Dry eye syndrome is a condition where the eyes either

• do not make enough tears, or
• the tears evaporate too quickly

• This can lead to the eyes drying out and becoming inflamed.
• It is a common condition and becomes more common with age, especially in women.
• Up to a third of people age 65 or older may have dry eye syndrome.
• It is more common in those with connective tissue disorders, in blepharitis and contact lens wearers.

Symptoms

• Feelings of dryness, grittiness, soreness, tired eyes which get worse throughout the day
• Mildly sensitive to light
• Slight blurred vision
• Both eyes are usually affected 

Signs

• Redness of the eyes
• Stringy discharge or foamy tears
• Spotty (“punctate”) fluorescein staining lower cornea
• May be associated blepharitis 

Eye examination

• Observe lids, conjunctiva and cornea with white light
• Instil 1 drop of proxymetacaine 0.5% with fluorescein 0.25%
• Observe for corneal staining preferably using a blue light
• Consider Schirmer tear test (wetting of tear test strip in 5 minutes,

Treatment

• Tear substitutes: mild to moderate cases of dry eye syndrome can usually be successfully treated using over-the-counter artificial tear drops; if a patient has severe symptoms, and needs to use eye drops more than six times a day, or if they wear contact lenses, advise them to use preservative-free eye drops 
• Eye ointment can also be used to help lubricate eyes, but it can often cause blurred vision, so it is probably best used only at night
• More severe cases may require specialist medication or lacrimal punctal plugs