Understanding Sudden Onset Dry Eyes

If your eyes have suddenly become dry, irritated, or gritty despite never having dealt with these symptoms before you’re not alone. Sudden dry eye can feel puzzling, but it often has an identifiable cause. From environmental shifts to new medications, a range of triggers can disrupt your tear film, leaving your eyes feeling parched and uncomfortable.

Common Causes of Sudden Dry Eye

Even without a prior history, dry eyes can develop quickly due to changes in your health, habits, or environment. Here are some of the most frequent culprits:

• New medications: Antihistamines, decongestants, antidepressants, oral contraceptives, and certain blood pressure drugs can decrease tear production.

• Contact lens use: Contact lenses can reduce oxygen flow to the eye and interfere with natural tear distribution.

• Environmental changes: Moving to a drier climate or an area with more pollution or wind exposure can increase tear evaporation.

• Hormonal shifts: Around age 50, natural oil production in the eyes often decreases, especially in women.

• Autoimmune disorders: Conditions like Sjögren’s syndrome, rheumatoid arthritis, or lupus may reduce tear or oil production.

• Incomplete eyelid closure: If your eyelids no longer fully close (e.g., during sleep), tears can evaporate more rapidly.

• Increased screen time: You blink less while staring at screens, which means tears aren’t evenly distributed across the eye’s surface.

What Dry Eye Feels Like

Dry eye symptoms can develop abruptly and vary in intensity. You may notice:

• A gritty or sandy sensation

• Burning or stinging in the eyes

• Light sensitivity

• Blurred vision

• Redness or irritation

• The feeling that something is stuck in your eye

Quick Relief for Sudden Dry Eyes

If your symptoms are mild, you may be able to reduce discomfort with a few at-home strategies:

• Use preservative-free artificial tears multiple times a day to hydrate your eyes.

• Apply a warm compress to your eyelids to help unblock oil glands and support tear film stability.

• Hydrate regularly adequate fluid intake supports healthy tear production.

• Adjust your environment: Avoid fans, AC vents, smoke, and dry air. Use a humidifier, especially during winter.

• Limit screen time or take frequent breaks using the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.

• Wear wraparound sunglasses outdoors to protect against wind and UV exposure.

Medical Evaluation and Diagnosis

If symptoms persist, it’s time to see an eye specialist either an optometrist or ophthalmologist. A comprehensive exam can help pinpoint the root cause of your dry eye. Your provider may:

1. Review your medical history and medications

2. Perform tear film assessments, such as:

   • Schirmer’s test (measures tear production)

   • Tear breakup time (evaluates tear film stability)

   • Osmolarity test (assesses salt concentration in tears)

   • Meibomian gland evaluation (checks oil gland function)

3. Screen for underlying conditions, such as thyroid disease, diabetes, rosacea, or autoimmune disorders

Post-Viral and COVID-19-Related Dry Eye

Emerging research shows that post-viral inflammation, including after COVID-19, can affect the eyes. Some people experience dry eyes, conjunctivitis, retinal issues, or even eye stroke within weeks of recovery. If you've had COVID-19 recently and notice new eye symptoms, mention it to your provider.

When Treatment Goes Beyond Artificial Tears

If the root cause of your dry eyes requires more than just over-the-counter drops, your provider may recommend:

• Prescription anti-inflammatory drops, such as Restasis (cyclosporine) or Xiidra (lifitegrast)

• Eye inserts that release lubricating medication throughout the day

• Punctal plugs to block tear drainage and keep more moisture on the eye’s surface

• Oral medications, such as pilocarpine, especially for autoimmune-related dry eye (e.g., Sjögren’s)

• Changes in contact lens type or wearing schedule

• Lifestyle adjustments to minimize exposure to triggers like dry air or smoke

What to Do Next

If your dry eye symptoms came on suddenly, don’t ignore them. Quick relief is often possible, and identifying the underlying cause can prevent the issue from worsening. From medication changes to autoimmune screening, the right treatment plan starts with a thorough diagnosis.

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