What can be the causes for dry eye despite artificial tears?

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I understand your concern.

Dry eye disease is common when your tears cannot provide adequate lubrication for your eyes. Tears can be inadequate and unstable for many reasons. For example, dry eyes may only happen if you produce enough or good-quality tears. This tear instability leads to inflammation and damage to the eye's surface. Dry eyes feel uncomfortable. If you have dry eyes, your eyes may sting or burn. You may experience dry eyes in certain situations, such as on an airplane, in an air-conditioned room, while riding a bike, or after looking at a computer screen for a few hours. Treatments for dry eyes may make you more comfortable. These treatments can include lifestyle changes and eye drops. You will likely need to take these measures indefinitely to control the symptoms of dry eyes.

Causes:

1. Dry eyes are caused by various reasons that disrupt the healthy tear film. Your tear film has three layers: fatty oils, aqueous fluid, and mucus. This combination usually keeps the surface of your eyes lubricated, smooth, and straightforward. Problems with any of these layers can cause dry eyes.
2. There are many reasons for tear film dysfunction, including hormone changes, autoimmune disease, inflamed eyelid glands, or allergic eye disease. For some people, the cause of dry eyes is decreased tear production or increased tear evaporation.

Complications:

1. Eye infections. Your tears protect the surface of your eyes from disease. Without adequate tears, you may have an increased risk of eye infection.
2. Damage to the surface of your eyes. If left untreated, severe dry eyes may lead to inflammation, abrasion of the corneal surface, corneal ulcers, and vision loss.
3. Decreased quality of life. Dry eyes can make it difficult to perform everyday activities like reading.

Prevention:

1. If you experience dry eyes, pay attention to the situations most likely to cause your symptoms. Then, find ways to avoid those situations to prevent dry eye symptoms. Avoid air blowing in your eyes. Do not direct hair dryers, car heaters, air conditioners, or fans toward your eyes.
2. Add moisture to the air. In winter, a humidifier can add moisture to dry indoor air.
3. Consider wearing wraparound sunglasses or other protective eyewear. Safety shields can be added to the tops and sides of eyeglasses to block wind and dry air. Ask about shields.
4. Take eye breaks during long tasks. Take periodic eye breaks if reading or doing another job requiring visual concentration.
5. Close your eyes for a few minutes. Blink repeatedly for a few seconds to help spread your tears evenly over your eyes.
6. Be aware of your environment. Air at high altitudes, desert areas, and airplanes can be arid. When spending time in such an environment, it may be helpful to frequently close your eyes for a few minutes to minimize evaporation of your tears.
7. Position your computer screen below eye level. If your computer screen is above eye level, you will open your eyes wider to view the screen. Position your computer screen below eye level so you would not open your eyes as wide. This may help slow the evaporation of your tears between eye blinks.
8. Stop smoking and avoid smoke. If you smoke, ask your healthcare provider for help devising a quit-smoking strategy that is most likely to work for you. If you do not smoke, stay away from people who do. Smoke can worsen dry eye symptoms.
9. Use artificial tears regularly. If you have chronic dry eyes, use eye drops even when your eyes feel fine to keep them well-lubricated.

I hope this information will help you. Kindly follow up if you have more doubts.

Thanks.