over time.

If your eyes are often uncomfortable, red, or watery, or your vision blurs a lot during the day, please do come in and have them checked.

In a future post, I will talk more about blepharitis and meibomian gland disease, and how they tie into dry eye.

For a hands-on demo of the warm compress, watch one of my videos on the easy fix for a swollen eyelid — it shows the rice-sock method step by step, while this article goes deeper on why dry eye happens.

As always, this is general information, not medical advice for your specific situation. Please do see an ophthalmologist if you have ongoing eye discomfort.