Dry Eyes and Tear Dysfunction Syndrome: Causes, Symptoms, and Treatments

What causes dry eyes or tear dysfunction syndrome? Penn Medicine ophthalmologist and Penn Dry Eye & Ocular Surface Center co-director, Giacomina Massaro-Giordano, MD discusses here.
Tear dysfunction syndrome is a very common medical condition that over 20% of the American population has been diagnosed with. However, this condition is often times ignored or not properly diagnosed and treated which can negatively impact individuals’ quality of life.
Tears are made up of three main components: oil, water, and mucous. When an individual is missing any of these components, their eyes may become dry. Other causes of tear dysfunction syndrome include infections, inflammation of the eye especially around the eyelids (also known as Blepharitis) or cornea, Conjunctivochalasis or loosening of the conjunctive attachments of the eye, issues with the various glands that produce tears, evaporation of tears and more.
There are many ways to treat tear dysfunction syndrome including the use of artificial tear drops, stabilizing the oil, a change in environment, utilizing humidifiers, inserting punctual plugs, changing your diet, and using certain medications. Some individuals may also suffer from tear dysfunction syndrome due to another present medical condition that they can seek treatment for. Other treatment options include oral sustained release Pilocarpine which induces lacrimal gland secretion, the insertion of lacrisert pellets, a fitting for Boston Scleral Lenses which allow a tear-fluid interchange and prevent the intrusion of air, and intense pulsed light treatment.
Learn more about dry eyes diagnosis and treatment at Penn’s Scheie Eye Institute: www.pennmedicine.org/ophthalmo...
Meet Dr. Massaro-Giordano:
www.pennmedicine.org/wagform/m...
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[@milels6917]

I’m 81 I want to say thank you for this I had pain in my eyes I know I have dry eye I happened to find this blog I have tears and yet I’m told I have dry eyes wishing you were my optical doctor

[@Restless_Vibes27]

having dry eyes really kills your self esteem, everyday i have to walk out the door knowing i dont have healthy white eyes and will stay like that for most of the day people always think you are a drug addict or sick and strangers treat you very different and arent as friendly to you as they would be to somebody whos eyes look normal, even cashiers and staff at stores, ever since i got dry eyes, socially its destroyed my confidence i hope i can get it treated permenantly asap so i can be treated normal again like everybody else

[@musicalnostalgician4083]

Stay strong man, your eyes will get cured someday! :)

[@coburnic]

You just described my life, I feel the same way and it’s horrible. I’ve been avoiding people because I can’t stand to make eye contact because of how my eyes look and I have to constantly look away and am visibly in pain.

[@Dakappon]

How are you doing buddy?

[@333Eriana]

@@coburnic i have to use artificial tears all the time - one of my tear ducts does not work my vision is always crappy , but after i use boric-acid -eyewash i can see just fine - - until the dirt build s up on my eyeballs - I had my eyes exrayed and the doctor said i want you to go home and use drops for a week then come back - because i might give you the wrong prescriptions - my eyeballs were imbedded with dirt . When i went back - he examines and tested and i didn't need new glasses

[@ronipineda9847]

@@coburnic I feel the same way. I’m new to this. Less than a year

[@nfc598]

Can't even believe how helpful this turned out to be. I've grown to expect the bare minimum from conventional doctors but this woman has proven me wrong.

[@elizabethmaxwell7053]

The most comprehensive lecture on dry eye I've ever seen--wonderful clear speaker-easy on the ear. Lots of valuable information here.

[@brucelee7782]

Kudos to this doctor. She went above and beyond what many doctors have not. Thank you.

[@tamarapThenTheresTwo424]

Great information for us sufferers; wish all doctors were this informative. (sigh)

[@user-xv1kp6qf7h]

I wish all docs had her wholistic approach to finding root cause to then dx and treat based on type and cause. She’s amazing 😉

[@raraavis7782]

I‘ve actually considered wearing swimming googles at night, because my eyes get painfully dry during the night. Glad to hear, I‘m not crazy! Very useful presentation, learnt lots. Wish, regular doctors were half as passionate and helpful.

[@aravindram1480]

What kind of dry eyes you had ?

[@Aesthetic_Weirdo]

this was so helpful and made me realise that I'm NOT crazy..... I need a more accurate diagnosis then I can determine the best treatment!!!

[@marlo55]

Excellent presentation. I wish she was my doctor.

[@samward8154]

Can you discuss Isotretinoin and how it affects eyes

[@BeachButterfly22]

Excellent Doctor and information. Thank you. Women are often told or treated like they are "crazy"and its 2022 (when it comes to health related issues esp as they age) This information you presented is priceless to me,regards.

[@DrumMan423]

This professor is awesome!! I enjoyed this lecture very much.

[@keeplearning102]

This is a very high quality presentation. It is detailed and at the same time simple for patients with non-medical background to understand. Its extremely practical and seemed exhaustive.

[@terencelamb1382]

I really appreciate those who made this video possible, and the great presentation that this ophthalmologist gave. It was easy to listen to and I didn't get bored out of my tree. I had been watching some short videos from others giving ideas on how they treated their dry and gritty eyes. My own doctor simply suggested drops and rinsing my eyes out with a saline solution. My dad had an enormous problem with his eyes in the last 20 years of his life: he died 10 years ago. The doctors of the time probably didn't know what you know. Unfortunately it appears your average GP should be passing patients on to those who do know. But is this knowledge specific to Penn Medicine or is it widely known among ophthalmologists?

[@cate499]

Thank you for being so passionate about treating the people suffering from dry eye.

[@lillebrowning2231]

I Need an appointment with her! She’s amazing W

[@gordonalexander4016]

VERY Thorough talk!!! Thank you! You have a true gift. KEEP RISING!

[@mrs.b.s.7212]

I cannot believe how much I am learning from this video! I cannot believe that 3 eye "doctors" just totally dismissed me & said there's nothing they can do without even trying.

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@shamimali2849]

Thank you for posting this video. It's really very clear and comprehensive information about dry eyes.

[@deepakkpal]

The best non-tech lecture i have heard in recent time,Thank you for so informative content, i wish my doc has this much information.

[@yilunguo9495]

suffered from dry eye for years and this is the most helpful explaination including all ophthalmologist I've ever visited. Thank you!

[@hamthelad]

An excellent informative presentation from Dr Massaro-Giordano. She explains the condition and treatment options in a very concise and clear manner and has given me great ideas for when I next speak to my ophthalmologist about my dry eye issues.

[@gillianstewart8442]

Excellent lecture. I suffer from dry eyes due to cornea abrasion and my doctor failed to diagnose it for years! I find it very difficult to open my eyes in the morning it can take up to 5 minutes and a lot of drops. I'm in my 50s and know this horrible disease can only be managed not cured. There's very little information out there even amongst professionals so thank you !

[@buckleupbuckeroo]

What a star this woman is. Well done. Great lecture.

[@creativesolutions902]

It can make you feel like you’re blind, because you can’t ever see a damn thing! Thank you so much for this it was a wealth of information :-)

[@Hong_Mei]

Thank you for sharing. Creating awareness and clarifing misunderstanding is fundamental. Your research work and that of your Department is indeed appreciated, Thank you!

[@ronipineda9847]

I feel the same way As a lot of you were mentioning I was recently diagnosed. It has been so difficult. Nothing works 100% and I never have complete relief. It’s affecting my personal life as well as my social life. It’s really affected everything. But this doctor is amazing I’m listening to her and she is describing everything to the t.

[@iiieagle926]

Hi, did you try re

[@iiieagle926]

Restasis

[@aravindram1480]

Hi how many months you suffered?

[@kingnole4237]

​@@aravindram1480 how are you aravind

[@kamilekapel]

Yes, it does affect one's personal life a great deal. Have you tried optimel Manuka honey gel? It gives me complete relief for a delicious period of time.

[@joewalker76]

Very impressive presentation, this really helps me understand and hopefully resolve my dry eye problem. I cannot thank you enough.

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@n.d8001]

Clear educational presentation. Easy to follow. Easy to understand. So helpful. This lecture is gold. Thank you so much

[@annieyahu676]

Excellent Lecture!!!! So well presented and very clear. Thank you for making this possible. Gives me new hope for the medical industry since I have been misdiagnosed twice.

[@114db]

where was this video all my life??? Thank you

[@davidsim4979]

Thanks! It is a great lecture! It has enabled to understand better the pathology and its different treatments!

[@wendyaleman4615]

Great video! Thanks for posting. So much good information!

[@Simon_Hawkshaw]

Wonderful insights into this condition. Many thanks. We need more awareness globally.

[@StevePhillips]

Good video. I have dry eyes it's very painful almost blind now in left eye, and light sensitive. I have preservative free eye drops. Pain every day agony most of the time. Pain goes down my neck. It started following left eye graft 1990-91. I wish I never had it.

[@mrs.b.s.7212]

You are an angel sent from God, lady! A LITERAL answer to my prayers!! I feel like there's going to be an end to my suffering some where in the near future.

[@Nonotkidding]

Excellent ! I feel well informed now, thank you, Jon

[@reyjasso5259]

I want to share that I had an appointment with my eye doctor about my dry 👀, I was glad to hear that the FDA has been approved the generic for Restasis, but is not in the stores yet. I wish you all of you the best with their treatments.

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@philipturner5100]

Great presentation. Clear and easy for a non medical person to understand.

[@qa4057]

Always a pleasure and a valuable tool to watch thorough explanations that our doctors never have close to the time to explain. Thank You! I am going in today for a OCT (Optical Coherence Tomography) test.

[@warodomthamrongthanyawong691]

Very eloquent and persuasive. This is a first-rated presentation!

[@speshedbigils]

IMPRESSIVE Presentation...Knowledge & such a Sweet lovely Doctor! Thank you🙏👏👏👏

[@lucywambui1576]

Wow, the best presentation ever. Very systematic

[@marylombardi6224]

This has been so very helpful! Thank you

[@denisepearson9552]

this was an excellent lecture!

[@gigieyre]

Wow! Thank you so much for making this video. I have an excellent doctor and he has talked about lots of things that I heard here. Before finding this doctor, I went to another doctor that was like the speaker described that her mother went to. They just didn't care . They were considered a dry eye specialist yet they only wanted to sell me a very expensive machine. Thankfully I found my new doctor and he has been patient and knowledgeable about all these things in the video. It was great being able to listen and pause the video. It's hard to take in all this information during a regular office visit.

[@nirmaladesai636]

Can you please let me know name of your doctor ? I would like to consult him for my dry eyes . Thank you

[@forgive70x70]

Excellent! Thank you for your full explanation of my dry eyes. Just received my punctual plugs and already feeling so much better 😍

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@anniewhitmore7627]

What an interesting lecture - I agree wholeheartedly with what other people have said - if only our regular doctors understood this condition better. There are so many potential reasons why people have this condition and just packing us off with eye drops doesn't solve the problem. I believe my sudden dry eye is perhaps hormone related and this Prof. highlighted it for me. Thank you very much :)

[@gretaaarons4941]

A clean gut, thyroid issues ruled out and no deficiency of B12

[@luzangelavalencia8857]

Thank you very much for explaining everything soo well. Finally I understand my condition. Thank you.

[@eileensteele9003]

What an awesome presentation !!!!

[@garufia]

Very competent and informative Doctor.

[@radhikaraj9533]

Thank you very much for sharing your knowledge . God Bless 🙏❤️

[@RamKumar-ju2vs]

This lecture is full of knowledge.

[@benjaminfowler2457]

Thank you SO much. You know everything about the eye!!!

[@abig0007]

This video contains excellent information and helpful treatments

[@ruthie2222]

Why can my eye department in my local hospital here in the UK have this knowledge 😔

[@michellewan2dance]

I went to my hospital today, and I have just been subscribe some eye drops

[@Jerlbing]

Thank you this is very informative.

[@bhaktideb6841]

Thank you...I learned a lot about dry eyes.

[@mrringway1733]

A brilliantly informative lecture. The presentation is excellent and very easy to listen to. May I also say, what a very beautiful woman she is. She is very lucky and should thank her parents for her looks.

[@ilovemiley345678]

I wish you were my doctor

[@saudiaally8495]

Amazing is the Education she provided for dry eyes. I want to go to her clinic . I Am From New York

[@kathym6603]

Dear Doctor, You have a spectacularly pleasing speaking voice!! My eyes are pretty valuable!! Thanks for your help. 👁 👁

[@GK-qt6vh]

Great video, thank you very much for such great and educational material.

[@jcool4358]

This was a wonderful video. This lady is amazing. Do all eye doctors know about all this. I find any doctors I have been to ignore my complaints about my eyes i.e., tearing itching, etc.

[@lindsaywang4413]

15 years of telling all my doctors and eye specialists that my eyes are dry and irritated, all I got was prescriptions of freaking expensive artificial tear drops which does nothing than 10 mins relief. And here I am watching this video from 10 years ago feeling like a fool under the stupid medical system

[@erizabeth613]

Tear drops are waste of money we need permanent solution. F dry eyes

[@Drd3wq]

Till this moment is your eye ok? I have this shit for 4 years and it kill my life i am just 22 years old kid god why me 🥺

[@hnuda]

me to ...do you know any treatment for it ​@@Drd3wq

[@aliiozturkk]

@@Drd3wqI’m 18 and I’ve this bs for 2 years😭😭😭

[@Music.23.]

3 months and still it's the same condition

[@r.mercado9737]

This presentation is most helpful. I warmly thank you.

[@r.mercado9737]

Thank you.

[@drmms2001]

This is very helpful. I tried all the advice given in this video. It was helpful. I would also like to add that changing my diet to include lots of Vit A also helped me drastically.

[@amritshahzad1227]

Wonderful presentation, clear style, comprehensive information, passionate about the subject, and lots of useful information for patients. Loved the detail about warm, moist compresses for dry eye. Thanks for posting this video.

[@thomaspurvey]

Excellent delivery and I've learned so much, Put my name down for your clinic or send this clip to Doctors in Scotland, Thank's for posting : )

[@ramasynaicker8271]

Thank you for information.will try some of these methods

[@RichardDowdell1981]

Very good talk on Tear Dysfunction Syndrome, thanks Dr Massaro-Giodano. Almost everyone I see over the age of 40 has meibomian dysfunction and often chlasis.

[@karlaagee-seldon5017]

Why don't doctors just tell us that we have a vitamin A deficiency? I had dry eyes for years until I found out that it was all due to malnourishment. I started eating eggs again after 18 years, but I made sure they were pastured grass-fed organic eggs with organic butter and everything that was organic that was high in Vitamin A and incorporating more organic carrots, dod liver oil liver, and cheese in my diet. The Kale and the collard greens although weren't a true vitamin A, they were at least a pre-vitamin A that converted to an active form in my body. The real culprit was that I was insulin resistant that affected my gallbladder which became sluggish because of all the bad foods I was eating and my gallbladder wasn't producing enough bile to breakdown the fat-soluble nutrients from the food I was eating regardless of the quality of food. Now my dry eyes are gone. I started really reading the back of the stevia to make sure it had no added ingredients with the worst culprit being maltodextrin. I didn't realize that not all stevia is true stevia and the kind I was consuming was worse than sugar. I would've been better off with pure cane sugar than the fake stevia I was buying. I had no idea that maltodextrin was in my large bag of stevia for baking. I really have to read the label because that extremely high level of sugar was pulling out my vitamins and minerals from my body. It's very refreshing to hear information from a doctor that talks about what may be lacking in the diet, you're a breath of fresh air. Thank you.

[@kirstymackenzie2437]

Karla Agee-Seldon. Thank you for pointing out the matter of maltodextrin! I’m pre-diabetic and it seems to be in a lot of foodstuffs which is not good for me, like sweeteners. I’m going to stop using them straight away. Again thank you.

[@MicheleLeeMD]

Great explanation of dry eye!!!

[@311rbb]

Love this!! A very integrative approach. Helping the causes vs just the symptoms!!

[@amalelchayeb7229]

I have seethrough balloons coming out from lower eye lid that No Doctor could tell me what is it or how to get rid of except suggestions for warm compressions...did no difference !!

[@amalelchayeb7229]

For about 5 years now, am over 60 yrs now.

[@violetcastillo8918]

Very clear explanations

[@user-en4uo4fj9g]

Amazing lecture, thank you

[@growinglove9216]

Very informative, I which you were here in Hawaii. Any suggestions for places here?

[@jennycadoret1768]

Excellent lecture. I'm applying some of your tips in my daily life and it works to have the humidifier on in the winter months. Wish I knew this earlier 😄

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@marthayew5404]

excellent.. detailed and useful inf.. tnx

[@athirameretty6611]

Good presentation. Difference between a good Doctor and a lousy one. Thank you.

[@katieshore5139]

I've had severe dry eye for a while now and now have ocular migraine..are they both connected? I love your video..so informative thankyou 😃🤗

[@mixytampa812]

I just had ocular migrane yesterday eye doctor wants to see me tomorrow I had lasik surgery 4 years ago Today I have small floaters but I been working too hard on the computer without blue light glasses I just ordered them today well see

[@mikejvevo3153]

am seventeen years now from The Gambia West Africa , but i began to get this symptoms when i was eight years old i went to many hospitals every year and all they could tell me was that i was allergic to dust smoke sunlight ray. i was given variety of medicines that didn't make any difference. so i began to make research for myself and after nine years i got unlimited access to the internet after i was bought a laptop and today i finally found the real reason for my years of suffering thank you doc i really am in your debt

[@arvindram951]

Hi man. How you doing. Now do you got over this?

[@aravindram1480]

Hi how did you get over this now??

[@aravindram1480]

Please can you tell me i am suffering now.

[@allisonhunt9222]

This is so informative. I have had eye issues for 6 months and still not sorted I am on another referral . I bet if I saw this specialist they would have it sorted in no time!

[@aravindram1480]

Hi. How you feeling now. Is it reversed

[@squelch9]

This woman KNOWS HER SHIT!

[@gretaaarons4941]

She gave a list of factors and treatment alongwith diet and nutrition. Keeping the gut clean is so important to avoid deficiencies of B vitamins that can cause dry eyes and inflammation too especially in people with hypothyroidism.

[@7019602]

Brilliant! So well explained and comprehensive.

[@sicosismusic]

Brilliant , thank you so much for the information as I suffer with anterior blepharitis & it sucks Big Time !

[@trishbrown9442]

Fantastic presentation! Very informative and I have taken notes to present to my ophthalmologist to, at the least, receive a comprehensive examination to determine the cause of my tear dysfunction syndrome in my right eye. Strange that it isn't in my left eye, too.

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@nelbut1]

great video thankyou

[@Christine-zu7fi]

Seriously thank you. God I wish you were my dr. I’ve had this for 2 weeks and going crazy. Thank you for the discussion on importance of identifying cause, Omega 3 discussion and Doxycycline comments. I have rosacea. Bless you.

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@2047helen]

Thank you for caring for people with dry eyes!!❤ I have huge problem with dry eyes, for many years. I have to take drops all the time (Hylo-Gel, Oftagel) I live in Sweden and the is no help to get here…. they orten just shaking there head ”there is nothing to do…) Many hugs /Helen

[@integinteg9222]

Thank you. So helpful.

[@SamY-nm6pn]

I just take my coffee ☕️ and enjoying the lecture

[@SBGames8]

Recently diagnosed with Blepharitis and Meibomian Gland Dysfunction at age 29. I've been doing a cleaning, scrub, warm compress, and hypochlorous acid regimen, but I still have itchy eyelids and blocked glands. Hopefully I can get it to a comfortable point and manage it.

[@aravindram1480]

Hi brother where do you stay. How did you found that you had meibomian gland dysfunction

[@Priyan0000]

Heyy How r u now... Please reply 😭😭 I m suffering... Please brother reply😭

[@jcvideo1001]

I had dry eyes for years , tried various medicines wasn't much help. However ever since my husband adviced me to put on safety goggles to block wind, plus wearing a face mask, the combined effect was instantly felt. the loss of tear due to evaporation was gretly reduced

[@Cchheettaann]

How Face mask will help you

[@aravindram1480]

@@Cchheettaann bro you still face the dry eyes issue??

[@RetriGod]

Same. Everytime i wear face mask my eyes felt great

[@kamilekapel]

There are fashionable sunglasses you can get now with a goggle like attachment.

[@medhikasingh6327]

do you get any tears while crying or cutting onion?

[@kordaling]

Any new traitement for dryness caused by Lasik ? thank you.

[@laurabul1974]

Thank you so very much for this information. This condition was starting to drive me crazy. It affects my daily life and is very frustrating. Ill be sure to see an opthamologist to get to the bottom of whats causing this.

[@sandravillecco3268]

I´m so so grateful to this wonderful doctor who made the video. Thank you so much!! No doctor has ever given me 5 % of this information.

[@Priyan0000]

how r u now... Please reply 🥺🥺 I m suffering 😭😭

[@mrs.b.s.7212]

I really thank you for this information!! Im watching and rewatching & taking notes. I AM going to find an eye dr who will help me. And, through education via your video, I'm going to help them help me! Hopefully before I go blind from this.

[@kayhussein6863]

HI, thank you for this very useful presentation , I have a RA and tears production stopped for more that 4 years I do not feel any problem on my eyes except that I have no tears at all, I am on Resistas eye drops now for 5 month without improvement, I also took omega3 , is there any treatment to help my eyes produce tears again. Thank you