Dry, Irritated or Watery Eyes? Dry Eye Is Often More Complex Than People Realise  

Smart Vision Optometry is encouraging Sydney patients not to ignore ongoing dry, irritated, gritty or watery eyes, warning that dry eye symptoms can affect comfort, concentration, contact lens wear and daily quality of life.

Dry eye is often thought of as a simple lack of tears. In reality, modern clinical definitions describe it as a multi-factorial condition involving the tear film and ocular surface. The Tear Film & Ocular Surface Society describes dry eye as a multi-factorial disease involving loss of tear film homeostasis, accompanied by ocular symptoms.

Gary Rodney, creator and founder of Smart Vision Optometry, is a Master of Optometry, Behavioural Optometrist, Fellow of the International Academy of Orthokeratology and Myopia Control, and has more than 30 years of clinical experience.

“Many people put up with dry eye symptoms because they assume it is just part of ageing, screen use or contact lens wear,” Rodney said. “But dry eye is not always simple, and the right management depends on understanding what is contributing to the symptoms.”

Symptoms may include burning, stinging, grittiness, redness, watery eyes, fluctuating vision, light sensitivity, contact lens discomfort, tired eyes or the feeling that something is in the eye.

Jacquie Gattegno, principal senior optometrist at Eyes InDesign Smart Vision Optometry Bondi, is an experienced Behavioural Optometrist and Orthokeratologist.

“People often say, ‘My eyes can’t be dry because they water all the time,’” Gattegno said. “But reflex watering can occur when the tear film is unstable or the eye surface is irritated and this reflex tearing is the wrong sort of tears to wet the eye. . That is why assessment is important.”

Smart Vision Optometry provides bespoke eye care wellness treatment programs  for children, teenagers and adults through its Bondi Beach and Mosman practices. Its dry eye approach is assessment-led and may include reviewing symptoms, tear film quality, eyelid health, meibomian gland function, environmental factors, medications, screen habits and contact lens history.

Rodney said dry eye has become increasingly relevant for office workers, students and people using digital devices for long periods.

“When people concentrate on screens, they often blink less completely and less frequently,” Rodney said. “That can affect the tear film and make symptoms worse, particularly in air-conditioned offices or dry environments.”

Digital eye strain can be associated with symptoms such as tired eyes, irritation, blurred vision and headaches. Practical measures such as screen breaks and appropriate work setup are commonly recommended to reduce visual strain during prolonged screen use.

Gattegno said management should be tailored rather than generic.

“Artificial tears can be helpful for some patients, but they are not the whole story,” Gattegno said. “Eye drops only give temporary relief and never solve the underlying issue of dry eye disease. Most patients with dry eye disease will benefit from eyelid hygiene, warm compresses, environmental changes, contact lens changes, treatment for meibomian gland dysfunction or referral where appropriate.”

Clinical clarification: The quotation is retained as given in the interview. Lubricating drops mainly relieve symptoms, while some prescription drops address inflammation or tear production. The statement that drops “never” address an underlying issue should not be applied to all medicines; the choice depends on the diagnosis.

Meibomian glands are small glands in the eyelids that produce the oil layer of the tear film. When these glands are not functioning well, tears may evaporate too quickly, contributing to dryness and irritation.

Rodney said this is one reason patients need more than a quick product recommendation.

“Two people can both say they have dry eyes, but the underlying causes may be different,” Rodney said. “One may have evaporative dry eye, another may have inflammation, another may have contact lens-related discomfort, and another may be affected by medication or environment. The management plan should reflect the person in front of us.”

Dry eye can also affect vision quality. Many patients report that their vision seems to blur and then clear after blinking. This can happen when the tear film is unstable.

Gattegno said patients should take note of patterns.

“If symptoms are worse at the end of the day, after screen use, in air conditioning, while driving, or when wearing contact lenses, that information helps us understand what may be happening,” Gattegno said.

Smart Vision Optometry’s dry eye assessments may involve clinical observation of the ocular surface, eyelids and tear film, as well as discussion of lifestyle factors. The aim is to identify contributing factors and recommend appropriate management.

Rodney said patients should be cautious about self-managing chronic symptoms for months or years.

“Occasional dryness may settle quickly, but persistent symptoms deserve proper assessment,” Rodney said. “The eye surface is delicate, and chronic irritation can become frustrating and disruptive. Patients do not need to simply live with it.”

Gattegno said dry eye care is often a process rather than a single appointment.

“We explain to patients that dry eye management may require review and adjustment,” Gattegno said. “The goal is to improve comfort, stability and daily function, but we need to monitor how the eyes respond.”

Smart Vision Optometry encourages patients to seek care if they experience regular dryness, irritation, watery eyes, burning, fluctuating vision, light sensitivity or contact lens discomfort.

“Dry eye is common, but that does not mean it should be dismissed,” Rodney said. “With proper assessment, many patients can better understand their symptoms and actually improve their current dry eye situation and minimise the normal further age related deterioration .”To learn more about dry eye assessment and management, book an appointment with Smart Vision Optometry, or call the Bondi clinic on (02) 9365 5047 or the Mosman clinic on (02) 9969 1600.