Our eyes need a constant flow of tears to stay moist and healthy, and so they’re continually lubricated throughout the day. When we don’t have enough moisture, inadequate lubrication or dry eye syndrome can result.

Dry eyes may seem like an inconvenience that can be overlooked but, if the problem persists, it can lead to dry eye syndrome. If left untreated, this condition can become severe, leading to eye discomfort, pain, corneal scarring, and even vision loss.

To reduce the risk of long-term vision problems, it’s important to know the causes of dry eye syndrome, symptoms to look for, and how to effectively address the issue.

The Diabetes-Dry Eye Connection

When we think of dry eyes, many of us likely envision common causes such as too much screen time; a dry, windy, or smoky environment; contact lenses (especially if worn for too long); topical medications; antihistamines, getting older; etc. 

But there’s another common cause that may not readily come to mind: diabetes.

Type 1 or 2 diabetes can lead to dry eyes because of high blood sugar (glucose).

• Elevated blood sugar can cause damage to eye nerves that can make tear production difficult.
• In rare cases, elevated blood sugar may also cause systemic inflammation that can make it difficult for the eye’s lacrimal glands to produce tears.

Besides dry eye syndrome, diabetes can also be associated with:

• Diabetic retinopathy, where blood vessels of the retina are damaged
• Diabetic macular edema, in which blood vessels of the macula (a part of the retina that gives us central vision) leak and cause swelling
• Cataracts, where the lens becomes cloudy and causes blurred vision
• Glaucoma, where damage to the optic nerve causes gradual vision loss if left untreated

The good news is that keeping blood sugar within a healthy level through proper management can decrease the risk of conditions like dry eye syndrome.

Recognizing Dry Eye Symptoms

Symptoms of inadequate tear production and eye irritation can include:

• Eye redness
• Blurred vision
• Burning or stinging in the eye
• A gritty sensation
• Eye discharge
• Reading difficulty
• Difficulty with contact lenses
• Wind or sun sensitivity

Dry eyes can sometimes resolve on their own if caused by something other than diabetes, like being in a dry environment. If diabetes or another underlying issue is the likely cause, a healthcare professional should be consulted. As a rule of thumb, seeing a doctor is advised if dry eye symptoms do not disappear after a couple of days.

Treating Dry Eyes

Dry eye treatment depends on symptom severity and diabetes management. Dry eye symptoms caused by diabetes can often be helped by managing blood sugar. In the process of stabilizing blood sugar levels, a doctor may recommend:

• Artificial tears
• Over-the-counter eye lubricants

Additional treatment options for dry eye syndrome include:

• Antibiotics for reducing eyelid inflammation and helping tear production
• Eye drops containing cyclosporine (Restasis®) to reduce inflammation
• Corticosteroids for short-term use in helping with severe eye inflammation
• Tear-stimulating medications available as eye drops and in gel and pill form

In especially severe cases, the tear duct can also be closed off with removable collagen, silicone plugs, or using heat for a more permanent fix that helps tears remain in the eyes for longer periods of time. Surgical options are typically reserved for cases in which other treatments have failed to relieve symptoms.

Self-care

Steps you can take on your own while waiting to see a doctor include:

• Over-the-counter artificial tears used several times a day
• A humidifier to counter dry indoor air
• Reducing screen time (take regular breaks from the computer, smartphone, etc.)
• A warm compress to soothe the eyes
• Drinking more water (aim for at least eight glasses a day)
• Using baby shampoo to gently wash the eyelids
• Avoiding smoke that can irritate eyes

Creating a Treatment Plan

To best resolve diabetes-related dry eyes, people are advised to work with their doctor to design a plan that keeps blood sugar levels in balance, which could include artificial tears and prescription eye drops while their diabetes is being controlled.

People with diabetes are also advised to have their eyes checked by an ophthalmologist a minimum of once a year.

*This article was reviewed and edited for accuracy by Alan Robin, M.D., a Responsum Health Advisory Council member, ophthalmologist, glaucoma treatment specialist, and leader in the clinical management and scientific study of the disease.

*Behring, S. (2022, January 14). Can Diabetes Cause Dry Eyes? Healthline. https://www.healthline.com/health/dry-eye/dry-eyes-diabetes