The basic facts
Dry eye disease and its associated symptoms of dry, gritty, itchy burning eyes is caused by your natural tears becoming disrupted or too concentrated. These concentrated salty tears ‘stress’ your ocular environment and trigger an immune response and inflammation; this includes the release of signalling chemicals which cause those irritating symptoms. Inflammation can damage the surface of the eye and tear making glands resulting in further immune response and even saltier tears!
It’s what is called a ‘vicious cycle’ or a self-perpetuating loop.
Why your tears become too concentrated and unstable
If you suffer with dry eye disease your natural tears become too concentrated due to you producing too few tears, or the quality of your tears becoming compromised. Concentrated salty tears can result in inflammation and cell damage on the surface of the eye, either way it’s the start of the dry eye spiral.
The one thing you need to do
The one thing you need to do to bring these debilitating symptoms under control is to break that dry eye vicious cycle – and restore ocular comfort.
How to do this
The fastest way to do this is to rebalance the salt concentration of your tears. You can do this by adding artificial tears to your eyes regularly throughout the day. This will rapidly lower the salt concentration reducing inflammation. In recent years artificial tear technology has come on a pace, with some drops now moving beyond simply making the eyes feel better, to actually helping improve the condition of the eye surface. Ideally you should seek the advice of an eye care professional as to which drops are most suitable for your eyes.
Stay ahead of the game
The Dry Eye Zone experts recommend that you apply dry eye drops before symptoms begin. It is always harder to restore ocular comfort once the ‘vicious cycle of inflammation’ has begun and those inflammatory chemicals have been released. So, if you regularly endure dry eye episodes and know you’re going to be in an environment where this is likely to be exacerbated, then prevention is always better than ‘cure’.
Just the start – you need to tackle the causes
Breaking the cycle of eye irritation is just the start of truly getting your dry eye under control. Your eye care professional will be able to tell you exactly what type of dry eye you have and provide a treatment plan to tackle the underlying causes. Using drops, although they have an important role, are not a long-term answer as, whilst the latest drop formulations can have some therapeutic benefit, ultimately this is simply alleviating symptoms and can be masking the root cause of the problem.
You need to tackle the root cause
It is important for long-term dry eye management success that, as far as possible, you address the underlying causes. This may not always be possible as increased dry eye risk goes hand-in-hand with the natural aging process. However, many causes are linked to aspects of our lifestyle such as extended periods of digital work, air-conditioning and poor hydration. The causes of dry eye disease are many and this is why a visit to see an eye care professional can make sure you are going in the right direction for the best outcome.
Are there other ways to break the dry eye cycle?
The short answer is yes. Dry eye clinicians can approach this problem from different angles. For example, anti-inflammatory medication is used to help break the cycle when dry eye is well established and may be in danger of causing damage to the surface of the eye. Depending on the type of dry eye you have you may be recommended a programme of heat therapy to improve the quality of your tears, slow evaporation and restore balance.
This is what happens if you do not tackle the dry eye ‘vicious cycle’
The resulting inflammation causes further eye irritation which left unchecked can result in physical damage to the surface of the eye, ultimately affecting your vision and overall quality of life. The longer things are left unmanaged the worse things can become, this is why dry eye is described as a progressive and chronic condition. Dry eye disease cannot be cured but it can be controlled with the right management programme – and a bit of determination…
Make sure you explore the many links in this blog to bring more depth to the subjects touched on here and to help give you a fuller knowledge of all things dry eye related.
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If you are experiencing dry eye symptoms then you should ask the advice of your eye care professional.
Sources:
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Caroline Richards, How dry eye disease can become a complex vicious cycle, Ophthalmology Times Europe. January 7, 2021 Volume 17 Issue 1. https://www.ophthalmologytimes.com/view/how-dry-eye-disease-can-become-a-complex-vicious-cycle
Kaur RP, Gurnani B, Kaur K. Intricate insights into immune response in dry eye disease. Indian J Ophthalmol. 2023 Apr;71(4):1248-1255. doi: 10.4103/IJO.IJO_481_23. PMID: 37026255; PMCID: PMC10276682.
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Reena Mukamal, Reviewed by Christopher E Starr, MD. How To Manage a Dry Eye Disease Flare-up. American Academy of Ophthalmology. March 15, 2022. https://www.aao.org/eye-health/tips-prevention/treatment-symptom-relieve-dry-eye-flare
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Saram, S.J.; Thomas, M.N.; Feinberg, L.; Roberts, H.W.; Ramsden, C.M.; Woronkowicz, M.; Skopiński, P. The Immunobiology of Dry Eye Disease: A Review of the Pathogenesis, Regulation and Therapeutic Implications. Int. J. Mol. Sci. 2025, 26, 10583. https://doi.org/10.3390/ijms262110583
