Diabetes and Dry Eye Disease

Reviewed by: HU Medical Review Board | Last reviewed: March 2021.

Dry eye syndrome or dry eye disease is a common problem in people with diabetes. However, diabetic retinopathy and cataracts are better known diabetic complications that affect vision.

Dry eyes and type 2 diabetes

Studies show that up to half of people with type 2 diabetes have dry eye disease. Dry eyes are also more common several groups that overlap people with diabetes, including:1

  • Women
  • Those over age 65
  • People who have diabetic retinopathy
  • People who take some high blood pressure drugs and other medicines

Doctors do not fully understand how dry eyes and diabetes are connected. However, they do know that someone is at higher risk of developing dry eye disease the higher their blood glucose levels.1

Dry eyes and peripheral neuropathy

Dry eye disease is especially common in people with diabetes who also have peripheral neuropathy. Peripheral nerves are the nerves outside the brain and spinal cord. Peripheral neuropathy is a type of damage to the nerves and is a common complication of diabetes.1,3

Doctors believe peripheral neuropathy makes it harder to feel pain or discomfort on the surface of the eye, just like it makes it harder to feel foot or hand pain. This lack of feeling means the person may not feel dry eye symptoms, but damage to the eye is still happening. This may lead to eye infections, poor vision, or in the worst cases, blindness.1-3

The high blood glucose levels of diabetes may also lead to other changes in the body that lead to dry eye disease, including:1

  • Making fewer tears
  • Changes in the tear quality
  • Changes in blinking

Symptoms of dry eye

You should know the symptoms of dry eye and let your doctor know if you notice your eyes are:3

  • Red
  • Stinging, scratching, or burning
  • Sensitive to light
  • Watery
  • Have stringy mucus near the eye
  • Blurry vision


It is important to talk with your doctor if you have any symptoms of dry eye because the pain and vision changes of dry eye disease can impact your quality of life. The good news is that there are several options to treat dry eye.

Treatment for dry eye disease caused by diabetes is not much different than treatment in people without diabetes. The most common treatments are:3

  • Adding tears through over-the-counter eye drops called artificial tears
  • Tear duct plugs or surgery to close the tear ducts
  • Prescription eye drops that increase tear production
  • Ointments or eyelid cleaners that decrease inflammation around the eyes

Several other things your eye doctor may recommend include:3

  • Taking an extra omega-3 fatty acid supplement
  • Using a warm compress on the eyes
  • Massaging the lids
  • Remembering to blink more often, especially when reading or on the computer
  • Increasing the humidity in your home
  • Wearing wraparound sunglasses outside
  • Drinking plenty of water

Controlling your blood glucose levels is also important to prevent or delay long-term complications and vision loss.4

Since several different types of drugs can make dry eye symptoms worse, your doctor may change one of your prescriptions4

The overall goal of treatment for chronic dry eye is to improve or maintain the normal amount and quality of tears on the surface of the eye. This decreases dryness and the overall discomfort related to chronic dry eyes.1,4

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