Why Are My Eyes Dry?
Understanding the Origins of Dry Eye Symptoms
Dry Eye
We use the term dry eyes to describe a state where the person has chronic symptoms related to a deficiency in the volume or quality of tears. Dry eye affects 5-15 percent of the US population, equating to 16-49 million people who suffer from chronic dry eye symptoms.
- Common symptoms of dry eyes are:
- Stinging
- Burning
- Redness
- Foreign body sensation
- Tired eyes
- Sore Eyes
- Excess Tearing
- Sticky eyes
- Sharp intermittent pain
- Light sensitivity
- Fluctuating or hazy vision
- Unable to wear contact lenses comfortably
- Non-modifiable Risk Factors
- Age
- Gender(female)
- Sjogren's Disease
- Race(Asian)
- Autoimmune Disorders
- Modifiable Risk Factors
- Meibomian Gland Dysfunction
- Electronic Device Usage
- Environment
- Hormone Imbalance
- Medications
- Smoking
Meibomian Gland Dysfunction
The meibomian glands are a set of glands that put oil into the tear film, which is critical to reduce evaporation and to lubricate the eye. These glands are notorious for becoming impacted, inflamed, and infected. 86 percent of patients who complain of dry eyes have meibomian gland dysfunction.
Abnormal Meibomian gland function(MGD) is responsible for many disorders ranging from mild irritation to total loss of corneal clarity. As mentioned, MGD is present in 86% of dry eye patients. In addition, MGD is responsible for the formation of styes and other related lid infections. Much of the discomfort and pain experienced in and around the eyes is a result of MGD. Therefore, treating and establishing a maintenance regimen for meibomian gland health is a key factor in improving daily comfort
Auto-immune Disorders
Patients with auto-immune disorders are also more likely to experience moderate to severe dry eye. Unlike MGD, where the tear problem is a result of abnormal tear composition, having a lack of the lipid(oil) component to the tear film, in auto-immune disorders, symptoms are generally related to insufficient production of the aqueous(watery) tears.
This is often due to changes in the lacrimal gland under the upper lid. While these patients may also have MGD, our primary goal is to help the patient retain moisture at the eye surface. Sjogren’s, Lupus, RA, IBS, Crohns, and others are commonly associated with dry eye symptoms.
Medications
A significant number of medications can cause or exacerbate dry eye symptoms. Research suggests that glaucoma and other long-term drops may contribute to MGD. These systemic medications are also known to cause dry eyes:
- Accutane
- Antihistamines
- Beta-blockers
- Diuretics
- SSRI’s
- Birth control meds
- Medical Marijuana
- Antipsychotics
Environmental Factors
Many environmental factors can precipitate or exacerbate dry eyes. Air pollutants from industry, dust, smoke, pollen, volatile fumes, electronic device usage, and many others contribute to symptoms. Reducing or eliminating these factors can significantly improve symptoms.
This is often due to changes in the lacrimal gland under the
upper lid. While these patients may also have MGD, our primary goal
is to help the patient retain moisture at the eye surface. Sjogren’s,
Lupus, RA, IBS, Crohns, and others are commonly associated with dry
eye symptoms.