Dry Eye vs. Eye Infection: How to Tell the Difference 

Table of Contents

Dry Eye vs. Eye Infection: How to Tell the Difference

Introduction

When your eyes seem to be getting red, they feel irritated, and are very uncomfortable, you wonder what could be causing this. You wonder if it could be dry eye, possibly some kind of infection, or maybe something completely different. This is a very common issue and easily gotten wrong unless you have the correct information. Although both of these conditions cause very similar symptoms, there are different causes for each of them, and for that reason, they each need to be treated differently. If you are approaching them in the wrong way, your recovery might be delayed. With some patients, the wrong treatment can make the problem even worse. Here, in this blog, we’ll explain the main differences between dry eye and an eye infection so that you will know what to be on the lookout for, and when it would be a good time to contact Golden Vision for an appointment.

What Are Dry Eyes and Eye Infections, and Why Do They Often Get Confused?

Dry Eye and eye infection are completely different conditions. However, there are enough similarities in their symptoms that it is understandable why people mistake one of them for the other. Dry eye is a condition in which your eyes aren’t producing a sufficient amount of tears. Or, if the tears that they do produce are of such poor quality that they can’t keep your eyes as well lubricated as they should. An eye infection, however, is caused by bacteria, viruses, or other pathogens entering part of your eye or its surrounding tissue.

The two conditions are confusing to most people because each one can cause redness, irritation and the feeling that something just doesn’t seem normal. Unless you know what to be on the lookout for, you might reach for some over-the-counter eye drops, hoping that they will clear up this issue. However, if you treat an infection as though it is dry eye, or vice versa, it can not only delay getting relief, but with some people, it can make the problem even worse.

What Does Dry Eye Actually Feel Like?

People generally think of dry eye as a constant, low-grade type of discomfort, and not a sudden or very severe pain. It generally develops gradually and gets worse as the day progresses, particularly after looking at your electronic screens for a long time, reading, or being in areas that are dry or windy. Did you know that in some cases, watery eyes are actually a sign that you could have dry eye. This is because when the surface of your eye becomes too dry, it causes a reflexive action of producing too many tears.

Common dry eye symptoms include:

  • A scratchy, gritty or sandy feeling that you have something in your eye.
  • That burning, stinging feeling that gets worse in dry, windy, or air-conditioned areas.
  • Blurred vision that gets better for a short period of time after you blink
  • A lot of teary or watery eyes, which is a reflexive response
  • Eyes feeling tired or heavy, mainly after looking at screens or even reading.
  • Being sensitive to light
  • An uncomfortable feeling when wearing your contacts

If your symptoms worsen in certain situations, such as spending a long time looking at your computer screen or after a long flight, dry eye is most likely the problem. However, with the right treatment plan, your dry eye can be managed very easily

What Are the Warning Signs of an Eye Infection?

An eye infection makes a more sudden appearance than dry eye and generally presents with more symptoms than just feeling uncomfortable. One of the most common kinds of eye infection is conjunctivitis (pink eye), but there can also be infections that affect the cornea, eyelids, or even other eye structures. If you are aware of the type and timing of symptoms, you will be more aware that your symptoms are caused by an infection.

Warning signs of an eye infection include:

  • White of the eye looks pink or red
  • Yellow, green, or white discharge that forms a crust on your eyelashes, mainly after sleeping.
  • A great deal of eyelid swelling or its surrounding tissue
  • More light sensitivity (photophobia)
  • A feeling of real pain, not simply an uncomfortable feeling in the eye, or around it.
  • Symptoms that get worse very quickly as the day progresses
  • Your symptoms are only in one eye (although an infection can spread to both eyes)

An eye infection is different from an infection because infections don’t get better on their own unless you receive specific treatment. If your symptoms include discharge, obvious swelling or even pain in your eye, having your eyes checked immediately is key to prevent more serious complications.

Which Symptoms Overlap Between the Two Conditions?

Dry eye and eye infections can each cause redness, irritation, sensitivity to light, and an overall feeling of eye discomfort. This is why many people find it difficult to tell them apart. Eyes that get watery or tear up a lot are another symptom that each condition shares because both of these conditions can cause a reflexive teary response. In both of these cases, even vision that has gotten mildly blurry makes self-diagnosis pretty difficult.

The important point is to be sure to look at the complete issue, instead of focusing on any one of the troublesome symptoms. If you’re experiencing discharge, swelling and eye pain, it’s more likely that you have an infection. However, if these symptoms show up because of environmental triggers or excessive screen time, it is more likely that dry eye is the culprit. When you are unsure, it is always safest to get professionally evaluated because getting the wrong treatment (like using eye drops in an infected eye) might do more harm than good.

What Causes Dry Eye vs. What Causes an Eye Infection?

Although the outward symptoms of the two conditions seem very similar, their root causes are very different.

Dry eye is typically caused by:

  • Getting older, mainly in those over 50
  • Changes in hormones, particularly during menopause
  • Looking at screens for a long time that lowers the blink rate
  • Antihistamines, antidepressants, and drugs for controlling blood pressure
  • Exposure to dry climates, wind, or air-conditioned environments
  • Those who wear contact lenses
  • Sjogren’s Syndrome or even rheumatoid arthritis which are autoimmune conditions
  • Other eye surgeries you’ve had including LASIK

Eye infections are typically caused by:

  • Many bacteria, (particularly Staphylococcus or the Streptococcus species)
  • Certain viruses like adenovirus and herpes simplex
  • fungi, or parasites that are not as common, but are more serious
  • Being in close contact with a person who is already infected, or with a contaminated surface
  • Poor cleanliness of contact lenses, or wearing them too much
  • Your immune system has become weakened

Having a good understanding of the root causes of each is important because it affects your treatment and the way you approach it. You can manage dry eye by making a few adjustments to your lifestyle and continuing eye care. Infections, on the other hand, need prescription medications to be completely resolved.

Can You Have Both at the Same Time?

Yes, having both simultaneously is much more common than people think. If you have chronic dry eye, it can raise your risk of getting an eye infection. When the tear film is not sufficiently adequate, the eye’s natural defenses become compromised. This makes it easier for bacteria and other pathogens to gain traction. Those wearing contacts are especially susceptible.

If both of these conditions appear at the same time, it can be more difficult to interpret them as treatment becomes more exacting. Here’s a good example – some treatments for dry eye might need adjustment in case there is already an infection. For this reason, it is important to get the correct diagnosis from your eye care professional rather than treating it by yourself. Your eye doctor will know if one of these conditions is affecting the other and will tailor a plan for you that will address both.

What Are the Treatment Options for Dry Eye vs. Eye Infection?

The treatments are different. It depends on which condition is affecting you. For this reason, getting an accurate diagnosis is key.

Dry eye treatments may include:

  • Over-the-counter or even prescription medications like artificial tears or lubricating eye drops
  • Anti-inflammatory prescription eye drops like cyclosporine (Restasis) or Lifitegrast (Xiidra)
  • Use of a warm compress and good lid hygiene to deal with meibomian gland dysfunction
  • A good supplement like Omega-3 fatty acid
  • Reduction of tear drainage with punctal plugs
  • Certain in-office treatments like LipiFlow or an intense pulsed light (IPL) therapy
  • Getting adjustments made to medications that might be adding to the dryness

Eye infection treatments may include:

  • Use of antibiotic eye drops or ointments for infections that are of a bacterial nature.
  • Using antiviral medications for a viral infection like herpes-related conjunctivitis
  • Use of antifungal treatments when the infections are fungi-related
  • Use of cold compresses and getting supporting care when mild viral conjunctivitis is the cause
  • Stop using contact lenses until the infection has completely cleared up
  • In cases that are more severe, the use of oral medicines or keeping a watchful eye in order to prevent damage to your eyesight

In most cases, over-the-counter eyedrops by themselves are hardly ever sufficient to clear up an eye infection. The very best way to recover as fast as possible and avoid spreading the infection to others if you think you might have an eye infection, is to get the correct prescription treatment as soon as you can.

When Should You Schedule an Appointment at Golden Vision for Dry Eye or an Eye Infection?

It is always prudent to get your eyes checked sooner instead of later when it comes to caring for your eyes. It is important to schedule your appointment at Golden Vision if you notice certain symptoms such as redness, irritated eyes or prolonged discomfort. Other symptoms such as discharge, crusting or swelling around the eye area or even pain or suddenly becoming sensitive to light also warrant making a Golden Vision appointment.

At Golden Vision, our experienced team will be able to determine precisely what is happening with your eyes and can recommend a personally tailored treatment plan. When it comes to your vision, don’t guess. Book your appointment today so that you will get the answers you need.

FAQs

Yes, dry eye that is chronic can increase the risk that you will develop an eye infection. When there is insufficient tear film, the eye’s natural defensive barrier is weakened, which makes it easier for bacteria and other pathogens to take hold. This is particularly true for those wearing contact lenses as they are already facing a greater risk of developing an infection. By managing your dry eye symptoms proactively, you will have one of the best ways to keep your general eye health protected.
Although it is true that over-the-counter lubricating eye drops can indeed soothe your irritated eyes for a short period of time, they cannot treat an infection that has become active. Bacterial infections need to be treated with antibiotic eye drops. Viral or fungal infections need to be treated with other specific prescription medications. If you use the wrong drops, you will be masking the symptoms without dealing with the actual causes. This gives the infection the opportunity to become worse. If you feel you might have an infection, don’t just take any old medication off the shelf, but do yourself a huge favor and make the appointment to see your eye doctor right away.
Generally, dry eye is a chronic condition and not something that goes away by itself after a short period. When they are treated consistently, most people can see an improvement in a few weeks to a few months. It depends upon how severe the problem is, as well as the root cause. With some people, mainly those who are too old or have autoimmune conditions, they need an ongoing management plan and not just a one-time fix. Your eye doctor will be able to help you create that long-term plan to keep your symptoms under control.
Pink eye, also known as conjunctivitis, is the term that describes the redness and inflammation of the conjunctiva. It doesn’t necessarily mean that you have an infection. It can be caused by bacteria, viruses, allergens, or even dry eye and chemical irritants. You might have allergic conjunctivitis which is quite common. It has no relationship to an infectious pathogen. It is very important to get the proper diagnosis because every kind of conjunctivitis needs a different manner of treatment.
An eye infection is not usually an emergency. Certain symptoms, however, require urgent care immediately. Some symptoms like sudden, very severe eye pain, significant loss of vision, extreme light sensitivity, or even a cloudy appearance on the cornea, are all symptoms that point to more serious conditions like corneal ulcers or severe bacterial infections that threaten your eyesight if they aren’t treated promptly. If you have any of these symptoms, be sure to get care from your eye doctor or your urgent care facility as soon as you possibly can.

Medically Reviewed by Our Content Review Committee

This article has been reviewed for accuracy by the licensed optometrists at Golden Vision, including
Timothy Fries, OD, Stephanie Tsang, OD, and Eric Leung, OD. To learn more about our editorial standards and review process, visit our Content Review Committee page.