Burning Eyes: Causes and Relief

Why do my eyes burn?

The surface of the eye is covered by a thin tear film made of oil, water and mucus. It keeps the cornea smooth, moist and protected. When the film breaks down, or something irritates the surface, the dense nerve endings in the cornea send burning and stinging signals. Most causes fit into three groups: not enough good-quality tears, inflammation of the eyelids or eye surface, and direct irritants or injury. For stinging after a specific exposure, see also eye burns or stings.

Common causes of burning eyes

Dry eye

Dry eye is the most common reason for burning eyes. Clues:

• burning, grittiness or a feeling of sand in the eyes
• worse later in the day, after reading or screens, and in wind, heating or air conditioning
• paradoxically, watery eyes, as the irritated eye makes reflex tears
• blurred vision that clears with blinking

Risk factors include age over 50, menopause, contact lens use, autoimmune diseases, previous LASIK, and medicines such as antihistamines, decongestants, some antidepressants and acne treatment with isotretinoin.

Blepharitis and meibomian gland dysfunction

Blepharitis is inflammation of the eyelid margins. The oil glands in the lids (meibomian glands) become blocked, so the tear film lacks oil and evaporates quickly. Eyes burn and feel gritty, especially in the morning, with red lid edges, crusts or flakes on the lashes. It is often linked with rosacea and dandruff.

Allergies

Allergic conjunctivitis mainly itches, but often burns too. Both eyes are red and watery, often with sneezing and a runny nose during pollen season or around pets.

Screen use and eye strain

When you concentrate on a screen, you blink up to half as often, and many blinks are incomplete. The tear film dries out, causing burning, tiredness and blurred vision by the end of the day.

Environmental irritants

Smoke, smog, chlorine in pools, wind, dry air, perfumes, hairspray and makeup all irritate the eye surface. Cutting onions releases a sulfur gas that stings.

Contact lenses

Wearing lenses too long, sleeping in them, poor cleaning, or a reaction to solutions can cause burning. Contact lens wearers are at higher risk of a corneal infection, which causes pain, redness and blurred vision.

Urgent causes

• Chemical burns: alkalis (cement, lime, oven and drain cleaners) are more dangerous than acids because they penetrate deeper. Immediate, prolonged rinsing is the most important treatment. See chemical burns of the eye.
• UV keratitis: a sunburn of the cornea after welding without protection, sunbeds or bright snow. Severe burning, watering and light sensitivity start several hours later.
• Keratitis and corneal ulcer: infection or inflammation of the cornea, with pain, light sensitivity and blurred vision.
• Uveitis: inflammation inside the eye causing a deep ache, redness around the colored part of the eye and light sensitivity.
• Ocular rosacea: burning, red eyes and eyelid inflammation in people with facial flushing and rosacea.

Telling the causes apart

Quick relief for burning eyes

• Rinse with clean water or sterile saline if an irritant got in your eyes.
• Use preservative-free artificial tears several times a day. Gel or ointment at night helps more severe dryness.
• Warm compresses: a clean warm cloth or heated eye mask over closed lids for 5 to 10 minutes softens blocked oil glands. Follow with gentle lid cleaning.
• Follow the 20-20-20 rule: every 20 minutes, look at something 6 meters (20 feet) away for 20 seconds, and blink fully.
• Add moisture to the air with a humidifier, and point car and desk fans away from your face.
• Wear wraparound sunglasses outdoors in wind and sun, and goggles when swimming.
• Take a break from contact lenses until the burning settles.
• Avoid "redness relief" drops, which can cause rebound redness and do not treat the cause.
• Do not rub your eyes.

Medical treatment

An eye doctor may recommend prescription anti-inflammatory drops for dry eye (such as cyclosporine or lifitegrast), short courses of steroid drops, antibiotic ointment or oral antibiotics for blepharitis and rosacea, tiny plugs to keep tears on the eye (punctal plugs), or in-office treatments that clear blocked oil glands. Allergy drops treat allergic burning.

How a doctor finds the cause

An optometrist or ophthalmologist will ask when the burning happens, about screens, lenses, medicines and general health, then examine the eyelids and eye surface with a slit lamp. They may use dye to look for dry patches or scratches, measure how fast the tear film breaks up, and test tear production. Blood tests may be suggested if an autoimmune condition such as Sjogren's syndrome is possible.

Frequently asked questions

Why do my eyes burn at night or at the end of the day?

By evening the tear film has thinned from hours of screen use and less blinking, and the eyes are tired. This is a classic sign of dry eye and eye strain. Artificial tears, screen breaks and good lighting usually help.

Can allergies make your eyes burn?

Yes. Allergies mainly cause itching, but burning, redness and watering are common too. Both eyes are usually affected, often with sneezing. Antihistamine eye drops and avoiding the trigger give the best relief.

What should I do if a chemical gets in my eye?

Rinse immediately with clean, lukewarm running water for at least 15 minutes, holding the eyelids open. Remove contact lenses if possible. Then go to the ER or call 911. Do not wait for symptoms to settle, especially with alkali products like cement or drain cleaner.

Are burning eyes a sign of something serious?

Usually not. Most burning is from dry eye, blepharitis or irritants. It is more serious if it comes with pain, light sensitivity, blurred vision, a chemical splash, or a red painful eye in a contact lens wearer. These need prompt assessment.

Why do my eyes burn and water at the same time?

Irritation of the eye surface triggers reflex tears. These watery tears lack the oil and mucus that keep tears on the eye, so they run off without fixing the dryness. Treating the dry eye or blepharitis usually reduces the watering too.