Dry eye disease is a chronic, progressive disease of the ocular surface that affects vision quality, reading ability, work productivity, mood, and quality of life.
It is often dismissed as:
• “screen strain”
• “dust allergy”
• “just irritation”
• “age-related dryness”
It is not about redness or watering. It is about unstable vision and fatigued eyes over time. And because it looks mild, it is usually ignored, says Dr Bhartiya.
Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term. Emphasis on early detection, risk assessment, and continuity of care. She is rated 5 stars across 1,500+ patient reviews on Google.
Seeing Clearly vs Seeing Comfortably
Many people with dry eye have 6/6 vision on the chart.
Yet they say:
• Letters blur after 5 minutes
• Reading becomes exhausting
• Driving at night is difficult
• Screens feel unbearable
• Eyes burn by evening
This happens because dry eye affects the tear film, the first refracting surface of the eye.
When the tear film is unstable: Vision fluctuates. Not permanently blurred. But unpredictably unstable. That instability is deeply tiring for the eyes and the brain.
Dry Eye Is a Chronic Disease, Not an Episode
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Dry eye behaves like diabetes or hypertension:
• It fluctuates
• It needs long-term care
• It worsens if ignored
• It improves slowly, with consistency
There is no single drop that cures it.
Treatment is layered:
• Lifestyle changes
• Eyelid care
• Tear substitutes
• Anti-inflammatory therapy
• Environmental modification
Why Tests Can Look Normal
Dry eye disease frustrates patients because tests don’t always match symptoms.
Reasons include:
- Tear film instability fluctuates during the day
- Standard tests are brief snapshots
- Early disease hides behind compensation
- The brain adapts to discomfort
So a patient can be told: “Everything looks fine.” Yet feel miserable. This symptom–sign mismatch is real and common. Your experience is valid.
The Hidden Cause: Meibomian Gland Dysfunction
In most patients, dry eye is caused by blocked oil glands in the eyelids.
These glands produce the oil layer that prevents tears from evaporating.
When they stop working:
• Tears evaporate too fast
• Vision fluctuates
• Eyes burn
• Reading becomes hard
This is called meibomian gland dysfunction, and it is often missed unless looked for specifically.
Why Screens Make Dry Eye Worse
Screens reduce blink rate. Air-conditioning increases tear evaporation. Late nights reduce gland function. Hormonal changes affect tear chemistry. Modern life is almost designed to worsen dry eye. This is not your fault. It is a systems problem.
Dry Eye and Glaucoma: An Important Link
Many glaucoma patients develop dry eye because of long-term eye drops. Preservatives and multiple medications can damage the ocular surface.
This leads to:
• Burning
• Redness
• Drop intolerance
• Poor compliance
Managing dry eye in glaucoma is essential to protect vision in the long run.
What Helps (In Real Life)
Most patients improve with simple, consistent care:
• Warm compress 10 minutes daily
• Gentle lid cleaning
• Preservative-free artificial tears
• Regular blinking breaks
• Adequate sleep
• Hydration
• Omega-3 rich diet
For some patients, we add:
• Anti-inflammatory drops
• Punctal plugs
• IPL or gland treatment
• Hormonal evaluation
And very rarely, autologous serum drops. Treatment is personalised. There is no one-size-fits-all.
When to Seek Help
You should see an ophthalmologist if you have:
• Burning or stinging eyes
• Fluctuating vision
• Light sensitivity
• Reading fatigue
• Contact lens intolerance
• Red eyes that don’t improve
Especially if symptoms last more than 2–3 weeks. Early care prevents chronic discomfort.
The Long-Arc View
Dry eye is not dramatic. It doesn’t cause sudden blindness.
But it narrows life quietly:
• Less reading
• Less driving
• Less screen tolerance
• Less comfort
And over years, this matters. Early, boring, consistent care makes a real difference.
If You Need a Structured Evaluation
If you would like a detailed dry eye evaluation or second opinion, bring
• Current medications
• Previous eye reports
• Screen-time history
• Hormonal/thyroid history
We will build a long-term care plan together.
Read the research articles
This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine. This article was updated in April 2026.
She has published peer-reviewed research on glaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.
As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.
Access her work on Pubmed, Google Scholar, ResearchGate and ORCID.
Dr Shibal Bhartiya
Glaucoma • Second Opinion • Advanced Care
www.drshibalbhartiya.com
+91 88826 38735
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