Your Health

Lack of tears can make your dry eyes cry

Man putting drops into his eye.
Photo of Amanda Nash. ALI SYED
Winnipeg Regional Health Authority
Published Friday, February 17, 2017

Have your eyes been feeling a little gritty and sore lately? Do you sometimes experience blurred vision or sensitivity to light?

While these symptoms can be an indication of a serious eye problem, it is far more likely that you are experiencing a very common and treatable one.

That condition is called dry eye, and as the name suggests, it is generally caused by a lack of tears lubricating between the cornea (of the clear part at the front of the eyes) and the lids. As the lid moves up and down it will rub against the cornea causing discomfort, such as sandpaper rubbing against the wall.

Sometimes, people with dry eye will actually complain of excessive tearing because the irritation from being dry is so great that the body tries to compensate by producing extra tears. This paradoxical presentation can be confusing and is known as reflex tearing.

The lack of tears can also cause the cornea’s smooth surface to become irregular. This can cause scattering of light as it enters the eye, resulting in glare and consequently lead to blurred vision, glare and sensitivity to light.

As one might expect, dry eye is associated with a number of risk factors.

In winter, for example, low humidity and cold temperature can play a major role in drying tears by process of evaporation, particularly worse in high wind condition. Mild symptoms of dry eye can be also be caused by prolonged concentration tasks such as computer use, watching television, reading or long distance driving. With frequent use of computers, phones and tablets we tend to blink less frequently. Individuals should make a conscious effort to blink more often especially on digital devices. A good rule of thumb is to take a 20 second break every 20 minutes and gaze off at 20 feet. This is called the 20-20-20 rule.

Aging is also a factor. Sometimes the lower lids can sag over time interfering with the normal refreshing of the tear film on the eye that occurs with blinking.

Women experiencing hormonal changes related to menopause, pregnancy and use of oral contraceptive can have problems with dry eye. Other medications such as anti-depressants, anti-hypertensives, anti-histamines and decongestants can also sometimes cause dry eye.

Refractive corneal surgery such as LASIK may damage the corneal nerves contributing to less corneal sensation. This can cause dry eye syndrome because the eye may not sense the need for lubrication and make enough tears. Similarly, contact lenses can also be the cause of dryness.

Additionally, dry eye can be caused by blepharitis, a condition where dandruff like material can accumulate on the base of eyelashes and get into the eye with blinking.

So, what can you do to treat and manage dry eye? Here are a few suggestions:

  • Lubricate your eyes. Lubrication comes in variety of formulas which are readily available to buy over the counter. It is important to remember that one product does not work for everyone, so you may have to try a few options to see which works best for you.
  • Use a humidifier in your house to increase the moisture level in the air.
  • Avoid sitting in areas with drafts or fans.
  • Avoid areas with cigarette or other kinds of smoke.
  • Check the listed side-effects of the medications you are taking. If any are optional and known to cause dry eye, consider stopping them to see if this helps. Consult your family doctor if there might be an alternative that causes fewer problems with dry eyes that you could try.
  • If you have blepharitis, it is important to maintain good lid hygiene. This consists of cleaning away any debris that is accumulating on the lashes and applying warm compresses regularly to enhance the drainage of the eyelid oil glands.
  • Some people benefit from increased omega 3 fatty acid intake, either through supplements or dietary change. Good sources of omega-3 include fish, soybeans, and flaxseed and fish oil.

If these steps do not help, then you should see your optometrist or ophthalmologist to get advice on treatment. They will take a history or use a questionnaire plus examine your eyes to come up with a treatment plan for you.

Ali Syed is an internationally trained optometrist currently on an externship at Misericordia Health Centre’s Buhler Eye Care Centre. This column was originally published in the Winnipeg Free Press on Friday, February 17, 2017.

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