Could better understanding your gut help explain persistent dry eye? A growing body of research suggests that the microorganisms living in the digestive system may influence the health and comfort of the eyes.
This emerging relationship is known as the gut–eye connection, or gut–eye axis. Scientists are discovering that the gut microbiome may affect immune regulation, inflammation, and the stability of the ocular surface.
Dry eye remains a multifactorial condition, but the gut microbiome may be an important part of the wider picture—particularly for people with autoimmune disease, chronic inflammation, or recurring symptoms.

 

What is dry eye disease?

Dry eye develops when the tear film or ocular surface loses its normal balance. The eyes may not produce enough tears, tears may evaporate too quickly, or the tear film may not provide adequate protection and lubrication.
Common symptoms include:

• Burning, stinging, or a gritty sensation
• Redness and irritation
• Sensitivity to light
• Watery eyes
• Blurred or fluctuating vision
• Difficulty wearing contact lenses

Dry eye may be associated with aging, prolonged screen use, contact lenses, dry environments, certain medicines, eyelid conditions, autoimmune disease, or meibomian gland dysfunction.
Because several factors may contribute at the same time, identifying the individual causes is important for effective treatment.
 
 

What is the gut microbiome?

The gut microbiome is the community of bacteria, fungi, viruses, and other microorganisms living mainly in the intestines.
These microorganisms support much more than digestion. They help maintain the intestinal barrier, produce beneficial compounds, communicate with immune cells, and influence inflammatory responses throughout the body.
When the balance or function of this microbial community changes, it is often described as gut dysbiosis. Research increasingly suggests that these changes may have effects beyond the digestive system, potentially including the ocular surface.

 

How may the gut influence the eyes?

The gut–eye axis involves communication among gut microorganisms, microbial metabolites, immune cells, and inflammatory pathways.
The surface of the eye depends on a stable tear film and carefully regulated immune activity. Changes in the gut microbiome may influence immune signals that travel through the body and affect inflammation at the ocular surface.
Studies have found differences in the gut microbiome of some people with dry eye, particularly those with Sjögren’s disease and other immune-related conditions. Researchers have also identified associations between certain microbiome patterns and dry eye symptoms or clinical severity.
These findings strengthen the possibility that the microbiome may help influence how dry eye develops, persists, or responds to treatment. The precise relationship is complex, but the growing evidence is helping researchers view dry eye as a condition that may involve interactions between the eyes and the wider body.

 

Could probiotics and diet support dry eye care?

Researchers are now exploring whether probiotics, prebiotics, and dietary approaches could support dry eye management by promoting healthier immune and inflammatory responses.
Some early clinical studies have examined potential improvements in symptoms, tear-film measurements, or inflammatory markers. Although no specific probiotic is currently established as standard dry eye treatment, this research is opening promising possibilities for more comprehensive and personalized care.
 
 

Daily habits that may support gut and eye health include:

• Eating a varied diet rich in vegetables, fruits, legumes, whole grains, and healthy fats
• Drinking enough water throughout the day
• Taking regular breaks from digital screens
• Blinking fully during prolonged screen use
• Following appropriate contact lens hygiene
• Getting consistent, restorative sleep
• Managing allergies, autoimmune diseases, and digestive conditions with medical guidance

Probiotics and other supplements should be discussed with a healthcare professional, particularly for people with underlying medical conditions or those taking regular medicines.

 

When should you see an eye specialist?

Consult an ophthalmologist when dryness is persistent, painful, affects vision, interferes with contact lens use, or does not improve with basic care. Sudden vision loss, severe pain, injury, or marked redness requires urgent assessment.
At Bumrungrad International Hospital’s Eye Excellence Center, ophthalmologists can evaluate the tear film, cornea, eyelids, meibomian glands, lifestyle factors, medicines, and related health conditions.
Depending on the findings, care may include tear support, eyelid hygiene, treatment for meibomian gland dysfunction, anti-inflammatory therapy, or other individualized options.
The gut–eye connection represents an exciting development in dry eye research. As knowledge continues to grow, understanding the microbiome may help doctors identify new risk factors and develop more personalized approaches to supporting long-term ocular surface health.
 
 

Frequently asked questions

Can gut health influence dry eye?
Yes, growing evidence suggests that the gut microbiome may influence dry eye through immune, metabolic, and inflammatory pathways. The connection appears particularly relevant in people with autoimmune or chronic inflammatory conditions.
Can probiotics help with dry eye?
Early research suggests that probiotics and prebiotics may have potential as supportive approaches. However, more studies are needed before a specific product or formulation can be recommended as standard treatment.
 
 

Medical references

1. Perez VL, Chen W, Craig JP, et al. TFOS DEWS III: Executive Summary. American Journal of Ophthalmology. 2026;282:135–145. doi:10.1016/j.ajo.2025.09.035.
2. Labetoulle M, Baudouin C, Benitez-del-Castillo JM, et al. How gut microbiota may impact ocular surface homeostasis and related disorders. Progress in Retinal and Eye Research. 2024;100:101250. doi:10.1016/j.preteyeres.2024.101250.
3. Antman G, Ritzer L, Galor A, et al. The relationship between dry eye disease and human microbiota: A review of the science. Experimental Eye Research. 2024;245:109951. doi:10.1016/j.exer.2024.109951.
4. Song J, Dong H, Wang T, et al. What is the impact of microbiota on dry eye: A literature review of the gut–eye axis. BMC Ophthalmology. 2024;24:262. doi:10.1186/s12886-024-03526-2.
5. Moon J, Choi SH, Yoon CH, et al. Gut dysbiosis is prevailing in Sjögren’s syndrome and is related to dry eye severity. PLoS One. 2020;15(2):e0229029. doi:10.1371/journal.pone.0229029.
6. Tavakoli A, Flanagan J, Papas E, Markoulli M. The impact of probiotics and prebiotics on ocular and systemic inflammation in dry eye disease: A double-masked, randomised controlled trial. Clinical and Experimental Optometry. 2026;109(1):75–82. doi:10.1080/08164622.2025.2502529.

 

Medically reviewed by:
Ngamjit Kasetsuwan, M.D.
Comprehensive Ophthalmology; Cornea & Refractive Surgery
Last medically reviewed: August 2026