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“Why Do My Eyes Get Dry?” by Dr. Jeff Sakai

Young girl takes care of her eyes with eye drops.

I often get asked this question in my practice because I examine and treat patients with dry eye disease every day. In order to understand the answer, you first need to know a little about tears. There is a tear film that constantly coats and bathes the eyeball’s exposed structures. It acts to wash away debris, provide nutrients and oxygen to the eye, help prevent injuries and infections, and maintain a clear optical surface for good vision, among other things. The tear film consists of three layers: 1. mucin, 2. aqueous (watery), and 3. lipid (oily). Those three components must remain in the proper balance in order to keep the eye properly lubricated.

There are two main categories of dry eye disease: 1. aqueous-deficient and 2. evaporative. In aqueous-deficient dry eye, the lacrimal glands in the eyelids do not produce enough of the watery component of the tears. In evaporative dry eye, tears evaporate too quickly because of an inadequate oily layer. Inflammation of the lacrimal glands often result in aqueous-deficient dry eye, and this is especially common in patients who have certain autoimmune conditions like lupus and Sjögren’s syndrome. However, aqueous-deficient dry eye patients may also have the evaporative type if their meibomian (oil-producing) glands in their eyelids are plugged up.


The best treatment options largely depend on the category of the disease. Possible treatments can include artificial tears and lubricants, topical eye medications such as corticosteroids and cyclosporine, oral medications or nutritional supplements, temporary or permanent closure of the tear drainage system, and various procedures to clear up the blocked oil glands. It is important to see an eye doctor in order to be properly diagnosed, and to be provided with a treatment plan that is tailored for you. I will discuss common dry eye treatment options in a future blog post.


If you suffer from dry eye disease and would like to schedule an examination, please call our Kalihi office at (808)845-4521 or contact us through our website, If you would like information about lupus or Sjögren’s syndrome, please contact the Sjögren’s and Lupus Foundation of Hawaii at




The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.