15 Dry Eye Symptoms and Risk Factors You Need To Know

Most of the recommendations on this blog are taken straight out of our Rethinking Dry Eye Treatment book, which you can get free for a limited time, just pay shipping.  Click here to purchase and learn more.

Let’s face it: We often take our eyes for granted. In fact, when we are able to see clearly and don't feel any discomfort, we usually don’t give them a second thought. But there are times when they make their presence known — and your life miserable — particularly if you’ve encountered a condition known as dry eye. The symptoms of dry eye are vast, ranging from pretty unpleasant to just plain painful. Irritation, a gritty or burning feeling, excess watering, and blurred vision are just a few you may notice.

The minute you blink, a film of tears unfurls over the eye, ensuring that the surface of the eye remains smooth and flawless. Without this tear film, good vision is impossible and dry eye symptoms are probable.

The tear film is made up of three layers:

  • An oily layer (lipid)
  • A watery layer (aqueous)
  • A layer of mucus (mucin)

Each layer has its own function. The oily layer, generated by the meibomian glands, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and decrease the evaporation of tears. The middle watery layer makes up a great amount of what we generally imagine as tears. This layer is created by the lacrimal glands in the eyelids, cleanses the eye, and washes away external particles or nuisances. The inner layer, composed of mucus produced by the conjunctiva, permits the watery layer to spread evenly over the outer layer of the eye and helps the eye stay moist and comfortable. Without mucus, tears will not stay on the eyeball and will instead fall onto the cheeks.

In an ideal word, our eyes work like a smooth, well-oiled machine. Tears, including all three ayers, play the part of lubricant. The layer which is closest to the cornea is a thin mucus that supports tear adhesion to the surface. The middle layer holds the watery portion of the tears. The outer layer is made up of fatty oils. An appropriate mix helps maintain healthy tears, which coat and lubricate the eyes, nourish cells, wash-down dust and other irritants to ward off infection and keep the surface smooth so you can see clearly.

There are hundreds of different treatments for dry eyes depending on what form of dry eye you have and depending on what’s causing your specific dry eye disease. Below, we’ll dive into a little more about what dry eye disease actually is, the symptoms to be aware of, the risk factors, and a few of these treatment options.

What is Dry Eye Syndrome?

Let’s make it simple. Dry eye syndrome occurs when your eyes aren’t making sufficient tears or when those tears are evaporating from the eyes too quickly. It’s a possibility that the lacrimal gland isn’t making adequate amounts of the liquid part of the tears, or it could be meibomian gland dysfunction where the meibomian glands don’t release appropriate oil to layer the surface of this eyes. This means your tears may evaporate too quickly — commonly known as evaporative dry eye.

Moreover, as we grow older, we’re more likely to encounter medical conditions that can impact the function of our tears, causing dry eye — systemic autoimmune diseases (such as rheumatoid arthritis and lupus), in addition to diabetes, strokes and thyroid problems. Medication use also upsurges as we age, and some medications can affect tear gland function, contributing to dry eye. Some of these include antihistamines, high blood pressure medications, decongestants, antidepressants and anti-anxiety medication, and hormone replacement therapy to treat symptoms of menopause.

Commonly, dry eye disease tends to be chronic and doesn’t go away entirely. But it’s usually a controllable condition. Dry eye syndrome (DES), also called dry eye or dry eye disease, is a common condition of the tear film that affects a noteworthy percentage of the population, especially in people who are 40 years of age or above.

Dry eye syndrome can disturb any race and is more commonly found in women when compared to men. Over 3 million American women over the age of 50 have moderate to severe dry eyes, on the other hand, more than 1.5 million American men who passed the age of 50 are equally afflicted. So many others face mild dry eyes and may not even be aware of it.

In addition to affecting ocular health, the discomfort and irritation of dry eyes can cause deterioration of general well-being, emotional health, and social functioning. Some findings have verified that people with chronic dry eye are three times more likely than those without dry eyes to have difficulty with reading, computer work, watching TV, and driving.

Uninterrupted costs of dry eyes, such as frequent physician visits, diagnostic tests, and charges for medication and surgery, impact our health care resources. In addition, there are immeasurable indirect costs related to decreased productivity and efficiency as well as lost work time.

What Are the Symptoms of Dry Eye?

If your eyes feel like they are wearing tiny wool sweaters, then you likely are suffering from dry eyes. Persistent scratchiness, redness and burning are all common symptoms, as is the feeling that a foreign object is in your eye.

Dry eye symptoms appear to get worse in dry or windy climates and with higher temperatures and lower humidity. Symptoms may also be worse with prolonged focusing of the eyes (for example, while reading, watching TV, using a computer, and driving) and just before the end of the day.

Occasionally, a symptom of dry eye syndrome may, in fact, be intermittent excessive tearing. With dry eye, when the eyes become slightly dry and irritated, it may initiate reflex tearing with the release of a great number of tears all at once to try to compensate for the issue.

Regrettably, the eyes can only handle so many tears at once; the remaining pour over the eyelids and slide down the cheeks. Soon, the eyes will become slightly dry and irritated again and the whole procedure may repeat itself. It’s an awful cycle!

Dry eye can be irritating at best and very painful at worst. It can show up with a range of signs and symptoms. Here are the ones you should keep in mind:

  • Dryness
  • Itchiness
  • Scratchiness
  • Stinging
  • Burning
  • Redness
  • Pain
  • Watery eyes
  • A sense that something is in your eyes when actually nothing is there
  • Stringy eye discharge that seems like mucus
  • Sensitivity to light
  • Discomfort when wearing contact lenses
  • Difficulty driving at night
  • Eye fatigue

While it seems that you may not be able to do much to help dry eyes, and there are often conditions which you cannot control (such as hormonal changes during pregnancy and menopause), you should be aware of other risk factors that you can control.  

You are Suffering from a Health Condition

There are a number of health-related reasons why you might not be able to make enough tears. Various symptoms are caused by Sjögren's syndrome, which is a huge cause of dry eyes. The most usual symptoms are dry eyes and dry mouth. So this means dry eyes are also caused as the symptoms of other diseases such as Sjögren's syndrome. It is a category of autoimmune disease.

Normally, our body makes antibodies to battle infections - for example, when we get a cold or have a sore throat. These antibodies work to kill the germ cells (bacteria or viruses) triggering the infection. In the condition of autoimmune diseases, the body produces similar antibodies (autoantibodies) that attack its own cells. The reason for this is undefined but is thought to be a combination of genes and factors in the environment. During Sjögren's syndrome, these autoantibodies attack the cells of certain glands, which result in a number of symptoms such as dry eye and dry mouth. Your best course of treatment for dry eyes stemming from Sjogren’s syndrome is to treat the condition itself.

The Eyes Generate Poor Tear Quality

Keep in mind there are multiple things which have to combine together to make healthy tears. If any single element isn’t working as well as the others, you might end up with less than optimal tear quality. One of the most common reasons for this is blepharitis. It’s an inflammation of your eyelids that can affect your meibomian glands, which create the oily part of your tears. If you don’t have enough oil provided by the eyelids, your tears don’t make that protective coat and tend to evaporate too quickly.

Fortunately, you may be able to fix this condition pretty easily by using a warm compress eye mask once or twice per day and practicing proper eyelid hygiene daily. This is a really simple way to take better care of your eyes, whether or not you’re dealing with chronic dry eye symptoms.

You’re on Medications that can Cause Dry Eyes

Numerous drugs can cause tear reduction, including antihistamines, decongestants, antidepressants, hormone replacement therapy to relieve symptoms of menopause, and medications for anxiety, Parkinson’s disease, and high blood pressure. Click here to read a full list of medications that can cause dry eyes.

You may be able to tolerate these medications without issue, but others cannot. If you face dry eye syndrome symptoms and are on any sort of medication, make sure to tell your doctor about all the drugs you’re taking, even if they’re not relevant in your opinion. Your doctor may want to tweak your medication to observe if your dry eye symptoms get better. As with any medication changes, make sure to discuss changes with your doctor before discontinuing a medication yourself.

Exposure to Wind, Smoke, or Dry Air

If you step outdoors on a windy day, it’s questionable that alone will give you a dry eye. But if you’re frequently in dry, windy conditions without eye protection, it could lead to the condition. Wind and dry air is a large reason for evaporation of the tear film. The best prevention is to wear sunglasses when you go outside, ideally, ones that wrap around and protect your eyes from all angles (or are at least enough to give your eyes a ton of protection).

Smoke contains chemicals and foreign substances which, when introduced to your tear film, can mess with your tear quality. If you encounter smoke or other irritants at work, look into safety glasses or other eyewear that can benefit you and protect your vision while working.

You’re Always Working on the Computer

It’s not the computer itself that’s the problem... it’s how frequently you blink when you’re on it. It is proven that people just don’t blink as often as they should when they’re using the computer or similar technological devices. In such case when you don’t blink frequently enough, you’re not spreading tear film across your eyes as required, which results in dry eye disease symptoms.

If you’re spending an extended period of time playing with your phone or on the computer, you should stop to take “blinking breaks” every 30 minutes to pause, blink a cluster, then go back to what you were doing. If you know you’re going to forget, try setting an alarm so it begins to feel like a habit, or go with the 20-20-20 rule if it’s easier to remember: Every 20 minutes, set your gaze on something 20 feet away for at least 20 seconds. Give your eyes a break! You can also purchase a pair of blue light blocking glasses, which will help reduce eye fatigue while on the computer all day.

Laser Eye Surgery

Dry eye disease symptoms can be a side effect of laser eye surgery, though it usually halts as your eyes adjust to their new normal. Dry eye syndrome is one of the most common problems treated by eye physicians that occur after laser surgery. Although it does not cause vision loss, dry eye syndrome can be painful and severely decrease quality of life for its victims especially after laser surgery and other common eye surgeries (cataract surgery can contribute to dry eyes as well).

LASIK surgery uses small laser cuts to reshape the surface of the cornea, in order to eliminate farsightedness or nearsightedness, and to relieve the patient of the need for glasses or contacts. As a matter of fact, many also choose LASIK for cosmetic reasons. In the past few years, thousands of military personnel have opted for LASIK surgery because it can help them see better and identify objects and people on the ground more quickly. It also relieves them of the anxiety about lost or damaged glasses.

Habitually, LASIK causes some dry eye syndrome directly after surgery, but in most cases, the condition resolves within a few months. However, in a minor number of cases,  the dry eye condition following LASIK can be converted to chronic and impact functioning of individuals for years after surgery. A small few will even develop corneal neuralgia, which can be devastating.

You’re Not Taking Care of your Contact Lenses

At the end of the day, your contacts are foreign objects on your eyes, so it’s no wonder that they can mess up your tear film. Contact lenses can do this in a couple of ways. First, the fit of your contacts matters a lot. Remember how your eyes were examined thoroughly by your doctor before prescribing contact lenses? The reason behind this is, if your contacts are too tight, they won’t allow for tears to get in below them and if they’re too loose, they’ll move around too much and may allow evaporation of the tear film. If you modify to a new kind of contact lens and are suddenly dealing with dry eye symptoms, this could be the possible cause.

Then there are the people sleeping in their contacts. Such activity can block enough oxygen from getting to your eyes, which can cause or exacerbate dry eye symptoms. It can also set you up for an eye infection, which can damage your vision permanently. It’s better is avoid doing so! If you think your contact lenses are causing your dry eye symptoms, talk to your eye doctor. They may have other suggestions for contact lenses that may work well for you, including daily disposables. Click here to read more about contact lenses for dry eyes.

Now that we’ve discussed a few of the risk factors for the symptoms of dry eye disease, make sure to address these factors in your own life to rid yourself of these symptoms.

Dry Eye Prevalence 

Results published in the British Journal of Ophthalmology are as follows:

Prevalence of one or more of the six dry eye symptoms often or all the time adjusted for age was 27.5%, and other studies have found even higher numbers. Independent risk factors for dry eye were pterygium and a history of current cigarette smoking.

Researchers concluded that the presence of a pterygium is an independent factor in the risk of dry eye associated with age, gender, and history of smoking cigarettes. A pterygium is a growth that covers the white part of the eye and is often in a wedge shape, a benign or noncancerous growth that extends onto the cornea. The wedge-shaped pterygium then grows in size and distorts vision and puts pressure on the tear ducts, preventing much-needed eye fluid from lubricating the eye, causing dry eye. Dry eye is more prevalent according to age (50 and older), gender (women), and lifestyle choices such as smoking cigarettes and other harmful practices.

Even though age and gender play a part in dry eye syndrome, prevention comes with choices we make when we are younger. Eating vitamin-rich foods, taking multivitamins daily and quitting all forms of smoking also greatly reduce the risk of dry eye later in life. Since women are twice as likely to get dry eye as men, women have twice as much incentive to eat right and stop harmful practices sooner rather than later.  

Do you know what risk factor caused your dry eyes? What have you done to alleviate your symptoms? Let us know in the comments below!

One Love,

Dr. Jenna

Join us in the Dry Eye Syndrome Support Community on Facebook and on YouTube for the Dry Eye Show

The risk factors discussed in this blog are taken straight out of our Rethinking Dry Eye Treatment book, which you can get free for a limited time, just pay shipping.  Click here to purchase and learn more.

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