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Why is it so challenging to treat dry-eye

Why is it so challenging to treat dry-eye?

Thursday 10 February 2022

Dry-eye is the discomfort caused by your eyes not forming enough tears, or high enough quality tears to keep them moist. This can lead to redness, long-term irritation, and general soreness. The condition is most common in people who are over the age of 50, although it is still unclear why tear ducts become less effective at this age.

Chronic Dry-Eye affects a surprisingly large proportion of the population - approximately 1 in 10. It frustrates those that suffer with it, as it makes a number of daily tasks more challenging and adds discomfort to all other aspects of daily life. It can make driving in the dark more difficult, it may reduce your ability to work at a computer for a long stretch of time, and it makes hobbies less enjoyable.

Many people who suffer from dry eyes not only have to deal with the condition - but can also become frustrated with the way they are treated. As a condition which primarily affects those of us who are 50+, some patients feel they are dismissed as having “an old-person’s disease”, while others feel that doctors may misdiagnose their symptoms as allergic reactions. Finally, and perhaps the most difficult to overcome, is the lack of effective over-the-counter treatments for dry eyes. Only around 15% of sufferers see significant long-term improvements when using non-prescription eye-drops.

The difficulties of the condition

Dry-eye is difficult to treat because it presents as a symptom for several other related conditions, and if you aren’t sure what exactly is going wrong, many treatments will become ineffective.

While dry-eye is clearly related to the tear-ducts, treatment will change significantly based on what is going wrong. For example, if you are producing tears of a low quality, then increasing their flow will not help. Alternatively, if you have inflamed tear ducts, then improving the tears you produce again won’t alleviate your discomfort. This complexity makes the process of effectively treating dry-eye long and arduous, which can lead to frustration; both for physicians and patients. Diagnosis of the root cause is often a guessing game, with minimal meaningful progress.

What options do patients have?

According to the NHS, there are some lifestyle-measures we can take to avoid worsening the dryness of our eyes. These include minimising consumption of alcohol, smoking less, and spending too much time in dusty rooms or dry, air-conditioned environments.

Of course, there aren’t many people voluntarily sitting in dusty rooms for hours on end, so the NHS also suggests that removing contact lenses more regularly can help, along with using a humidifier to balance the moisture in the air.

Treatment options, as mentioned above, can fall into higher levels of complexity quite quickly. While the first port-of-call can be a pharmacist, further analysis from a GP could be necessary if you don’t see a meaningful improvement very quickly. They should refer you to an ophthalmologist if progress in treatment remains slow.


  1. Healthy Women.
  2. AAO.
  3. NHS.
  4. Health Line.

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