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Symptoms related to dry eye syndrome include:

• Stinging or burning
• Decreased or fluctuating vision
• Eye irritation or scratchiness
• Excess tearing, especially when reading, driving, or watching television
• Stringy mucus in or around the eyes
• Difficulty wearing contact lenses

The symptoms described above may not necessarily mean that you have dry eye. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.

Diagnosis begins with a complete eye examination by your ophthalmologist to look for signs of dryness or an irregular tear film as well as common causes of these symptoms such as eyelid inflammation or plugging of your eye’s natural oil glands. Your doctor also may measure your eye’s baseline rate of tear production by placing filter-paper strips under your lower eyelids. Occasionally, the composition of tears being produced can be analyzed.  A review of your overall health and medication use is also important.

• Eyelid Hygiene: Plugged or inflamed oil glands along the eyelid can lead to poor quality tears and dry eye syndrome. This often can be treated by attention to eyelid hygiene, which involves applying warm compresses to the eyelids to open blocked glands and allow them to release natural oils into the tear film. Eyelids also can be cleaned with over-the-counter medicated eyelid scrubs and sprays.
• Blinking: Some patients with mild dryness may benefit from blinking more frequently, especially when reading, driving, or watching television.
• Artificial Tears: Dry eye is often treated using eye drops called "artificial tears." Artificial tears are available without a prescription. You may want to try several brands to find the one that you like best. Preservative-free eye drops are available if you are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you. Thicker artificial tear gels and ointments can also be used to provide longer relief, but can temporarily blur the vision. Solid lid inserts that gradually release lubricants during the day also may be beneficial for some people. View Guide to Ocular Lubricants: Drops, Gels, and Ointments for recommended brands.
• Conserving tears (punctal occlusion): Conserving the tears in your eyes is another approach to keeping the eyes moist. Tears drain out of the eye through a small canal into the nose (that is why your nose runs when you cry). Your ophthalmologist may close these canals either temporarily or permanently in order to conserve your own tears and make artificial tears last longer.
• Topical steroids and anti-inflammatory eye drops: Prescription-strength medicated drops for dry eyes address inflammation on the ocular surface and sometimes increase the production of tears. Commonly prescribed eye drops include Restasis (Cyclosporine 0.05%), Cequa (Cyclosporine 0.09%) and Xiidra (Lifitegrast 5%).  Steroid eye drops can also be used for short periods of time to decrease symptoms of dry eye syndrome by reducing inflammation. Your doctor will discuss if these medications would be appropriate for you. 
• Serum tears: In more severe cases of dry eye syndrome, specially formulated tear drops that are made from the clear part of a patient’s own blood, called serum tears, are used. Serum tears contain growth factors and other nutrients that can decrease the symptoms of dry eye syndrome.
• PROSE device: For patients with severe dry eye syndrome, a special contact called Prosthetic Rehabilitation of the Ocular Surface Ecosystem (PROSE) can be used. This device is highly customized for each patient and bathes the front of the eye in artificial tears.
• Intense pulsed light treatment (IPL): For dry eye caused by meibomian gland dysfunction, IPL treatment warms the lid, which reduces inflammation in the blood vessels of the lid that get irritated and prevent the meibomian glands from functioning correctly.
• Other methods to prevent the evaporation of tears:
  • In winter, add moisture to the air by placing a humidifier or a pan of water on the radiator
  • Wear wrap-around glasses (illegal to wear while driving in some states) that may reduce the drying effect of the wind
  • Avoid anything that adds to dryness, such as an overly warm room, hair dryers, or wind
  • Stop smoking or being around smoke
  • Use ointment at bedtime if you have "scratchy eyes" when you wake up. Use the smallest amount of ointment necessary for comfort since it can cause your vision to blur temporarily.