What it is
Dry eye is a condition in which the eyes don't have enough healthy tears, or the tears don't stay on the surface of the eye well enough. When it is described as severe, symptoms are often more persistent and may affect comfort, vision, or daily life.
Eye doctors sometimes group this under dry eye disease or ocular surface disease, because the tear film, eyelids, glands, and the surface of the eye all work together. A problem in one area can affect the others.
Severe dry eye can be linked to many things, including eyelid gland problems, autoimmune conditions such as Sjögren's, certain medications, past eye surgery, or environment. Only a licensed eye doctor can determine what is going on in a particular person's eyes.
How it’s traditionally been approached
Dry eye care has traditionally started with a careful evaluation of the eyes, followed by approaches aimed at supporting the tear film and the ocular surface. These have often included over-the-counter artificial tears, lid hygiene, and changes to environment or screen habits.
When symptoms are more significant, eye doctors have also used prescription eye drops, in-office procedures, and options that help tears stay on the eye longer. Which of these is considered depends entirely on an individual evaluation.
For some people with severe or hard-to-manage dry eye, clinicians have also discussed specialty options such as autologous serum tears, which are compounded by a pharmacy from the patient's own blood and are not an FDA-approved drug. Amniotic-derived eye drops and serums are, in most cases, also not FDA-approved as drugs, while some amniotic membrane devices are regulated as human tissue products, which is a different regulatory pathway. These are not stem-cell treatments, since most processed amniotic tissue products contain no living stem cells.
How the right eye doctor may help
The right eye doctor may help by examining the surface of your eyes, looking at your tear film and eyelids, and asking about your symptoms, health history, and medications. A visit often includes a conversation about what you've already tried and how dryness affects your daily life.
If an underlying condition such as an autoimmune disorder may be involved, your eye doctor may coordinate with your other healthcare providers. Only a licensed clinician can decide what is appropriate for you after an evaluation, and nothing here promises any particular result.
If a specialty product comes up, consider asking: What is this product, and where does it come from? How is it processed or prepared? What is its FDA or regulatory status? What is the total cost, and is any of it covered? What are the possible risks, and what should I watch for? You can also ask what follow-up looks like.
The whole-person view
Body, mind, and stress affect one another. Ongoing eye discomfort can make it harder to focus, sleep, or enjoy daily activities, and stress or poor rest can in turn make symptoms feel more noticeable. Looking at the whole person can be a helpful complement to eye care.
Some people find that body-based support such as Somatic Experiences helps them work with stress held in the body, and others value talk therapy through Therapists.plus when living with a long-term condition feels draining. These are complementary options, not replacements for eye care, and every approach has its place.
Keep in mind
- Severe dry eye can sometimes be connected to other health conditions, so licensed professionals should guide your care.
- Sudden eye pain, sudden vision changes, or a chemical injury to the eye is an emergency: call 911 or seek urgent care right away.
- Autologous serum tears and most amniotic-derived drops or serums are not FDA-approved drugs, so ask a licensed eye doctor about any product's source, processing, regulatory status, and total cost before use.
- If you are feeling overwhelmed or in crisis, call or text the 988 Lifeline.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Frequently asked questions
What are the severe dry eye treatment options?
Severe dry eye treatment options have traditionally ranged from artificial tears and lid care to prescription drops, in-office procedures, and specialty options chosen after an exam. Which options make sense depends on the cause and on your eyes. Only a licensed eye doctor can decide what is appropriate for you.
When is dry eye considered severe?
Dry eye is generally called severe when symptoms are persistent, significantly affect daily life, or involve changes to the surface of the eye. Only an eye doctor can assess severity through an examination. If your symptoms are not improving, an evaluation is a reasonable next step.
Are autologous serum tears FDA-approved?
No, autologous serum tears are not an FDA-approved drug. They are compounded by a pharmacy from the patient's own blood. Ask a licensed eye doctor whether they are appropriate for you and how they are prepared.
Are amniotic eye drops FDA-approved for dry eye?
Most amniotic-derived eye drops and serums are not FDA-approved as drugs. Some amniotic membrane devices are regulated as human tissue products, which is a different pathway. Ask your provider about the specific product's source, processing, regulatory status, and cost.
Are amniotic eye products stem-cell treatments?
No, they should not be described as stem-cell treatments. Most amniotic tissue products contain no living stem cells after processing. Ask your eye doctor exactly what a product contains.
Should I see a specialist for severe dry eye?
Seeing a licensed eye doctor is a good idea if dryness is ongoing or severe, and a dry eye evaluation can look at possible causes. If an autoimmune condition such as Sjögren's may be involved, your doctor may coordinate with other providers. Seek urgent care for sudden pain or vision changes.
Educational resource. Placenta-Derived Eye Serum shares general information and connects people with independent eye doctors. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.