Dry eyes: causes, eye drops and a video doctor visit

Tears keep the eye moist and protected. With dry eye, your eyes do not make enough tears, the tears dry up too fast or they do not work well. It is very common: according to the National Eye Institute (NEI), about 16.4 million people in the United States have it.

It is more common after 50 and in women, because of the hormone changes of pregnancy and menopause. Other factors:

• Your environment: air conditioning, wind, sun and cigarette smoke.
• Screens: we blink less when looking at a phone or computer.
• Contact lenses.
• Some medicines: for colds and allergies, depression and high blood pressure.
• Some conditions: diabetes, thyroid problems, lupus, Sjögren syndrome and rosacea, which can affect the eyes.
• Laser eye surgery.

If your eyes feel more irritated on Saharan dust days, the same steps help; read about Saharan dust.

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A doctor visit costs US$79, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. We do not bill insurance; the pharmacy and any eye specialist charge separately. See all prices. The service is run by The Health Initiative, a nonprofit.

The most common symptoms are:

• A gritty or scratchy feeling, like something is in your eye
• Burning or itching eyes
• Red eyes
• Sensitivity to light
• Blurry vision that clears when you blink

Artificial tears: the first treatment, sold without a prescription. Use them at least 2 to 4 times a day. If you are not better after a couple of weeks, use them more often, switch to preservative-free drops (single-use vials) or try another brand. Lubricating gels and ointments help at night but blur your vision for a while.

In your environment and routine:

• Do not point the air conditioning or a fan at your face, and use a humidifier if the room is very dry.
• Wear wraparound sunglasses outdoors against sun and wind.
• Take breaks from screens and blink on purpose.
• Do not smoke, and avoid smoke.
• Clean your eyelid edges and use warm compresses.
• Drink enough water and get enough sleep.

If that is not enough: there are prescription drops that help the eye make more tears, tear-duct plugs and other treatments from an ophthalmologist; if you need them, we refer you. Untreated, severe dry eye can damage the cornea.

For your safety, see an eye doctor the same day or go to the emergency room if you have any of these signs. Call 911 if it is severe. See when to go to the ER.

• Severe eye pain, or pain that gets worse
• Vision loss, or sudden blurry vision that does not clear when you blink
• You wear contact lenses and have a red, painful eye, light sensitivity or discharge: take the lenses out and get seen that same day (possible corneal infection)
• An injury or blow to the eye, or a sore on the eye or eyelid
• A bulging eye or a suddenly drooping eyelid