Dry eyes during pregnancy: Symptoms, causes, treatments

Note: This article is for educational purposes only and is not a substitute for medical care from your OB-GYN, midwife, optometrist, or ophthalmologist.

Pregnancy is a master of plot twists. One week it is cravings, the next week it is heartburn, and somewhere in the middle your eyes decide they would like to feel like two tiny deserts. Charming.

If you have noticed burning, stinging, blurry vision, or that annoying “there is definitely an invisible eyelash in my eye” sensation, dry eyes during pregnancy may be the culprit. It is not the most glamorous pregnancy symptom, but it is a real one. Hormonal shifts can affect tear production and tear quality, which means your eyes may not stay as comfortable and well-lubricated as usual.

The good news is that pregnancy dry eye is often manageable. The less-fun news is that not every eye symptom in pregnancy should be brushed off as simple dryness. Knowing what is normal, what might help, and when to call a doctor can make a big difference.

Can pregnancy really cause dry eyes?

Yes. Dry eyes during pregnancy are a real thing, not a dramatic performance staged by your eyeballs. Pregnancy changes hormone levels, and those shifts can affect the lacrimal glands that help produce tears, as well as the overall tear film that protects the surface of the eye. When the tear film becomes unstable, the result can be irritation, inflammation, blurred vision, and that classic gritty feeling.

Pregnancy can also make contact lenses feel less comfortable, which is especially rude if you already have enough on your plate. Some people notice symptoms only occasionally, while others feel them most days, especially in dry air, while staring at screens, or after a long day of trying to function like a superhero on three hours of sleep.

Dry eye symptoms during pregnancy

Pregnancy-related dry eye can show up in ways that are surprisingly sneaky. The symptoms are not always just “my eyes feel dry.” In fact, watery eyes can also happen because irritated eyes may reflexively produce tears that do not actually solve the underlying dryness.

Common symptoms include:

• Burning or stinging eyes
• A gritty, sandy, or scratchy feeling
• Redness
• Watery eyes that still somehow feel dry
• Blurred or fluctuating vision
• Eye fatigue, especially later in the day
• Sensitivity to light
• Stringy mucus around the eyes
• Difficulty wearing contact lenses
• A feeling like something is stuck in the eye

If that list sounds like your daily eye diary, dry eye may be part of the story.

What causes dry eyes during pregnancy?

There is rarely one single cause. Dry eye usually happens because the eyes do not make enough tears, the tears evaporate too quickly, or the tears are missing the right balance of oil, water, and mucus. Pregnancy can nudge this whole system off balance in several ways.

1. Hormonal changes

This is the headline act. Hormone shifts during pregnancy can interfere with tear production and tear film stability. That is one reason dry eye is more common in women during times of hormonal change, including pregnancy.

2. Changes in the oily layer of tears

Your tear film has layers, and the outer oily layer helps keep tears from evaporating too quickly. If the oil-producing meibomian glands are not working well, tears can disappear faster than you can say, “Why do my eyes hate this air conditioner?”

3. Contact lens intolerance

If your contact lenses suddenly feel like tiny plastic pancakes, you are not imagining it. Pregnancy can make lenses less comfortable, especially if your eyes are already dry or irritated.

4. Screen time and reduced blinking

Looking at a laptop, phone, or tablet for long stretches lowers how often you blink. Less blinking means tears spread less evenly, which can make dryness worse. Translation: your inbox and your eyes may be teaming up against you.

5. Dry environments

Air conditioning, fans, low humidity, heaters, wind, and airplane cabins can all increase tear evaporation. Pregnancy does not cause these things, unfortunately, but it can make you more sensitive to them.

6. Medications and other health conditions

Some medicines can reduce tear production, including antihistamines, decongestants, antidepressants, and certain hormone-related medications. Dry eye can also be linked with allergies, blepharitis, thyroid disease, autoimmune conditions such as Sjögren’s syndrome, and vitamin deficiencies.

7. Smoke and irritation

Cigarette smoke and secondhand smoke can irritate the eyes and worsen dryness. The same goes for dusty rooms, strong fumes, and that one coworker who thinks every space should feel like the Sahara with a box fan.

How dry eye is diagnosed

If symptoms hang around, an eye doctor can help figure out whether it is truly dry eye, a contact lens problem, blepharitis, allergy, infection, or something more serious.

A dry eye evaluation may include:

• A review of your symptoms, medications, and pregnancy history
• A routine eye exam
• A slit-lamp exam to look at the surface of the eye
• Schirmer testing to measure tear production
• Tear breakup time testing to see how quickly tears evaporate
• Fluorescein or other dye testing to look for surface irritation
• Tear osmolarity testing in some cases
• Additional workup if an autoimmune condition or another medical issue is suspected

This matters because not every red or blurry eye is simple dryness. Pregnancy can overlap with other eye concerns, and getting the right diagnosis is half the battle.

Treatments for dry eyes during pregnancy

Treatment usually starts with the least invasive options and moves up only if symptoms keep crashing the party. Because you are pregnant, it is smart to review all eye products, even over-the-counter ones, with your prenatal clinician or eye doctor before using them regularly.

Artificial tears

Lubricating eye drops are often the first thing people try. They can add moisture and relieve that scratchy, irritated feeling. If you need drops frequently throughout the day, preservative-free artificial tears are often preferred because preservatives can irritate the eye surface when used often.

Skip “redness relief” drops unless your clinician tells you otherwise. These products can constrict blood vessels and may not address the actual problem.

Warm compresses

Warm compresses can help if clogged oil glands are part of the issue. A warm washcloth over closed eyelids for several minutes can encourage the meibomian glands to release oil more effectively. Some clinicians also recommend gentle eyelid massage afterward.

Eyelid hygiene

If you have crusting at the lash line, blepharitis, or irritated lids, lid hygiene can help. Cleaning the eyelid margins gently may improve the quality of the tear film over time.

Give your contacts a timeout

If contacts suddenly feel awful, reduce wearing time or switch to glasses temporarily. Pregnancy is not always the best season for forcing your eyes to “power through.” They will not be impressed, and neither will you.

Change the environment

• Use a humidifier
• Avoid direct air from fans, vents, heaters, and hair dryers
• Wear wraparound sunglasses outdoors
• Take regular screen breaks
• Position your screen slightly below eye level
• Blink on purpose during long reading or computer sessions
• Avoid smoke exposure

These steps sound simple, but simple is underrated when it actually works.

Nighttime support

If your eyes feel worse when you wake up, your doctor may suggest lubricating gel or ointment at night. Some people sleep with their eyes slightly open or have more tear evaporation overnight, which can make mornings feel especially rough.

Hydration and nutrition

Staying hydrated is good for overall health, and dehydration can make eyes feel worse. That said, drinking extra water is not a magic cure for most dry eye. Nutrition matters too. Diets low in vitamin A or omega-3 fatty acids may contribute to dryness in some cases. Focus on a well-rounded pregnancy-safe diet, and ask your prenatal clinician before starting any new supplement.

Prescription treatment or office procedures

If basic measures are not enough, an eye specialist may consider prescription eye drops or procedures such as punctal plugs, which help keep tears on the surface of the eye longer. In more stubborn cases, some people benefit from scleral lenses or treatment aimed at blocked oil glands.

The key point during pregnancy is this: do not self-prescribe medicated drops just because they are sold online or because your cousin’s neighbor’s yoga instructor swears by them. Pregnancy is a good time for professional guidance, not eye-drop roulette.

What to avoid

• Using old, expired, or recalled eye drops
• Touching the tip of the bottle to your eye, skin, or hands
• Wearing contacts too long, overnight, or past their replacement schedule
• Rubbing your eyes aggressively
• Ignoring ongoing pain, light sensitivity, or vision changes
• Assuming every blurry episode in pregnancy is “just dry eye”

Also, stop using eye drops and get medical advice if you develop discharge, worsening pain, or changes in vision. That is not the time to shrug and keep scrolling.

When to call a doctor right away

Dry eye can be annoying, but some eye symptoms in pregnancy need prompt medical attention. Call your healthcare provider or seek urgent care if you have:

• Sudden or severe blurred vision
• Flashes of light, new floaters, or a curtain-like shadow over vision
• Severe headache along with vision changes
• Eye pain that is significant or getting worse
• Marked light sensitivity
• Thick discharge or signs of infection
• Swelling of the face or hands with vision changes
• Symptoms after 20 weeks of pregnancy that raise concern for preeclampsia

That last point matters. Pregnancy-related vision changes can sometimes be a warning sign of preeclampsia or other serious conditions. Dry eye is common, but it should not become a catch-all excuse for every visual symptom.

Will dry eyes go away after pregnancy?

Often, yes. For many people, eye irritation and temporary vision changes improve after delivery as hormones settle. But “often” is not the same as “always.” If symptoms persist postpartum, especially if you are using screens constantly, sleeping very little, wearing contacts again, or dealing with an underlying eye condition, dry eye can stick around and deserves follow-up.

In other words, do not assume your eyes will automatically send a handwritten apology after the baby arrives.

Frequently asked questions

Can dry eye cause watery eyes?

Yes. Irritated eyes may produce reflex tears, which can make your eyes water even when the underlying problem is dryness.

Does drinking more water fix dry eye?

It can help if dehydration is part of the problem, but it usually does not solve dry eye by itself.

Can I still wear contacts during pregnancy?

Maybe, but you may need to wear them for shorter periods or switch to glasses if they become uncomfortable. Pregnancy can make contact lenses feel less tolerable.

Are all eye drops okay during pregnancy?

No. Even over-the-counter products should be chosen carefully. Ask your prenatal clinician or eye doctor before using medicated drops, redness-relief drops, or any product regularly.

Experiences related to dry eyes during pregnancy

One of the trickiest parts of dry eyes during pregnancy is that the experience is rarely dramatic enough to feel urgent, but it can still be miserable enough to make every normal task more annoying. Reading a recipe, answering emails, driving at dusk, or trying to binge one more episode of something comforting can suddenly feel like a challenge because your eyes burn, blur, or tire out faster than usual.

Many pregnant people describe the sensation the same way: it feels like there is sand in the eyes, except there is no beach nearby and certainly no vacation involved. Some notice the discomfort mostly in the morning, especially if they sleep with air blowing across the bed. Others feel it later in the day, after hours of staring at a computer screen and blinking roughly twice an hour like an overcommitted lizard.

Another common experience is confusion. Your eyes may water constantly, which makes it seem like dryness cannot possibly be the issue. But reflex tearing is common with dry eye. The tears show up in an emergency, do a poor job, and leave the scene. That can be frustrating when you feel both watery and dry at the same time, which sounds medically impossible but is absolutely a thing.

Contact lens wearers often have their own version of the saga. Lenses that were totally fine before pregnancy may start feeling scratchy, filmy, or strangely impossible to tolerate by lunchtime. Some people find themselves switching to glasses for a few weeks or months, not because they want a new aesthetic, but because their eyes have filed an official complaint.

There is also the emotional side. Pregnancy already comes with a parade of bodily surprises, and eye discomfort can feel like one symptom too many. It is hard to feel patient when your vision gets blurry during work, your eyes sting while reading messages from friends, or you find yourself carrying eye drops the way other people carry lip balm. Even mild symptoms can chip away at your comfort and concentration.

On the brighter side, many people also report that small adjustments help more than expected. A humidifier near the bed, shorter contact lens wear, regular screen breaks, preservative-free artificial tears, and warm compresses can sometimes turn a rough day into a manageable one. For others, getting properly evaluated by an eye doctor is the moment things start improving, because what seemed like “just pregnancy stuff” turns out to be dry eye plus eyelid inflammation or another treatable issue.

Perhaps the most important real-world experience is this: pregnant people often feel pressure to tough out symptoms that seem minor. But persistent dry eye deserves attention, especially if it affects daily life. And if vision changes come with headache, swelling, pain, or sudden worsening, that is not being dramatic. That is being appropriately cautious. Pregnancy asks your body to do a lot. You are allowed to take your eye symptoms seriously, too.

Conclusion

Dry eyes during pregnancy can be uncomfortable, distracting, and surprisingly disruptive, but they are usually manageable once you understand what is going on. Hormonal changes can affect the tear film, everyday habits like screen use can pile on, and contact lenses may become less friendly than usual. The smartest approach is simple: use practical relief strategies, choose eye drops carefully, and do not ignore symptoms that are persistent, painful, or paired with sudden vision changes.

Your pregnancy may already feel like a full-time job with overtime. Your eyes do not need to make it weird. A little moisture, a little caution, and a little expert help when needed can go a long way.