Everyone has experienced dry, stinging, gritty-feeling eyes at one time or another. Whether it’s due to wind, dry indoor air, eyestrain, or other causes, the discomfort of dry eyes usually resolves on its own.
For more than 16 million Americans, however, this condition is a constant irritation. If you have chronically dry, scratchy eyes—or excessive watering, which paradoxically is another symptom—natural treatments for dry eyes can help.
All About Tears
Dry eyes are characterized by an inadequate coating of tears, which lubricate and protect the eyes. But it’s more complicated than that.
Tears are complex structures made up of three layers:
- Outer lipid (oil) layer, produced by the meibomian glands in the upper and lower eyelids, provides lubrication and prevents the tears from drying out too rapidly.
- Middle aqueous (water) layer, produced by the lacrimal (tear) glands above the eyeball, keeps the eyes moist.
- Inner mucin (mucus) layer, produced by goblet cells in the conjunctiva and cornea, helps the tear film stick to the eye's surface.
Two Types of Dry Eye Syndrome
All three layers of the eyes—oil, water, and mucus—are essential, and when a problem occurs in any of these components, tear quality suffers. There are two major types of dry eye syndrome.
Aqueous deficiency is caused by reduced production of water by the lacrimal glands—your eyes don’t make enough tears. Only 10% of patients with dry eyes have this type.
Evaporative dry eye is the far more common type, affecting 90% of patients. It is usually due to meibomian gland dysfunction. These tiny oil-producing glands on the outer edges of your eyelids next to your upper and lower eyelashes become blocked and unable to secrete enough oil to produce a healthy tear film.
As a result, the tears evaporate too quickly, and your eyes feel dry and irritated. In some cases, the tear glands compensate by producing more tears, which may lead to the seemingly contradictory symptom of watery eyes.
Start with Lubricating Eye Drops…
Just as treatments for dry skin restore moisture to affected areas, treatments for dry eye syndrome restore moisture to the eyes.
Initial recommendations include lubricating eye drops, also called artificial tears. These products help maintain moisture on your eyes' surfaces and decrease tear evaporation.
There are many over-the-counter brands to choose from but stay away from “redness relief” eye drops and products with preservatives, as they may make symptoms worse.
Good preservative-free brands of lubricating eye drops include Refresh®, Systane®, and Genteal®, as well as generics with similar ingredients. Thicker gels and ointments may be helpful to use at bedtime if you experience symptoms during the night.
…And Omega-3 for Dry Eyes
The National Eye Institute reports that many patients find relief from dry eye symptoms with omega-3 fatty acids.
Inflammation is an underlying factor in meibomian gland dysfunction, and omega-3s have well-documented anti-inflammatory effects. By reducing inflammation, omega-3s enhance meibomian gland function and help restore your tear film balance.
These fatty acids are particularly abundant in salmon, sardines, tuna, herring, and other cold-water fish. Good plant-based sources include flax, chia, hemp seeds, and walnuts. A study involving more than 32,000 participants in the Women’s Health Study found that those who consumed the most omega-3-rich foods had a 17% lower risk of dry eye compared with women who ate little or none of these foods.
Supplemental fish oil is also beneficial. A 2019 meta-analysis of 17 clinical trials involving 3,363 patients concluded that omega-3 fatty acid supplements significantly improved symptoms and clinical markers of dry eye syndrome.
I recommend that all my patients with dry eyes increase their intake of omega-3 fatty acids by eating fish or plant foods abundant in omega-3s two or three times a week and taking 2,000–2,500 mg of supplemental fish oil daily. This will benefit not only your eyes but also your brain, cardiovascular system, and overall health.
Treating Meibomian Gland Dysfunction & Dry Eye
Meibomian gland dysfunction is far and away the most common problem in dry eye syndrome. Unfortunately, it is often overlooked. Sure, eye drops and omega-3s provide relief, and the latter also helps to reduce meibomian gland inflammation. But there’s more you can do.
Here are two more home remedies I recommend for lasting improvements:
- Clean your eyelids regularly. Careful cleaning removes oils and debris along the lashes that could clog up your Meibomian glands. Gentle cleansing and massaging the eyelids with diluted baby shampoo or eyelid scrubs or pads, like Ocusoft®, once or twice a day helps keep these glands open.
- Use warm compresses. Eye compresses not only help to prevent the glands from clogging up but also add moisture and provide rapid relief. I recommend reusable moist heat compresses available in most drugstores or online. These eye pads contain moisture beads; you heat the compress in the microwave for 10-15 seconds and then place it on your closed eyelids to provide sustained heat. Another option is to dip a clean washcloth in hot water (but not so hot that it will burn your skin!), wring it out, and hold it on your eyes for a few minutes. You will need to reheat the cloth with warm water as needed.
When to See Your Ophthalmologist
If these natural treatments for dry eyes aren’t enough, it’s time to consult your ophthalmologist. This is important because advanced dry eye syndrome can cause damage to the cornea, impair your vision, and lead to permanent, untreatable loss of the meibomian glands.
In my practice, I use an imaging device called Lipiscan® that analyzes the Meibomian glands and helps to determine appropriate treatments.
One of the most effective treatments is LipiFlow®, an office-based procedure that opens blocked Meibomian glands. It works by applying precisely targeted thermal pulsation to the eyelids that warms, massages, opens blockages, and restores normal oil production and tear quality.
This noninvasive treatment gets rave reviews from patients and usually results in long-term benefits for dry eyes.
Other Natural Treatments for Dry Eyes
Although meibomian gland dysfunction is the leading cause of dry eye syndrome, I want to share a few other natural therapies for preventing and treating dry, irritated eyes.
- Follow the 20-20 rule for digital screens. Blinking moistens the eyes, but we tend to blink less often when staring at smartphones, computers, and other digital screens. Take frequent breaks from your digital devices by following the 20-20 rule. Every 20 minutes, shut your eyes for 20 seconds to give your eyes a break and refresh your tear film.
- Eat a healthy diet & drink plenty of water. Omega-3s aren’t the only nutrients that support eye health. Adopt a healthy Mediterranean-style diet and include other foods with proven benefits for your eyes,such as leafy greens, broccoli, nuts, and dark berries. And make sure you drink plenty of water. Dry eyes are a symptom of dehydration.
- Take supportive supplements. Vitamins A, C, E, zinc, and other antioxidants play a role in eye health. I also recommend taking a comprehensive daily multivitamin and mineral supplement along with your fish oil. For even greater protection, add a vision-targeted supplement that contains lutein, zeaxanthin, and meso-zeaxanthin.
- Discuss your medications with your doctor. Numerous medications list dry eyes as a side effect. In addition to antihistamines and decongestants, they include some classes of drugs used to treat high blood pressure, acid reflux, depression, glaucoma, and acne, as well as birth control pills and estrogen. Talk to your doctor about potential alternatives.
- Get a handle on underlying health problems. Dry eyes are associated with thyroid disorders, allergies, diabetes, and autoimmune diseases such as Sjogren’s syndrome and rheumatoid arthritis.
- Do your best to minimize environmental irritants. Heavy wind, dust, air pollutants, excessive sun exposure, and dry climates can speed up tear evaporation and lead to dry eyes. So can fans, air conditioners, heaters, smoke (including second-hand smoke), and other indoor environmental factors. You can’t always control your environment, but you can minimize these effects with sunglasses, humidifiers, avoiding smoking, and more.
Dry eye syndrome is one of the most common eye complaints, but it can be treated.
Start by addressing the modifiable risk factors discussed above, such as environmental irritants, lifestyle changes, excessive digital screen time, medications, and health problems that can contribute to dry eye syndrome.
Optimize your nutritional status with a healthy diet, including regular servings of fish, seeds, nuts abundant in omega-3s, supplemental fish oil, 2,000–2,500 mg plus a daily multivitamin, and perhaps a vision supplement.
Finally, get serious about lubricating eye drops, compresses, and other natural treatments for dry eyes—and don’t hesitate to get professional help for meibomian gland dysfunction if needed.