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Dry Eyes and Glaucoma: Double Trouble

Dry Eye Syndrome and glaucoma commonly occur together. Patients may have irksome symptoms, but not associate them with dry eye syndrome.

For example, it's common for my dry eye patients to complain of tearing or that the eyes feel like sand. Another telling comment is, "My eyes just don't feel right; they bother me all day."

The symptoms of dry eye disease vary from person to person. Symptoms may come and go, and they're often subtle. My dry eye patients are often relieved and grateful when their symptoms are acknowledged and treated.

Like open-angle glaucoma, dry eye syndrome becomes more common with aging. Studies suggest that 40-50% of glaucoma patients have dry eye syndrome, and women are more likely than men to have it.

Treatment of two diseases can be a challenge for the patient and for the doctor. Treating the dry eye syndrome is very important both for the patient's comfort and for the long-term health of the surface of the eye. But because glaucoma can cause vision loss, when a patient has both dry eye syndrome and glaucoma, the glaucoma is usually treated first. Addressing the glaucoma treatment almost always takes precedence over treating the dry eye disease--even though the dry eye disease bothers the patient more.

What Causes Dry Eye Syndrome?

Dry eye can be caused by many different factors:

  • Inflammation of the eyelids or the glands that produce tears;
  • Previous eye infections or previous eye surgery;
  • Using glaucoma eye drops over a long period of time;
  • Low humidity, wind or forced air heating and cooling systems.

Treating Dry Eye and Glaucoma

Usually a combination of treatments is helpful, and your eye doctor may try several treatments to find the combination that works best. Treatments for dry eye include:

  • Artificial tears, most often in the form of eye drops;
  • Fish Oil/Omega 3 vitamins (also known to have cardiovascular benefits);
  • Cyclosporine medication drops that suppress inflammation;
  • Eyelid scrubs or warm compresses to minimize inflammation;
  • Doxycycline or other Medications to further treat lid inflammation.

Both glaucoma and dry eye disease are chronic conditions and it is important to treat both diseases. Because the treatment of both often includes using eye drops, keeping up with the regimen can be challenging for patients. Yet, keeping the tear surface healthy increases comfort, promotes eye health and even increases the success rates of some glaucoma surgeries.

Patients with glaucoma and dry eye disease have a lot to handle. Dry eye, like glaucoma, is not curable but is manageable; the management of both requires a team effort of both the doctor and the patient.


Article by Ruth D. Williams, MD, a glaucoma specialist and the President of Wheaton Eye Clinic, Ltd in Wheaton, Illinois. She is the President-Elect of the American Academy of Ophthalmology and a national spokesperson on ophthalmic issues.

Last reviewed on October 29, 2017

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