What Causes Dry Eyes?

Even when you’re happy, your eyes are full of tears. They provide moisture and lubrication to help you see and keep your peepers comfortable.

What’s in a tear? They’re a mix of:

  • Water, for moisture
  • Oils, for lubrication
  • Mucus, for even spreading
  • Antibodies and special proteins that keep infection at bay

The ingredients come from special glands around your eye. Dry eyes often mean your tear system is out of whack.

When tears don’t provide enough moisture, you might notice:

Sometimes, dry eyes create too many tears. This confusing condition is called reflex tearing. It happens because the lack of moisture irritates your eye. It sends a distress signal through your nervous system for more lubrication. Your body sends a flood of tears to try to make up for the dryness. It’s a lot like what happens when you get sand in your eye and it runs. But these tears are mostly water, so they don’t act like normal tears. They can wash debris away, but they can’t coat your eye’s surface.

What Causes Dry Eyes?

Sometimes, there's a lack of balance in your tear-flow system. Or your air conditioner, heater, or other things around you could dry out your tear film. Other causes include:

  • The natural aging process, especially menopause
  • Side effects of certain drugs like antihistamines
  • Diseases that affect your ability to make tears, like Sjogren's syndrome, rheumatoid arthritis, and collagen vascular diseases
  • Problems that don’t allow your eyelids to close the way they should

How Are Dry Eyes Treated?

There are a number of options. Ask your eye doctor what to do. Treatments include:

Artificial tear drops and ointments. This is the most common treatment. Many types of drops are available over the counter. No one product works for everyone, so you might have to try a few to figure out the one that’s right for you. If you have chronic dry eye, you need to use the drops even when your eyes feel fine, or they won’t stay wet enough. If your eyes dry out while you sleep, you can use a thick product, like an ointment, at night. You might think about sleeping with airtight goggles on. They'll create a mini "moisture chamber" for your eyes.

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Temporary punctal occlusion. Your doctor might opt to close the punctum, or duct that drains tears from your eye. He might start with a temporary plug designed to dissolve over time. Based on how it works, he'll know whether permanent plugs will help.

Nondissolving punctal plugs and punctal occlusion by cautery (application of heat to tear exit duct). If temporary plugs work well, your doctor may move to longer-lasting ones. Or he could choose a procedure called cautery. He'll give you a drug that relaxes you, then use a special tool to burn the opening shut. The scar that forms makes a permanent plug. These measures increase your tear level by blocking the “drainpipe” through which tears usually go from your eye to your nose. Tear plugs are easy to remove, but sometimes they come out on their own or fall down the tear drain. They can make your eyes feel better and lower your need for artificial tears.

Lipiflow. This medical device uses heat and pressure to unclog blocked glands on your eyelids. These glands produce the oil in your tears. It keeps your eye moist and prevents your tears from evaporating.

Testosterone cream. It doesn’t happen often, but dry eye can be related to a lack of testosterone in the oil glands on your eyelids. The doctor might give you a testosterone cream that you apply to your eyelids. It can help your oil glands work better.

Cyclosporine ( Restasis). This prescription eye drop helps your eyes boost tear production.

Lifitegrast (Xiidra). These drops are taken twice daily to kick-start tear production.

Other medications andnutrition: You can use steroid eye drops, for short periods, along with long-term measures. Adding fish oil or omega-3 to your diet or can also help.

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on December 08, 2016

Sources

SOURCES:

National Eye Institute.

University of California, Berkeley.

Review of Ophthalmology: “A Stepwise Approach to Treating OSD.”

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