This patient presented with blurry vision, eye pain, and burning OU which is caused by dry eye syndrome, also known as keratoconjunctivitis sicca (KCS), and keratitis sicca. This is a multifactorial disease of the tears and the ocular surface that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. You can see the disturbance and sandpaper appearance in the photos. Dry eye disease is a common form of ocular surface disease (OSD) and may overlap with other causes of OSD, such as ocular allergy and meibomian gland dysfunction (MGD).
I prescribed a short course of steroids, in addition to Xiidra therapy.