Your eyes are regularly bathed by tears, which help lubricate the blinking action of the eyelids and wash away any debris that lodges on the corneathe clear protective coating on the eye. One of the most common external eye complaints among people over age 40 is dry eye syndrome, or keratoconjunctivitis sicca (KCS), which produces an itchy, gritty feeling in your eyes. Surprisingly, overflowing tears are often a symptom of the condition, produced in response to underlying dryness.
Dry eyes are more likely to occur with age because the tear glands tend to shrink. This condition is also more common in women, especially after menopause.
Symptoms of Dry Eyes
- Excessive tearing, persistent scratchy and/or stinging sensation in the eye
- Redness, burning, swelling, itching or irritation (as if some gritty foreign body is under the eyelid)
- Blurry vision
- Light sensitivity
- Inability to wear contact lenses comfortably
What Causes Dry Eyes?
The discomfort of dry eyes is usually due to insufficient tear production by the lachrymal glands. Certain eyelid abnormalities or surface infections may also be responsible. The problem can also occur as a side effect of certain medications (diuretics and antidepressants), and it can be associated with rheumatoid arthritis. It also occurs in Sjögren’s syndrome, a type of autoimmune disorder in which the glands that produce lubricating solutionsincluding those for the mouth and vagina as well as the eyesare attacked.
The environment can also contribute to the problem. Too much exposure to dusty or dry environment, direct sunlight or extremes of wind and low humidity may quickly dry out the eyes, and in arid parts of the country many people develop dry-eye problems because tears evaporate quickly in the heat. When this happens, tears quickly flood the eyes as a protective measure, blurring vision in the process and leading people to mistakenly think the excessive tearing is a condition called wet eye, or epiphora. In reality, the excessive tears are masking the problem.
High altitudes, air conditioning, and air pollution can also contribute to dry eyes by increasing the rate of tear evaporation. Soft contact lenses can also have the same effect.
What If You Do Nothing?
Dry eyes may clear on their own if you are able to avoid or remove the source of the problem. But if you have persistent dryness, you should obtain a professional diagnosis.
Home Remedies for Dry Eyes
- Use “artificial tears” eyedrops on a regular basis. In some cases this may mean two drops, three to four times daily, of a nonprescription tear preparation. These nonprescription drops are often completely effective. Some solutions are thicker than others, but all can help protect the delicate front surface of the eye. Try several solutions and see which one works best for you. Be aware that most products will lose their effectiveness within an hour after application.
- You may find that while the thicker gel lubrication solutions relieve symptoms for a longer time, they may cause slightly blurred vision for a short period after they’ve been applied. (A good time to use the thicker products is at night, just before going to bed.)
- Some people have allergic reactions to the preservatives in these products; if you do, look for preservative-free artificial tears. As noted on the package, these products must be kept refrigerated after opening.
- Try a cooling soak. With a cool, wet facecloth, soak your closed eyes for three to five minutes. This helps constrict the blood vessels and ease the gritty sensation.
- Splash water in your eyes. This will help to quickly relubricate your eyes. (In addition, see the prevention tips below.)
- Protect your eyes from the wind. If you find that your eyes dry out because of high winds, be sure to wear goggles or glasses with protective side shields. These are available in many pharmacies as well as outdoor-equipment stores.
- Avoid smoky environments. Smoking dries the eyes, as does secondhand cigarette smoke.
- Keep alcohol and caffeine intake to a minimum. Both types of beverages have a diuretic effect that can exacerbate dryness.
- Alternate contact lenses with eyeglasses. If you work or live in a low-humidity environment, this will help ease the strain of dry eyes brought on by daily-wear or extended-wear lenses. When you wear your lenses, be sure to use rewetting drops at the first sign of dryness.
- Humidify your home. Cold winter air coupled with indoor heat can produce an extremely dry environment, particularly if rooms are overheated. A home humidifier can help reduce dryness, as can turning down the heat.
- Break up your computer time. As you work in front of a computer screen, you tend to blink less, which can cause eyes to become drier. Taking a break every hour or so can help prevent excessive dryness.
- Speak to your physician about your medications. Certain antihistamines, oral contraceptives, and antidepressants can contribute to dry eye. If it’s possible, try an alternative drug that doesn’t produce this particular side effect.
Beyond Home Remedies: When To Call Your Doctor
Contact your ophthalmologist if you don’t find relief for dry eyes in a day or two, or if you find that you need artificial tears on a daily basis.
What Your Doctor Will Do
The ophthalmologist will test your rate of tear production and check your eyes' blinking mechanism and possibly the chemical composition of your tears. If you have a dry mouth, joint pain, or other symptoms indicative of Sjögren’s syndrome or another autoimmune disorder, blood tests may also be ordered for indicators of autoimmune activity. Along with artificial tear solutions, your doctor may prescribe antibiotics to treat any associated bacterial eye infection.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media