Is dry eye disease the cause of your eye discomfort?

Stinging, burning, scratchy eyes? You’re not alone. According to the American Academy of Ophthalmology, about 20 million Americans have been diagnosed with dry eye disease (DED), and even more experience dry eye symptoms but are not yet diagnosed.

DED occurs when you’re not able to produce enough good-quality tears to keep the surface of your eyes lubricated.

“Your tear film is made up of three layers: fatty oils, aqueous fluid and mucus. When these three layers are combined in the right quantity, your eyes can stay lubricated and clear. A problem with any one of these layers can cause dry eye,” shares Michele Schlagheck, OD, an optometrist with ProMedica Physicians Vision Associates – Toledo.

Symptoms of Dry Eye Disease

You may experience DED symptoms when doing certain activities, such as driving at night or wearing contacts, or the symptoms may be constant. Common symptoms of DED include:

• Eye burning, itchiness or scratchiness.
• Eye redness.
• Light sensitivity.
• Blurred vision.

Causes of Dry Eye Disease

DED can be caused by certain health conditions, medications, and external or environmental factors.

Autoimmune Diseases

Autoimmune diseases, such as rheumatoid arthritis, lupus, thyroid disorders and Sjögren's syndrome, are large contributors to DED. “This is mainly caused by inflammation to the glands that produce tears or to the oil glands that produce a substance that reduces tear evaporation,” Dr. Schlagheck explains.

Medications

Many medications can also contribute to DED. The most common are antihistamines, decongestants, anti-depressants, birth control, medications for blood pressure or acne, and hormone replacement therapy.

Here’s how these medications can influence eye dryness:

• Antihistamines: These medications are intended to block common allergy symptoms, including watery eyes. They do this by telling your eyes to make less tears.
• Decongestants: Decongestants serve to reduce congestion when you have a stuffy nose or clogged sinuses. This in turn affects the mucus layer of your tear film.
• Anti-depressants: Anti-depressants affect the signals between nerve cells, which can have an effect on tear production.
• Blood pressure medications: These medications reduce tear production and the number of proteins in your tears.
• Birth control, acne medications and hormone replacement therapy: These medications cause changes in estrogen and progesterone levels. This can affect the glands that reduce tear evaporation.

External or Environmental Factors

Sometimes, dry eye symptoms are caused by factors outside our body and our control. DED may be triggered by wind, smoke or low humidity.

DED may also be caused by not blinking enough. Concentrating on something such as reading, driving or screen time may also cause dry eye symptoms.

Individuals who wear a continuous positive airway pressure (CPAP) mask may be more prone to dry eye. This is from air leaking from the mask and blowing onto the eyes, causing dryness.

Treatment for Dry Eye Disease

“For most people with mild or occasional symptoms, using non-prescription artificial tear eye drops are enough,” Dr. Schlagheck explains. “Some people may also benefit from prescription cyclosporine eye drops if their dry eye is caused by inflammation.”

Other options to treat chronic dry eyes include punctal plugs (small devices placed in the eye’s tear ducts to slow down tear drainage), special contact lenses (scleral lenses) that protect the surface of the eye and trap moisture, thermal pulsation devices, light therapy, and eyelid massage.

If you experience dry eye, drink plenty of water and incorporate Omega-3 fatty acids to your diet. Omega-3 is known to help with tear secretion and tear film stability. “Good eyelid hygiene is also very important to improve the function of your tear glands,” Dr. Schlagheck explains. “And warm compresses or eye masks can help relieve symptoms.”

When To See an Eye Doctor

DED causes an increased risk of infection. If left untreated, it can lead to corneal scarring, inflammation, corneal ulcers and even vision loss. This is why seeking care for dry eye is imperative.

“Consult with your eye care provider as soon as you have symptoms of dry eye,” Dr. Schlagheck recommends. They can provide guidance on approved over-the-counter artificial tear eye drops to start, and recommend additional treatments as needed.