Dry Eyes & Blurry Vision: Causes, Connection, and Treatment

Dry eye is one of the most common ocular surface diseases, affecting up to 16 million Americans. It stems from either inadequate tear production or the secretion of poor-quality tears. Lack of necessary lubrication leads to discomfort and vision problems, one of which is almost always blurry vision.

Dry eye syndrome presents with an uncomfortable, scratchy or gritty feeling, a sensation of something in the eye. Usually along with it comes fuzzy, unclear vision. 

Symptoms of Dry Eyes

If you develop dry eyes, you likely will experience the following symptoms: 

• A feeling of a foreign object in the eye
• Itchy and gritty eyes
• Redness 
• Photophobia (sensitivity to light)
• Watery eyes
• Burning or stinging eye sensation
• Stringy mucus around the eye
• Blurry vision

Chronic dry eye is primarily a disease of the elderly. However, with the ever-increasing screen use and reduced blinking rates among computer users, the prevalence of dry eye is on the rise. 

Several factors, including age, medications, medical conditions, and environment, can contribute to the development of dry eyes. 

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The Connection Between Dry Eyes and Blurry Vision

Untreated dry eye condition can lead to eye inflammation, corneal surface abrasion, consequent ulcers, and potentially vision loss.

Tears lubricate the eye, wash away debris on the cornea and keep the front surface of the eye clear. Thus, the lacrimal gland fluid reduces the risk of infection and enhances vision. With low volume or poor-quality tears, the possibility of developing an eye infection and vision changes also rises.

Leaving a dry eye condition untreated only invites more trouble. It can lead to eye inflammation, corneal surface abrasion, consequent ulcers and potentially vision loss.

Typically, dry eyes and blurry vision co-occur as symptoms. But in some instances, the two can signify other health conditions, particularly Sjogren’s syndrome and lupus.

How Do Dry Eyes Lead to Blurry Vision?

Eyes usually benefit from a microscopic film of lubrication from tears, which spread over the eye surface when we blink. The tear film consists of three layers:

• Fat-based oil layer
• Thin, watery fluid layer
• And mucus

This combination keeps eyes moist, which in turn assures clear vision (assuming no other eye conditions exist).

Any change in the tear film layers leads to uncomfortable dry eyes.

Causes of Dry Eyes and Blurry Vision

Dry eye disease is traditionally classified into aqueous deficient and evaporative, depending on the development mechanism. So the causes of dry eyes and blurry vision differ with the type of disease. 

For instance, Sjogren Syndrome is the primary cause of aqueous deficient dry eye (characterized by inadequate production of tears). At the same time, Meibomian gland dysfunction is the most common cause of evaporative dry eye disease. 

The two types of dry eyes are not mutually exclusive. Therefore, the cause of your dry eyes and blurry vision is most likely multifactorial, including local ocular disorders, systemic conditions and treatment-related events.

Here are the potential causes of dry eyes:

• Medications such as antihistamines, corticosteroids, glaucoma drops and anticholinergic drugs
• Rosacea, eczema and other skin diseases around the eye
• Autoimmune diseases like Sjogren’s syndrome, lupus and rheumatoid arthritis
• Meibomian gland dysfunction 
• Eye surgeries including cataract surgery, LASIK and keratoplasty
• Vitamin A deficiency leading to xerophthalmia
• Decreased blinking rates associated with screen use
• Ocular allergies
• Thermal and chemical burns causing conjunctival scarring
• Graft-versus-host disease in individuals with transplants
• Long-term contact lens wear or a viral infection causing decreased corneal sensation
• Environmental factors like low humidity and exposure to cigarette smoke

When doctors treat dry eye disease, they tackle the presenting symptoms, one of which is almost always blurry vision.

Treatments

You can treat dry eyes using home remedies such as warm compresses and over-the-counter artificial tears. However, it would be best to visit an eye specialist for in-office treatment in case of severe or chronic disease. 

Home Remedies for Dry Eye Syndrome

Artificial Tear Solutions

These ophthalmic preparations lubricate the eye, enhance contrast sensitivity, and reduce discomfort of the ocular surface. If you have Meibomian gland dysfunction, triglyceride-containing artificial tears are more helpful. 

As a general principle, avoid using home therapies such as artificial tears that contain preservatives.[5]

Warm compresses and eyelid massages can also alleviate the symptoms of dry eye. Nevertheless, the ultimate dry eye treatment requires identification and treatment of the cause.

Dangers If Dry Eyes are Left Untreated

Public awareness of dry eye has increased over the past five years. This also will drive up diagnoses going forward.

Caroline Blackie, O.D., Ph.D.

Potential complications of untreated, dry eyes include:

• Eye infections. Tears wash away debris and protect your eyes against infections by lysozyme activity. Therefore, having a dry eye increases the risk of developing eye infections such as keratitis.
• Vision loss. Untreated, dry eyes can lead to blindness as the condition causes inflammation followed by corneal abrasion, which can progress to ulceration. 
• Poor quality of life. Chronic dry eye makes it challenging to perform daily activities like driving or reading. 

When to See a Doctor

Artificial tears offer symptomatic relief to most patients with dry eyes. However, if your symptoms persist, you should consider visiting a doctor because of the associated risk of vision impairment. 

If you experience extreme eye pain, light sensitivity, or constant burning sensation with an eye discharge, consider visiting an ophthalmologist or optometrist. 

Prevention

If you experience dry eye symptoms, one action to take is to evaluate possible triggers and then avoid them or else modify your environment. For example: 

• Avoid visiting drier-than-normal environments such as high altitudes or deserts.
• Avoid dehydration by drinking the recommended glasses of water per day (8 to 10).
• Avoid directing blown air into your eyes when using air dryers or car heaters.
• Wear wraparound protective eyewear when working in the sun or windy conditions.
• Use humidifiers to increase the humidity at home, especially during winter.
• Eating omega 3 rich foods that also reduce dry eye symptoms.
• Take frequent breaks when using computer screens, observing the 20-20-20 rule: Every 20 minutes, look away for 20 seconds at another object that is at least 20 feet away.
• Stop smoking or avoid areas with cigarette smoke which can worsen the dry eye issues.

References

1. What Is Dry Eye? Symptoms, Causes and Treatment. (September 2021). American Academy of Ophthalmology.

2. Dry Eye. (December 2020). National Eye Institute.

3. Dry eye. American Optometric Association.

4. The Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease. (January 2015). Deutsches Arzteblatt International.

5. Preservatives in ophthalmology. (November 2021). Europe PMC.

6. Dry Eye Syndrome. (November 2021). StatPearls.

7. Dry Eye. Johns Hopkins Medicine.