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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Dry eye syndrome is assessed by video from the pattern of symptoms, screen habits, medicines and lens use; a drops plan is built and prescription treatments added where needed, and true eye pain or reduced vision needs in-person care.
- What it is: too few tears or tears that evaporate too fast, usually because the lid oil glands are not working well; it affects about 1 in 3 people over 50 and is commoner in women, especially after the menopause.
- Everyday drivers: concentrated screen use roughly halves the blink rate, dry or air-conditioned rooms, wind, contact lenses, and medicines such as antihistamines, some antidepressants, beta-blockers, diuretics and isotretinoin.
- Treatment: artificial tears used regularly (4 or more times a day for moderate dryness), gels or ointment at night, warm lid compresses, and a 20-second screen break every 20 minutes; preservative-free drops if used more than 4 times daily.
- Red flags: very dry eyes with a persistently dry mouth or joint pains need blood tests for Sjögren's syndrome rather than drops alone.
- Emergency: dry eye syndrome is never an emergency, but eye pain, marked light sensitivity, blurred vision that blinking does not clear, or a painful red eye in a contact-lens wearer are not dry eye and need in-person eye care now; call 112 if vision is disappearing.
Dry, gritty, burning eyes suit online care. True eye pain, marked light sensitivity, blurred or reduced vision that blinking does not clear, a chemical splash or injury, or a painful red eye in a contact-lens wearer do not: those need same-day in-person eye care. Very dry eyes alongside a persistently dry mouth or joint pains also deserve blood tests for an underlying cause rather than drops alone.
Can dry eye syndrome be treated online?
Usually, yes. Dry eye syndrome is diagnosed largely from the story: the gritty, burning, end-of-day pattern, screen time, medicines, lens wear and age tell the doctor most of what determines treatment, and a video call plus photos can often provide enough information to start it. Severe, painful or vision-affecting dryness, and suspected underlying disease such as Sjögren's syndrome, need in-person assessment.[1]
The honest limit is measurement: an online doctor cannot stain the eye surface or measure tear break-up time the way a slit-lamp examination can. What an online consultation does well is sort the common, habit-and-environment-driven majority from the minority who need that examination, and stop the frustrating cycle of buying one random drop after another without a plan.
How an online consultation helps with dry eye
- Finding the driver, not just wetting the eye: screens, lid-gland disease, medicines, hormones and air conditioning dry eyes in different ways, and the fix differs accordingly. The consultation works out which apply to you.
- A drops plan with a ladder: watery drops, gels, ointments and preservative-free versions each have a place. You leave knowing which type, how often, and what the next step is if comfort does not improve.
- A medicines review: antihistamines, some antidepressants, beta-blockers, diuretics and isotretinoin all dry the eye surface. The doctor spots the culprits and weighs alternatives with you.
- Specialist referral when it is warranted: persistent symptoms despite proper treatment, possible Sjögren's syndrome, or any surface damage signs are referred for slit-lamp examination rather than managed on hope.
📷 Photos help less than for most eye conditions, but two are still useful: a daylight close-up of each open eye showing any redness pattern, and one of each closed lid's lash line, since blepharitis so often travels with dryness. On the video call the doctor will also watch your blink rate and completeness, which is genuinely informative for screen-related dryness.
What the doctor checks in an online dry eye consultation
The assessment is structured around pattern, drivers and red flags. In a dry eye consultation, the doctor will typically assess:
- The symptom pattern: grittiness, burning and tired eyes worsening through the day point to evaporative dryness; paradoxical watering, worse in wind and cold, is also classic dry eye rather than "too many tears".[1]
- Screen exposure: hours per day, screen height, breaks, and whether symptoms track working days, because blinking roughly halves during concentrated screen use.
- Lid disease: crusted or greasy lash lines and blocked gland openings, since meibomian gland dysfunction and blepharitis are the commonest cause of evaporative dry eye and change the treatment.[1]
- Medicines and hormones: antihistamines, tricyclic and some other antidepressants, beta-blockers, diuretics, isotretinoin and hormonal change around menopause, all recognised drying factors.[1]
- Contact-lens habits: daily hours of wear, lens type and comfort, because lenses both cause and suffer from a poor tear film.
- Systemic clues: dry mouth, joint pains or known autoimmune disease, which raise Sjögren's syndrome and warrant investigation rather than drops alone.[1]
- The red-flag screen: true pain, light sensitivity, vision change, one-sided redness or injury, all of which redirect to same-day in-person care.
Why are my eyes so dry?
Tears are a three-layer film: watery fluid for volume, an oily surface layer that stops evaporation, and mucus that helps it cling to the eye. Dry eye syndrome happens when you either make too little of the watery layer or, far more often, lose the oily layer because the lid glands that make it are blocked or inflamed, so tears evaporate too fast.[1] Age, hormonal change around menopause, screen work, dry and air-conditioned environments, contact lenses, some medicines, laser eye surgery and lid-margin disease all push in the same direction. That is why treatment rarely stops at "add water": the oily layer and the environment usually need fixing too.
Dryness also gets mistaken for other problems. Itch with sneezing points to allergy; a sticky, discharging red eye points to conjunctivitis; sore crusted lid edges point to blepharitis, which so often coexists that the doctor examines your lash-line photos as a matter of course.
How can I stop screens drying my eyes out?
Screens dry eyes mainly by suppressing blinking: concentrating on a display roughly halves your blink rate and produces more incomplete blinks, so the tear film is spread less often and less well. The practical fixes are the 20-20-20 rule (every 20 minutes, look at something about six metres (20 feet) away, or as far as the room allows, for 20 seconds), consciously completing a few full blinks each break, and positioning the screen slightly below eye level so less of the eye surface is exposed.
Then fix the air. Point car vents and desk fans away from your face, lower heating a notch, and consider a humidifier in dry, heated or air-conditioned rooms. Use your drops before long screen sessions rather than only after the eyes burn, keep lens-wearing hours honest on heavy screen days, and remember that wraparound glasses or sunglasses outdoors blunt wind, one of the most underestimated drying exposures.
Which eye drops are best for dry eyes?
There is no single best drop; there is a ladder, climbed according to how severe and how persistent the dryness is. Artificial tears are the foundation at every step, and the commonest reason they "do not work" is using them only when the eyes already hurt instead of regularly, typically four times a day or more.[1]
- Step 1, watery drops: standard artificial tears (for example hypromellose or carmellose based) used regularly, not just on demand. Cheap, safe, and effective for mild dryness once used properly.
- Step 2, gels: thicker carbomer-type gels last longer between doses, suiting moderate dryness and long screen days, at the cost of brief blurring after each dose.
- Step 3, night ointment: paraffin-based ointment at bedtime for people who wake with dry, sticky eyes; too blurring for daytime use.
- Preservative-free versions: the rule of thumb at any step if you need drops more than four to six times a day, wear contact lenses, or find drops themselves start to sting, because preservatives can irritate the surface they are meant to soothe.[1]
Add lid care (warm compresses, massage and lash-line cleansing) whenever the lid glands are involved, which is often.[4] Prescription anti-inflammatory drops sit above this ladder and belong with specialists, as covered below.
Which dry eye treatment might the doctor recommend?
Treatment follows the pattern and the drivers. This is the framework the doctors use, aligned with the cited guidance:[1]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Gritty, burning eyes after screen work, worse by evening | Regular artificial tears plus screen-habit and environment changes | Usually yes | No improvement after 4–8 weeks of a properly followed plan |
| Dryness with crusty or greasy lid margins | Lid hygiene routine for the blepharitis component plus lubricants | Usually yes | Persistent surface symptoms despite combined treatment |
| Dryness on a drying medicine or around menopause | Medicines review, lubricants, and treating what can be changed | Usually yes | If symptoms persist once contributing factors are addressed |
| Severe dryness with dry mouth, joint pains or autoimmune disease | Blood tests and referral to investigate Sjögren's syndrome | Online to start the work-up | Usually; specialist confirmation and shared care |
| Eye pain, light sensitivity, vision change, or a painful red eye in a lens wearer | Same-day in-person eye assessment | No | Always; these are not dry eye symptoms |
Not sure which row is your eyes? A doctor can tell you in one consultation.
See available times →Treatment options for dry eye syndrome
What you can do yourself
Start with the ladder above: regular artificial tears in the right formulation, preservative-free where the rule of thumb applies, plus the screen, air and blink habits that reduce evaporation in the first place. Warm compresses and lid massage help whenever the oil glands are sluggish, omega-3-rich food may modestly improve oil quality, and drinking sensibly and sleeping enough are small but real contributors.[5] Give any properly followed regime several weeks before judging it, and avoid "redness-relief" whitening drops, which do nothing for dryness and can rebound.
Prescription treatment
A prescription is never issued without a consultation, and for dry eye the honest message is that most prescriptions are not step one. Short anti-inflammatory courses such as steroid drops belong with eye specialists after slit-lamp examination, and ciclosporin drops, licensed in the EU for severe keratitis in dry eye disease that has not responded to tear substitutes, are initiated by ophthalmologists.[2] For gland-related disease linked to rosacea, a doctor can sometimes add a low-dose oral tetracycline course.[3] Procedures such as punctal plugs, which slow tear drainage, are in-person specialist options for the persistent minority. What the online doctor contributes at that level is recognising you belong there and writing the referral.
When dry eye is treated online, and when you need in-person care
Treated online: typical screen-, environment- and age-related dry eye; dryness with a blepharitis component, treated together; medicine-related dryness, with a proper review of what you take; contact-lens-related dryness and wearing-habit advice; and stepped follow-up when the first rung of the ladder has not been enough.
In-person care: suspected Sjögren's syndrome or other autoimmune disease, after starting the blood-test work-up; persistent or severe symptoms despite a properly followed plan, which deserve slit-lamp examination; any true pain, light sensitivity or vision change; a painful red eye in a contact-lens wearer, always the same day; and dryness after eye surgery or injury, which belongs with the treating specialist.
When to get in-person care
Dry eye is uncomfortable, not dangerous, so treat a change in the picture seriously: severe eye pain, marked light sensitivity, sudden blurred or lost vision, a chemical splash (rinse the open eye with clean water for 15–20 minutes and seek emergency care), or a painful red eye in a contact-lens wearer all need same-day in-person assessment. If vision is disappearing or an injury is severe, call 112 immediately.
Treating dry eyes at home: what helps and what does not
Home care is the foundation of dry eye treatment: warm compresses on closed lids, gentle lid cleaning, deliberate screen breaks with full blinks, and pharmacy lubricating drops, choosing preservative-free versions if you need them more than a few times a day.
What home care cannot do: it cannot treat the causes behind stubborn dryness, from lid inflammation to medication side effects to autoimmune conditions, and it cannot judge when dryness has damaged the surface of the eye. Pain rather than grittiness, light sensitivity, or any change in vision needs prompt assessment, and dry eyes that rule your day despite honest home care have earned a proper diagnosis.
Staying at home is the point of Mobi Doctor: you can see a licensed doctor over video, usually within 15 minutes, with no waiting room. If medication is the right answer, the prescription follows. Book a video consultation: the exact price is shown before you pay.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Upload photos of your eyes and lash lines, then speak to a licensed doctor: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Get your drops plan and review date: if prescription treatment is right for you, it follows the consultation. If your doctor decides you need to be seen in person, you get a full refund.
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Not sure it’s dry eye syndrome? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Frequently asked questions about dry eye syndrome
What is dry eye syndrome?
Dry eye syndrome is a condition in which the eyes do not make enough tears, or the tears evaporate too quickly, so the surface of the eye is not kept smooth and comfortable. Most cases are evaporative, caused by the lid oil glands producing too little or poor quality oil, so the watery layer dries off. It is long-term, very common after 50, and managed with lubricants and habits rather than cured.
What are the symptoms of dry eye syndrome?
Dry eye syndrome causes gritty, burning, scratchy or tired eyes, a feeling of something in the eye, redness, sensitivity to light, blurred vision that clears with blinking, difficulty with screens and reading, discomfort with contact lenses and, confusingly, bursts of watering in wind or cold. Symptoms are usually in both eyes and worse at the end of the day or in dry air.
Why are my eyes so dry?
Dry eyes are caused by age, which reduces tear production, hormonal change around the menopause, blepharitis and blocked lid oil glands, long screen sessions that halve the blink rate, dry, windy or air-conditioned environments, contact lenses, laser eye surgery, and medicines such as antihistamines, some antidepressants, beta-blockers and diuretics. Autoimmune conditions such as Sjögren's syndrome and rheumatoid arthritis are less common causes.
Why do my dry eyes keep watering?
Because a poor tear film irritates the eye surface, which then triggers bursts of reflex tears, especially in wind or cold. Those watery tears lack the oily layer that makes tears stay put, so the eye waters and stays dry at the same time. Treating the dryness, with lubricants and lid care, usually stops the watering.
What is the best eye drop for dry eyes?
The best eye drop for dry eyes is the one matched to your severity, used regularly. Watery drops such as hypromellose or carmellose suit mild dryness, longer-lasting gels suit moderate dryness, and night ointment suits waking symptoms. Go preservative-free if you use drops more than four times a day or wear lenses, and use them on a schedule rather than only when the eyes complain.
Can an online doctor prescribe dry eye treatment in Europe?
Yes, within honest limits, and only after a consultation. Most dry eye syndrome treatment is about the right artificial tears and habits rather than prescriptions, and the strongest options, such as steroid or ciclosporin drops, are started after an in-person eye examination. The doctor can prescribe lubricants, treat blepharitis and review drying medicines, with prescriptions sent to a pharmacy near you.
How can I stop screens drying my eyes out?
Screens dry the eyes because concentration halves the blink rate. Follow the 20-20-20 rule (every 20 minutes, look 20 feet away for 20 seconds), blink deliberately, position the screen slightly below eye level so the lids cover more of the eye, use lubricating drops before long sessions, humidify dry rooms and point air conditioning away from your face. Dry eye syndrome from screens responds well to these changes.
Do dry eyes get better on their own?
Sometimes, when a clear trigger passes: a dry-aired office, a medication course, or heavy screen weeks. More often dry eye syndrome is a long-term tendency that needs ongoing habits and lubricants, managed rather than cured. It responds well to that management, and most people are comfortable within four to six weeks of a consistent routine.
Is dry eye syndrome serious?
Usually not: for most people dry eye syndrome is a comfort and quality-of-life problem. Severe untreated dryness can damage the eye surface, and dryness with a dry mouth or joint pains can point to an underlying condition such as Sjögren's syndrome worth investigating. Pain, light sensitivity or reduced vision are not features of simple dry eye and need in-person assessment.
Is it dry eye or an allergy?
Dry eye syndrome feels gritty, burning and tired and is worse at the end of the day; allergic conjunctivitis itches intensely, affects both eyes at once, makes the lids puffy and comes with sneezing or a known pollen or pet trigger. The two often coexist, and antihistamine tablets taken for allergy can worsen dry eyes, which is why the doctor asks about both.
Are dry eyes different in the menopause or in older people?
Yes. Falling oestrogen around the menopause reduces tear quality, so dry eye syndrome often starts or worsens then and responds to the usual lubricants and lid care; HRT has mixed effects on it. In older people, drying medicines, lid changes and lower tear production combine, so a medicines review and night ointment often matter more than switching drops.
How can I prevent dry eyes?
Prevent dry eye syndrome by taking regular screen breaks and blinking fully, humidifying dry rooms, wearing wraparound glasses in wind, keeping lids clean with a warm compress routine if you have blepharitis, limiting contact-lens wear, drinking enough, asking a doctor about alternatives to drying medicines, and eating oily fish, since omega-3 helps some people with the evaporative type.
- Dry eye syndrome: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2023.
- Ikervis (ciclosporin): European public assessment report, EMA, European Medicines Agency, 2015 (updated).
- Blepharitis: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2023.
- Dry eyes, HSE, Health Service Executive (Ireland), reviewed 2024.
- Omega-3 and omega-6 polyunsaturated fatty acid supplements for dry eye disease, Cochrane, Cochrane Library, 2019.
- Dry eyes, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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