What Happens If You Don’t Treat Dry Eyes? Risks of Not Treating and How to Manage

Dry eye disease is far more than just an occasional irritation. It is a chronic condition that can significantly impact daily living—affecting vision, comfort, and even emotional wellbeing. Left untreated, it can progress into a self-perpetuating cycle of discomfort and inflammation, damage to the ocular surface, and long-term complications. This blog will break down the risks if you don’t treat dry eyes, and what you can do to protect your eyes.

What Happens If You Don’t Treat Dry Eyes?

Untreated dry eye is more than a nuisance—it can become a damaging cycle:

• Poor tear film quality or quantity → surface irritation

• Surface irritation → release of inflammatory mediators

• Inflammation → further tear film instability and tissue damage

Adverse Outcomes of Dry Eye Disease:

• Sore, red eyes – chronic discomfort that reduces quality of life

• Keratitis – inflammation of the cornea, sometimes with punctate defects

• Eyelid changes – thickening, crusting, or irritation at the lid margin

• Meibomian gland changes – gland dropout or scarring limits oil secretion, making the disease harder to treat

• Light sensitivity (photophobia) – due to unstable tear film and corneal surface damage

• Reduced and unstable vision – fluctuating focus and blurriness

• Difficulty driving – especially at night or in glare conditions

• Intolerance to contact lenses – once a common option for vision correction, lenses may no longer be wearable

Who is at Risk of Dry Eye?

Several factors can increase the likelihood of developing dry eye syndrome:

• Pre-existing Eye Conditions such as blepharitis, rosacea-related eyelid disease, or prior surgery

• Ageing – tear production naturally declines with age

• Gender – women (especially post-menopausal) are at higher risk due to hormonal changes

• Medications – antidepressants (e.g. sertraline), antihistamines, ADHD medications like methylphenidate, and many others

• Medical Conditions – Sjogren’s syndrome, thyroid disease, rheumatoid arthritis, lupus, rosacea, diabetes

• Environmental Factors – air conditioning, heating, wind, smoke, dry climates, pollen

• Lifestyle Factors – prolonged digital screen use, excessive close work, reduced blink rate, contact lens wear

• Refractive or Cataract Surgery – surgery can affect corneal sensitivity and tear balance

Lifestyle Changes to Support Dry Eye Relief

Simple steps in daily life can make a big difference in treating dry eyes and mitigating risks:

• Stay hydrated: Drinking water helps maintain tear film stability

• Limit screen time, or take regular breaks (20-20-20 rule—look away every 20 minutes, for 20 seconds, at something 20 feet away)

• Humidify your environment: A humidifier can reduce dryness indoors

• Dietary Support: Omega-3 fatty acids (from oily fish or supplements) appear to improve oil composition in the tear film

• Protect your eyes: Sunglasses reduce UV, wind, and irritant exposure

• Avoid triggers: Smoke, wind, and dusty settings can worsen symptoms

Related Article:  What is Dry Eyes? Symptoms, Causes and Treatment

What to Do if You Have Dry Eye Syndrome:

Because dry eye syndrome, or disease, is chronic, ongoing management matters. Early and consistent treatment can prevent irreversible changes.

At-home treatments

• Lubricating eye drops (“artificial tears”) – replenishing moisture on the surface

• Warm compresses or heat packs – to soften and release oil from meibomian glands

• Lid hygiene – using lid wipes or foams to reduce bacteria, demodex mites, and crusting

For Eyes Optometrist practice treatments

• Meibomian Gland Expression – manual clearance of blocked oils

• IPL (Intense Pulsed Light) – improves meibomian gland function in rosacea-type dry eye

• Punctal plugs – inserted into tear ducts to slow drainage and keep tears in the eye longer

• Prescription treatments (such as topical anti-inflammatory drops) for more severe cases

Final Thoughts

Dry eye disease is more than just a minor annoyance. It is a progressive, chronic condition that worsens without treatment—and yet, with the right strategies, most people can achieve substantial relief. If you are experiencing symptoms, don’t ignore them. With proper care, lifestyle adjustments, and available treatments, you can protect your vision, improve comfort, and break the cycle of dry eye disease.

The Latest Thinking from DEWS III (2025)

The newly published DEWS III (2025) report is the most extensive global evidence-based review of dry eye disease since DEWS II (2017). Here are some of the key updates and perspectives it brings:

1. A Disease of Homeostasis

DEWS III emphasizes ocular surface homeostasis — meaning dry eye isn’t just about “not enough tears,” but about a disruption of the delicate balance that keeps the eye healthy. Inflammation, poor tear film stability, neurosensory changes, and meibomian gland dysfunction all contribute to this imbalance.

2. The Inflammatory Cycle is Central

The report highlights that chronic, low-grade inflammation is at the core of disease progression. Once inflammation sets in, it perpetuates the cycle of worsening symptoms and tissue damage, underscoring the need for early intervention.

3. Neurosensory Changes

A big theme in DEWS III is the role of the nerves of the cornea and ocular surface. In some cases, the pain or discomfort of dry eye is due not only to tear film instability but also nerve hypersensitivity or dysfunction. This explains why some people have severe symptoms with little visible eye damage, while others have significant ocular damage with fewer symptoms.

4. Classification Methods Have Evolved

Rather than rigid categories, DEWS III acknowledges dry eye as a spectrum:

• Evaporative (often linked to meibomian gland dysfunction)

• Aqueous-deficient (linked to tear gland function)

• Combination (the most common)

But the emphasis is now on individualised treatment plans based on the mix of mechanisms present in each patient.

5. Personalised, Stepwise Management

The report strongly reinforces a stepwise approach to management, starting with lifestyle and simple topical therapies, and escalating to advanced anti-inflammatory or procedural therapies where appropriate. Importantly, it stresses that dry eye is long-term and requires continued care, much like other chronic conditions.