Published: 1 November 2025 | Updated: 27 September 2026 | Author: Smart Vision Optometry
The Hidden Burden of Dry, Irritated Eyes
If you have ever ended a long day with burning, gritty, or watery eyes, you may have brushed it off as simple fatigue from too much screen time. But for many Australians, these symptoms point to something more serious: Dry Eye Disease (DED). This chronic condition is becoming increasingly common, and its effects extend far beyond momentary discomfort.
According to the TFOS DEWS II International Report, Dry Eye Disease is defined as a “multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, accompanied by ocular symptoms” (TFOS DEWS II, 2017). The definition reflects several interacting causes rather than a single tear problem.
“Dry eye is more than just a problem with tears,” says Gary Rodney, founder and creator of Smart Vision Optometry, Master of Optometry, Behavioural Optometrist and Fellow of the International Academy of Orthokeratology and Myopia Control (FIAOMC). “It is a complex, inflammatory condition that can impact daily life, psychological wellbeing, and overall quality of health.”
What Exactly Is Dry Eye Disease?
Dry Eye Disease occurs when the eyes do not produce enough tears, or when the tears evaporate too quickly. The tear film contains lipids, water, mucins and other components; disruption can affect its stability.
The two main subtypes are:
- Aqueous-deficient dry eye: when the eyes do not make enough watery tears.
- Evaporative dry eye: when oil gland blockages (meibomian gland dysfunction) cause tears to evaporate too quickly.
Both types can overlap. Meibomian gland dysfunction is an important contributor, but its reported frequency depends on the population and diagnostic criteria.
Symptoms may include:
- Dryness, burning, or stinging
- Sensitivity to light
- Blurred or fluctuating vision
- Feeling as though something is in the eye
- Difficulty with contact lens wear
“Some patients describe it as constant sand in their eyes, while others report sharp bursts of pain or watering that interferes with reading, driving, and work,” notes Jacquie Gattegno, Orthokeratologist and Principal Optometrist at Eyes InDesign Smart Vision Optometry Bondi.
How Common Is Dry Eye?
Reported prevalence varies with age, population and the definition used. The TFOS DEWS II patient summary describes estimates ranging from 5% to 50% across studies. This range is not an estimate for all Australians or for a particular age.
“By age 60, up to half of adults may experience dry eye symptoms,” Rodney explains. “And with longer screen times, indoor lifestyles, and environmental changes, we are seeing younger patients too.”
Factual context: The quoted age-60 estimate is retained as part of the original interview; it is not a verified population estimate. Prevalence figures depend on the study and case definition.
The Consequences of Untreated Dry Eye
Dry eye is not just uncomfortable—it can affect:
- Daily function: Reading, driving at night, and using digital devices become more challenging.
- Mental health: Dry-eye symptoms can affect wellbeing; an association with anxiety or depression does not establish that one causes the other.
- Ocular health: Severe dry eye can damage the eye surface. New pain or vision changes need assessment and should not automatically be attributed to dry eye.
“Patients sometimes dismiss dry eye as a nuisance,” Gattegno says. “But when left untreated, it can progress to chronic pain and reduce overall wellbeing. We want people to take it seriously.”
Diagnosing Dry Eye in 2025: New Tools
A dry-eye assessment combines the symptom history and examination. Tear-film testing and imaging may help evaluate meibomian gland structure and tear-film behaviour; the tests selected depend on the individual.
- Meibography shows whether glands are healthy or atrophying.
- Tear osmolarity testing identifies unstable tear chemistry.
- Non-invasive tear film analysis provides detailed insight into evaporation rates.
These technologies allow optometrists to differentiate between aqueous deficiency and gland dysfunction, helping to guide an individual management plan.
Treatment Options: From Lifestyle to Advanced Therapies
Lifestyle Adjustments
For mild cases, simple changes can help:
- Avoid direct air conditioning or fans
- Use humidifiers in dry environments
- Increase outdoor time to reduce screen-related strain
- Maintain a balanced diet; do not assume omega-3 supplements will treat dry eye
Medications
Lubricating drops or gels and, where appropriate, prescription treatments may be discussed after assessment. Medicine suitability and availability vary; do not start leftover antibiotic or steroid drops without professional advice.
In-Office Procedures
In-office options discussed in this interview include:
- BlephEx®: A gentle exfoliation of the eyelids to reduce bacterial biofilm.
- BlephaSteam®: Heat therapy to unclog meibomian glands.
- Smart IPL (Intense Pulsed Light): A treatment discussed for selected patients with meibomian gland dysfunction. Confirm availability and suitability with the Mosman practice.
Smart IPL: A Game-Changer in Dry Eye Care
IPL has been adapted for selected dry-eye patients. Its proposed effects and treatment goals include:
- Reducing inflammation: May influence inflammatory pathways associated with meibomian gland dysfunction.
- Targeting Demodex mites: A proposed effect that should not be treated as a guaranteed mite-eradication treatment.
- Restoring gland function: A treatment goal whose extent and durability vary between patients.
Treatment may involve a series of sessions and ongoing care. Discomfort and other risks are possible; benefits and their duration vary. Eye protection and an individual suitability assessment are essential.
“The Smart IPL treatment is the first TGA|FDA-approved IPL for dry eye, and it has transformed outcomes for patients who previously struggled with ongoing discomfort,” Rodney explains. “It addresses the root causes, not just the symptoms.”
Regulatory context: Gary’s original wording is retained. The FDA’s 2021 De Novo authorisation for Lumenis Stellar M22 concerns specified adults with dry eye due to meibomian gland dysfunction and use alongside other care. It does not establish a blanket approval for every IPL device or dry-eye condition. The exact device and Australian register entry supporting the interview’s TGA and “first” wording still require confirmation; that wording should not be relied on as a verified current regulatory claim.
Why Acting Early Matters
Persistent symptoms warrant assessment. Gland structure and function can change, but progression and response to care differ between patients; early treatment cannot guarantee a particular outcome.
“We can prevent further damage if we act promptly,” Gattegno stresses. “Waiting too long means patients may face irreversible changes to their ocular surface.”
Smart Vision Optometry: Personalised Dry Eye Care
At Smart Vision Optometry, patients undergo a Smart Dry Eye Assessment to assess likely contributors and the severity of their condition. From there, a tailored wellness plan may include lifestyle strategies, nutritional guidance, in-office therapies, and advanced treatments such as Smart IPL.
“We don’t just prescribe drops and send patients away,” Rodney concludes. “We provide long-term management plans designed to improve quality of life and protect eye health into the future.”
Take Action Today
If you suffer from burning, gritty, or watery eyes, don’t ignore the signs. Book a Smart Dry Eye Assessment at one of our Sydney clinics to explore the latest diagnostic tools and treatment options.Book an appointment, or call the Bondi clinic on (02) 9365 5047 or the Mosman clinic on (02) 9969 1600.
Editorial update and related reading
Gary’s and Jacquie’s interview comments remain in their original wording. Current context and corrections are stated separately. For foundational information, see the National Eye Institute’s dry-eye guide and the 2017 TFOS definition report. The NEI-funded DREAM trial found omega-3 supplements no better than placebo for dry-eye signs and symptoms.
Related interviews discuss blepharitis and dry eye, irritated or watery eyes, and IPL assessment and care.
When should symptoms be assessed urgently?
A painful red eye or red eye in a contact-lens wearer needs prompt assessment. Seek urgent medical help for sudden vision changes, significant light sensitivity or an eye injury. Healthdirect’s dry eye guidance sets out symptoms that need prompt or urgent care.
How can you prepare for your appointment?
Bring your symptom notes, current glasses or lenses, medicines list and the eye products you use. Discuss your goals and agree on when improvement will be reviewed. For a symptom-focused explanation, read why dry, irritated eyes can also be watery.
Frequently asked questions
Can dry eye cause watery eyes?
Yes. Watering can accompany an irritated eye surface, but an examination is needed to identify the cause.
Is the same treatment suitable for everyone?
No. Management depends on the assessment, contributing factors and the person’s response over time.
Should I stop my medicines if my eyes feel dry?
Do not stop prescribed medicines on your own. Discuss possible effects and alternatives with the prescriber.
Plan your next step
For persistent symptoms, explore our dry eye assessment and management service. Contact our Bondi Beach practice or Mosman practice to discuss appointment availability. The assessment guides suitable management or referral.
