No one wants to be a crybaby, but having eyes that won’t make tears can be even worse. Dry eyes can be annoying, painful and even disabling.
But figuring out what causes dry eyes can be difficult. Tears are made up of several substances: water, obviously, but also oils for lubrication, mucus and substances that stop infections. An imbalance in these things can cause eye symptoms.
Some symptoms of dry eyes are pretty obvious: eyes that feel gritty or like something is in them, itchiness and redness and blurry vision. Other symptoms may be more of a surprise, like sensitivity to light—or, ironically, overproduction of tears.
Your body may make too many tears when your eyes lack of moisture. They send a “help” signal to your brain, which responds with a flood of tears, a lot like when you get sand in your eyes. This is called “reflex tearing.” But if the mix of water to oils or mucus isn’t right in your eyes, the tears won’t do a lot of good. They can wash away any dirt you have in there but won’t coat your eye’s surface, so your eyes are really just as “dry” as before.
Dry eyes can be caused for a variety of reasons. Your dry eyes may be caused by a very simple reason. Maybe the fan or air conditioner is blowing on you, or the heater in your house has dried up all of the humidity. Maybe you’ve forgotten to drink enough water and have become dehydrated. If not, the reasons could be more complicated. Here is a list of possible reasons for having dry eyes.
- You are older. Older people have dryer eyes, and many women have a problem with dry eyes during and after menopause.
- You wear contact lenses.
- Your tear ducts are blocked, or your tear glands are damaged by inflammation, trauma or radiation therapy.
- Your tears are evaporating due to wind, smoke, or dry air
- You don’t blink enough while sitting at the computer
- You have a problem with your eyelids turning toward the inside or outside.
- Your tears have too much water and not enough oil or mucus, or vice versa. If the glands on the edge of your eyelids get clogged, your eyes won’t make enough oil. This tends to happen when people have inflammation on the edges of their eyelids or skin disorders like rosacea.
- You really have eye allergies. Symptoms of eye allergies can include redness, itching, blurring, burning, swollen eyelids and sensitivity to light. You might have extra tears if you have eye allergies, but if you are taking antihistamines, it can dry up your eyes.
- You are taking decongestants, hormone replacement drugs, antidepressants, or drugs for high blood pressure, acne, birth control or Parkinson’s disease.
- You just had Lasik surgery. Dry eye symptoms after laser surgery tend to improve, eventually.
- You have an autoimmune disease like Sjogren’s syndrome, which can dry up all of the mucus membranes in your body, or your dry eyes are a side effect of rheumatoid arthritis or lupus.
- You don’t have enough Vitamin A in your diet or your body isn’t absorbing vitamins correctly.
- You have a thyroid disorder.
- Your eyelids don’t close right.
So how are dry eyes treated? That depends on what’s wrong with your eyes. Good nutrition can help in some cases, and taking a fish oil supplement and adding Vitamin A to your diet can be useful.
The most common treatment is using artificial tears, many of which are available over the counter. Unfortunately, you may have to try many different kinds to figure out which ones work. Some eye drops sting; others don’t provide lubrication long enough. You may end up having to use the drops even when your eyes feel fine, so that they will stay wet enough.
Your doctor can prescribe a better-quality eye drop that you can get in the store, but that can be pricey. Cyclosporine (Cequa, Restasis) and Lifitegrast (Xiidra) are two common prescription brands. Your doctor may also give you steroid eye drops for a short time.
For eyes that dry out at night, you can use an ointment. Some people even sleep in goggles to keep moisture in their eyes. That sounds like a recipe for a migraine.
If your dry eyes are caused by a lack of testosterone, your doctor can give you a testosterone cream to apply to your eyelids, to help the oil glands work better.
If drops or creams don’t keep your eyes wet enough, your doctor might suggest temporarily plugging up the duct that drains the tears out of your eyes. This is called temporary punctal occlusion. These plugs will dissolve over time.
If temporary plugs work to keep tears in your eyes, your doctor might give you permanent punctal plugs. Or instead, your doctor might suggest punctal occlusion by cautery. In this case, the doctor gives you a sedative and then burns the opening of your tear duct shut. This makes a scar that plugs up the tear duct permanently.
If your tears don’t have enough oil in them, your doctor may try Lipiflow, a medical device that uses heat and pressure to unclog blocked glands on your eyelids. This will help prevent your tears from evaporating.
Disclaimer: This article does not provide medical advice. Do not take action based solely on this article and always consult with an appropriate healthcare professional. This article is purely for informational purposes.