Why Do We Get Dry Eyes in Winter? Prevention and Treatment Methods

Dry eyes in cold weather occur when dropping humidity levels, harsh winds, and indoor heaters dry out the air, causing your tear film to evaporate rapidly. When the moisture barrier protecting the surface of your eye weakens, you may start experiencing a stinging or burning sensation, as well as reflex tearing. For optimal winter eye health, wearing protective glasses outdoors, humidifying indoor spaces, and drinking plenty of water are the most effective preventive measures.

In Brief:

• Cold and windy winter air causes tears to evaporate quickly, triggering dryness.
• Heated, dry indoor environments increase irritation on the eye's surface.
• The most common symptoms include burning, stinging, redness, and blurred vision.
• Watery eyes in windy weather are actually a reflex response from a drying eye trying to protect itself.
• Treatment usually involves artificial tear drops; advanced cases may require further medical intervention.

What is Winter Dry Eye and Why Does It Happen?

Tears are a vital secretion that keeps the surface of your eye smooth, protects against infections, and ensures clear vision. A healthy tear film consists of three layers: mucus on the inside, water in the middle, and oil on the outside. The outer oil layer prevents the water underneath from evaporating. However, the harsh weather conditions we face in winter disrupt this delicate balance. Dry eyes in cold weather usually start when this outer oil layer loses its function and the water layer quickly evaporates into the air.

During the winter months, the amount of moisture held in the air is naturally quite low. On top of this, the heating systems we use in our homes, offices, and cars can drop indoor humidity to desert-like levels. This dry air acts almost like a sponge, drawing moisture right off the surface of your eyes. When you add in the reduced blinking reflex common among people who work long hours staring at screens, the eye's surface is left vulnerable, and the irritation process speeds up.

Symptoms of Dry Eyes

A decrease in the quantity or quality of your tears leads to microscopic damage on the surface of the eye. While dry eye symptoms vary from person to person, they usually worsen later in the day or when you step outside into the chilly, windy weather—perhaps while catching a ferry across the Bosphorus or walking down a breezy Istanbul street. What begins as a mild discomfort can seriously lower your quality of life if left unaddressed.

The most common complaints among people experiencing dry eyes include:

• A burning, stinging, or gritty (like sand in the eye) sensation
• Noticeable redness and broken capillaries in the whites of the eyes
• Sticky eyelids or crusting when waking up in the morning
• Increased sensitivity to light (photophobia)
• Blurred vision, especially when reading or driving
• A feeling of heaviness and fatigue around the eyes

Why Do Eyes Water in Windy Weather?

Many patients are surprised when a doctor diagnoses them with "dry eyes" while their eyes are constantly watering. Watery eyes in the wind are actually the body's emergency defense mechanism. When the surface of the eye becomes dry and irritated, a signal goes to the brain: "The eye is dry, send fluids immediately." In response, the tear glands suddenly produce a large amount of tears. However, because these reflex tears lack the necessary high-quality oils and mucus, they cannot cling to the eye's surface and simply roll down your cheeks. In short, your eye waters, but it doesn't get properly moisturised.

How is it Diagnosed at the Hospital?

Dry eye is diagnosed through a detailed examination by a specialist ophthalmologist. During the consultation, your doctor will listen to your symptoms and examine the surface of your eye under magnification using a special device called a biomicroscope. This examination evaluates any potential dry spots on the cornea (the clear front layer of the eye) and assesses the overall quality of your tear film.

The most common method used to clarify the diagnosis is the Schirmer test. In this test, a thin strip of filter paper is placed inside the lower eyelid, and the amount of tears you produce over five minutes is measured. Additionally, a Tear Break-Up Time (TBUT) test determines how long your tears can remain on the eye's surface before evaporating. When necessary, special dye drops (fluorescein) are used to make cellular damage visible, helping the doctor determine the extent of any corneal wear.

Treatment for Dry Eyes

Treatment for dry eyes is tailored to the underlying cause and the severity of the condition. The main goals are to replenish missing tears, prevent existing tears from evaporating, and suppress any inflammatory reaction on the eye's surface. The treatment process usually requires a step-by-step approach.

Medical Treatment Methods

The first step in treatment typically involves artificial tear drops. While liquid drops are preferred during the day, thicker gels or ointments are often used before bedtime to provide protection until morning. For patients who need to use drops more than four times a day, single-use, preservative-free vials are prescribed so that the preservatives do not harm the eye over time.

To help tears stay in the eye longer, a minor procedure to block the tear ducts with tiny silicone plugs (punctal plugs) may be performed. This ensures that the small amount of tears you produce, or the artificial tears you apply, do not immediately drain into your nasal passages but instead remain on the eye's surface. In cases of severe dryness and inflammation, cortisone drops or special prescription medications that regulate the immune system (such as cyclosporine) may be used under strict medical supervision.

Steps You Can Take at Home

In addition to medical treatment, simple home care practices can speed up the healing process. Applying a warm compress is highly effective for preventing the blockage of the meibomian glands, which are located on the edges of the eyelids and produce the oil layer of your tears. Soaking a clean cotton pad or towel in warm water and resting it on your closed eyelids for 5 to 10 minutes helps melt away hardened oil secretions. Afterwards, gently massaging the eyelids and cleaning the base of the eyelashes with special eye shampoos helps keep these glands functioning healthily.

Preventive Measures to Take

Making a few lifestyle changes during the winter can greatly prevent dryness from occurring. The necessary precautions cover both indoor and outdoor conditions:

• Humidify Indoor Spaces: Use humidifiers to keep the moisture level in your home and office around 45-50%, or simply place bowls of water on top of your radiators.
• Limit Screen Time: Follow the 20-20-20 rule when working on a computer, phone, or tablet. Every 20 minutes, rest your eyes by looking at something 20 feet (about 6 metres) away for 20 seconds, and make a conscious effort to blink frequently.
• Wear Protective Eyewear: When stepping outside in the winter, wear wide-framed sunglasses or protective glasses to stop the wind from directly hitting the surface of your eyes.
• Drink Plenty of Water: Your body's overall hydration directly affects tear production. Even if you don't feel as thirsty in cold weather, make sure to drink at least 2 to 2.5 litres of water a day.
• Watch Your Diet: Consuming foods rich in Omega-3 fatty acids, such as salmon, walnuts, and flaxseed, improves the quality of the oil layer in your tears.

Complications and Risk Groups

Severe dry eye, if left untreated, can pave the way for permanent damage to the eye's surface. A cornea that is not adequately lubricated becomes vulnerable to scratches and infections. In advanced cases, corneal ulcers, vision loss, and permanent scarring can develop.

Some people are more vulnerable to dry eyes during the winter. The risk is naturally higher in older adults because tear production naturally decreases with age. Contact lens wearers, those who have undergone laser eye surgery (LASIK), individuals with autoimmune diseases like rheumatoid arthritis or Sjögren's syndrome, and people taking blood pressure medications, antidepressants, or antihistamines are among the risk groups who feel these symptoms most intensely during this season.

When to See a Doctor

Although dry eye is usually a mild condition, certain symptoms can be a sign of a more serious eye problem. If your complaints do not resolve within a few days despite using artificial tears and humidifying your environment, you should consult an ophthalmologist.

If you experience any of the following warning signs, you should visit a healthcare facility without delay:

• Sudden, severe, and throbbing pain in the eye
• A sudden drop in visual clarity or double vision
• Thick, purulent discharge from the eye that is yellow or green
• Extreme sensitivity to light to the point where you cannot keep your eyes open
• Chemical exposure to the eye or a physical blow to the eye (In these situations, call the 112 Emergency Call Centre immediately or go to the nearest emergency department).

The Process at BHT CLINIC İstanbul Tema Hastanesi

At the Ophthalmology Department of BHT CLINIC İstanbul Tema Hastanesi, we offer comprehensive diagnostic and treatment services for dry eye complaints, which tend to peak during the winter months. Our specialist physicians measure your tear quality using the latest medical equipment to create the most appropriate treatment plan for you.

Not every pain felt around the eyes and head during winter is directly related to the eyes. Pain radiating to the forehead and behind the eyes can often be a symptom of sinusitis, which is frequently triggered in cold weather. In such complex cases, a multidisciplinary evaluation is carried out in collaboration with our hospital's Ear, Nose and Throat (ENT) department. If you would like to learn more about the relationship between headaches and eye health, you can read our article titled Not Every Headache is Stress: Your Eyes Might Be Sending a Signal!.

To avoid risking your eye health and to ensure a comfortable winter, you can rely on the support of our expert team. You can book an appointment for a detailed examination and treatment planning, or visit our 24/7 emergency department for urgent situations.

Frequently Asked Questions

Why do eyes water in cold weather?

In cold and windy weather, the surface of the eye dries out quickly. When the brain detects this dryness, it reflexively produces a large amount of tears to protect the eye. However, because these tears lack high-quality oils, they cannot stay on the eye and end up rolling down the cheeks.

Should I wear sunglasses in winter?

Yes, wearing sunglasses in winter is highly beneficial. Sunglasses not only protect against UV rays but also block cold winds from directly hitting the eye, preventing tear evaporation and dryness.

Does dry eye cause permanent blindness?

Simple dry eye does not directly lead to blindness. However, in very severe cases that are left untreated for a long time, the cornea can become damaged and infected, which may pave the way for permanent vision loss.

How do indoor heaters affect the eyes?

Heaters such as radiators, electric stoves, or air conditioners consume the moisture in indoor air. Dry air causes the moisture on the eye's surface to evaporate rapidly, initiating dryness complaints like stinging, burning, and redness.

Are artificial tear drops addictive?

Artificial tear drops do not cause habituation or addiction in the eyes. They are designed to replenish missing moisture. As long as they are needed, they can be safely used at the dose and frequency recommended by your doctor.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.