Is Dry Eye Real? What the Research Says and What Actually Helps

Yes, dry eye is real. It is a recognized, multifactorial disease of the eye’s surface, defined by the 2017 TFOS DEWS II report. Screen time, contact lenses, and aging raise risk, and daily eyelid hygiene may help relieve your symptoms.

Is dry eye real? We hear that question all the time from patients and even from eye doctors. My answer comes from almost personal experience. Last night, my wife woke up at 4 a.m. because her eyes hurt. She has dry eye, and it’s one of the reasons we started Peeq Pro. So I can say it plainly: yes, dry eye is real, and it stinks to have.

The longer answer is also yes, but it depends on how you define it. That definition has changed a lot over the last twenty years, and the research has changed with it, even as dry eye has become steadily more common.

How is dry eye defined today? (TFOS DEWS II)

As more people developed dry eye, eye doctors (both optometrists and ophthalmologists) formed a working group to better define and measure it. Most current studies now use the 2017 TFOS DEWS II definition:

“Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”

In plain words: your tears stop doing their job well, and your eyes become irritated and uncomfortable as a result.

Using only this definition, research suggests about 8% of Americans have dry eye disease. These people tend to be women over fifty, often with other risk factors such as smoking, cancer treatment, past eye surgery, or contact lens wear. (Source: Biological functions of tear film, PubMed.) If you’re in perimenopause or menopause, read more in Can Menopause Cause Dry Eyes?

Why is dry eye becoming more common?

That 8% figure misses how dry eye starts. Research points to many 21st-century habits, and one of the biggest is screen time. Looking at phones and computers appears to lower how often we blink and causes incomplete blinks. As a result, dry eye in younger adults is now almost as common as in women over fifty. Historically, that wasn’t the case. (Source: Blink Rate and Incomplete Blinks in Six Different Controlled Hard-Copy and Electronic Reading Conditions, IOVS.)

Other factors include changes in contact lens wear, eye surgeries, and new prescription medications. These overlap with screen use, which is the “multifactorial” part of the definition. Lots of things we do today are hard to study one at a time, but when researchers do, they often find a negative effect on dry eye. (Source: Is there a relationship between the severity of disease in major depressive disorder patients and dry eye disease?, PubMed.)

How do eye doctors test for dry eye?

Checking for dry eye is becoming a standard part of many comprehensive eye exams. Doctors usually look at two things:

1. Your symptoms, using a short survey such as the Ocular Surface Disease Index (OSDI) or the SPEED questionnaire.
2. Your meibomian glands, the tiny oil glands along your eyelids that keep tears from evaporating too fast. This is often checked along with tests like tear break-up time or a fluorescein stain.

Doctors look for meibomian gland dysfunction (MGD), which often comes before dry eye disease. (Source: Adaptation of the SPEED Questionnaire to European Portuguese (SPEED-Vp) in a Non-Clinical Sample, PubMed.)

Why do dry eye statistics vary so much?

Current estimates place MGD in American adults anywhere from 30% to 70%. A range that wide creates uncertainty for doctors and patients alike. We’d love a range of 3%, not 50%. There are three main reasons for it:

• Our behavior is changing the results. As screen use rises, so does dry eye, so older studies show different numbers than newer ones. (Source: Modifiable lifestyle risk factors for dry eye disease, ScienceDirect.)
• Definitions have changed. DEWS II came out in 2017, but many doctors only adopted it in the last few years, so dry eye and MGD weren’t categorized consistently until recently.
• Treatments have evolved. A study from 2000 might measure dry eye based on who received punctal plugs, while newer studies look at prescription drugs.

Together, this makes looking back through the research murky and a firm percentage hard to pin down.

What does this mean for you as a patient?

If you research dry eye online, you’ll find information that’s inconsistent and sometimes outdated. For example, some popular health sites still recommend baby shampoo for eyelid cleaning, which eye care professionals no longer consider best practice. Confusing advice like this makes it easy to give up on simple daily habits that may help.

Peeq Pro is in the business of helping people stick with their eyelid care, so we’ve collected unique data on why people don’t. There are four main reasons:

1. They never buy the right products. Most often they buy nothing; sometimes they buy the wrong thing. The right products are generally oil-based cleansers (tea tree and okra are the most common) that help manage Demodex mites, or hypochlorous acid products.
2. They don’t build a daily routine. Like brushing your teeth, eyelid hygiene is an everyday habit.
3. They stop. They run out of a sample, find it inconvenient to reorder, weren’t told it’s a lifelong habit, or stop “feeling” symptoms.
4. They don’t go back to the eye doctor. Skipping follow-ups means missing out on additional options such as intense pulsed light (IPL) or prescription treatments.

I’ve been diagnosed with dry eye. What should I do?

If you’ve been diagnosed with dry eye or MGD, we recommend three simple steps (and always follow your eye doctor’s advice):

1. Start an eyelid hygiene routine. We recommend a tea tree oil eyelid cleanser, unless you wear false eyelashes or lash extensions. Keep it where you wash your face, at the sink or in the shower, and use it every time you wash your face or hair. Put a little on your fingertip or a sponge and gently massage your upper and lower eyelids. This helps keep your eyelid oil glands flowing and helps keep Demodex mites in check. For sensitive eyes, try our Sensitive Skin Foaming Eyelid and Facial Cleanser.

2. Change your environment. Reduce fans and air vents blowing near you. That might mean turning your desk or favorite chair. Moving air dries out your eyes and eyelids. At work, think about where your chair sits in relation to your screen.

3. Change your habits. Drink more water. Ask your eye doctor whether a fish oil supplement is right for you. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. Break screen time into smaller chunks to ease eye strain.

Our Good, Better, Best dry eye routine

We’d love for you to use our products. If you want to become a Peeq customer, we recommend a Good, Better, Best routine:

Good: Eyelid cleanser and sponges. A great starting point if you want to stay ahead of dry eye, even if you don’t have symptoms yet. Find sponges in our supplies collection.

Better: Add a warm compress and eye drops. Start here if you’re female, have had eye surgery, wear contacts, or have other risk factors. Treat the Peeq Pro Silica Bead Heat Mask like a little spa moment: pair it with something you enjoy, like coffee, meditation, music, or an audiobook. Browse eye drops, or get it all together in our Dry Eye Essentials box.

Best: Use the Peeq Waiva. Our best-in-class eyelid cleansing system works like an electric toothbrush for your eyelids. Gentle vibration helps stimulate your eyelids and break up makeup so it’s easier to remove. If you want a deeper clean, the Waiva is the way to go.

The bottom line: peeq every day

Even if you never buy our products, the goal is to clean your eyelids every day. Letting water run over them isn’t enough; your oil glands need a gentle massage with the right cleanser. We call that “peeqing.”

Let us know how this article helped you. Follow us on Instagram and tell your dry eye story. We’ll help share it.

Want more clinical research behind this article? Visit our Blogs for Doctors. Learn more about symptoms in July Is Dry Eye Awareness Month, or shop all dry eye products.