Can Stress Cause Dry Eyes? The Cortisol Connection

Stress can affect far more than your mood. It influences many systems and organs in the body, including your eyes. When stress is ongoing, cortisol levels can stay higher than normal, affecting inflammation, tear production, blinking, and overall comfort¹. For people already prone to eye dryness, stressful periods can often make symptoms worse.

This article explains how stress interacts with the tear film, why symptoms arise, and what you can do to support your eyes.

Understanding Cortisol and Your Eyes

Cortisol is one of the body’s main stress hormones. It helps coordinate the “fight or flight” response by:

• Raising blood sugar to fuel muscles
• Adjusting blood pressure and heart rate
• Modifying how the immune system responds

In small doses, this response is protective. The challenge comes when stress becomes chronic. When cortisol stays elevated over time, it can contribute to low-grade inflammation in many tissues, including the ocular surface.¹

At the same time, stress affects the autonomic nervous system⁶, which helps regulate tear production, blinking, and oil secretion from the meibomian glands. All of these are key for a stable, comfortable tear film.

How Stress Contributes to Dry Eye Symptoms 

Research shows links between dry eye disease and stress, anxiety, and depression^2,3. Stress is not always the cause of dry eye disease alone, but it can be a major contributor. 

How stress affects eye comfort: 

• Inflammation increases¹
• Nerve sensitivity increases⁶
• Behavior shifts such as poor sleep, increased screen use, and dehydration from drinking less water can occur. 
• Blink rate⁴, especially with screen time

Can Stress and Anxiety Cause Dry Eyes? 

Several studies have found links between dry eye disease and higher levels of psychological stress³, anxiety, and depression. People with dry eye report more symptoms of anxiety and depressed mood than those without dry eye, and higher stress scores often correlate with more severe eye discomfort. 

Recent findings suggest that the relationship goes both ways: 

• Stress and anxiety may increase the risk of developing dry eye or worsening existing symptoms 

• Chronic dry eye discomfort can worsen stress, anxiety, and quality of life 

So while stress is rarely the only cause of dry eye disease, it can absolutely be a contributing factor. 

What Stress Related Eye Dryness Feels Like 

Stress and anxiety can affect the eyes in many ways. Some common symptoms that may overlap with dry eye disease include: 

• Burning, stinging, or gritty sensation 

• Tired or “heavy” eyes, especially late in the day 

• Blurred vision, particularly during screen use  

• Watery eyes that paradoxically still feel dry 

• Sensitivity to light 

• Eye twitching⁷ (eyelid myokymia) 

• A feeling of “pressure” or fullness behind the eyes 

• Headaches 

The Stress–Dry Eye Cycle:  A Feedback Loop 

Stress and dry eye often reinforce one another. Stress rises, blinking decreases, tear evaporation increases, discomfort worsens, and quality of life can lower. This cycle can repeat as a feedback loop without proper care and symptom management^2,3 

Lifestyle risk factors can have an impact on stress and dry eye.  

Tears, Hormones, and Stress 

Tears released during emotional times contain stress-related substances including cortisol⁵.  Crying may soothe dryness temporarily by coating the ocular surface and providing emotional release, but can also result in red, stinging, dry irritation after. 

Hormonal shifts that accompany menstrual cycles, pregnancy, postpartum, or menopause may affect tear production and meibomian gland function¹⁰. 

Kids and teens can also experience eye dryness from screens and school-related stress. 

How To Support Your Eyes When You’re Stressed 

• Improve digital habits at work and at home. Prolonged screen time has been shown to reduce blink rate by almost half.⁴  

• Use preservative-free eye drops for dry eyes. Lubricating artificial tears help stabilize the tear film to help manage discomforting symptoms. Evaporative dry eye or MGD sufferers can benefit from 
  eye drops specifically formulated for more severe and chronic conditions. 

• Warm compress therapy with an eye mask for dry eyes helps soften oils in the meibomian glands.  

• Maintain eyelid hygiene by integrating eyelid wipes into your daily routine.   

• Support nutrition, hydration, and sleep. Eating healthy foods and including 0mega-3 for dry eyes benefit tear production⁸:  Good sleep hygiene has an impact on overall eye health.⁹   

• Address the physical effects of stress directly. Breathing, movement breaks, exercise, and mindful pauses can help. Be aware of how chronic stress and dry eye symptoms can impact your mental health. 

When To See An Eye Care Professional

If symptoms become persistent or interfere with daily tasks, an eye care professional can evaluate tear stability, gland health, and lifestyle contributors.  Prepare questions to ask your eye doctor about dry eye in advance.
 

If you notice sudden flashes of light, a sudden increase in floaters, a dark curtain in your vision, eye pain, or a significant change in vision, consider it urgent and seek immediate medical attention. These symptoms can signal a condition that is far more serious than stress.