What Is Aqueous Tear-Deficient Dry Eye?

The tears your eyes make do much more than show your sorrow when you cry. These glands produce a constant supply of liquid your eyes need to keep them moist at all times.

Each time you blink, the action drags tears along the surface of your eye. This keeps it wet, clean, and healthy. If your glands don't produce enough tears, you can get a condition called aqueous tear-deficient dry eye. It causes eye pain, redness, and vision problems.

What Causes It

The condition has several causes. Two major ones are:

  • Age: The condition gets more common as the years pass. Tear glands have trouble working well as you get older.
  • Sjogren's syndrome: This disease targets the glands that make tears and spit. So it causes dry eye and dry mouth. Your doctor may call it an autoimmune disease, which means your immune system, which normally works to protect your body, is attacking it instead. Women are more likely to get this disease than men. About 10% of people with dry eye have Sjogren's. This syndrome is associated with rheumatoid arthritis, an autoimmune disorder. 

Other health problems that can cause aqueous tear-deficient dry eye include:

  • Viruses
  • Hepatitis C
  • HIV and AIDS
  • Lymphoma
  • Sarcoidosis
  • Hemochromatosis
  • Amyloidosis
  • Graft versus host disease
  • Damage to tear glands or tear ducts

 

Symptoms

If you have dry eye because your glands don't make enough tears, you may notice:

  • Eye pain, burning, or redness
  • Itchy eyes
  • Feeling like there's sand or dirt in your eyes
  • Blurry vision
  • Eyes that feel tired after reading
  • Trouble wearing contact lenses
  • Not being able to produce tears when you cry

 

How Is It Diagnosed?

Your doctor can help you figure out why you don't make enough tears. Because many people with this problem have Sjogren's syndrome, she'll likely test you for it. She'll take your medical history, ask about your symptoms, and give you an exam. She also may send you to get blood tests or to see a specialist.

If Sjogren's syndrome isn't the cause, your doctor will check to see if your glands make enough tears.

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How Is It Treated?

You'll need to add moisture to your eyes and keep them healthy. You can:

  • Treat other problems. If you have Sjogren's syndrome or another disease that causes dry eye, seek care for that problem. It should help improve your eyes.
  • Use eye drops. Keep your eyes moist with artificial (fake) tears. They're designed to mimic the real thing. So they'll give your eyes the right type of moisture. It's best to use drops without preservatives.
  • Take supplements. You might try fish oil or flaxseed oil, which are rich in omega-3 fatty acids. Before you take any pills, get your doctor's OK and ask what dosage is right for you.
  • Try medicine. Your doctor can prescribe a drug that could help your tear glands produce more tears. The most common medication is a nonsteroidal anti-inflammatory such as cyclosporine eye drops. 
  • Get plugs. Your doctor may decide to plug the drainage holes at the inner corners of your eyes. This can keep the tears that you produce in your eyes for longer periods. After your doctor inserts the special plugs, you shouldn't be able to feel them. Most plugs are temporary, but your doctor may place permanent plugs if she thinks that they're right for you.
  • Consider surgery. There is a way to close the drainage holes at the inner corners of your eyes. This is a permanent method to keep your tears in your eyes for as long as possible.

 

Can It Be Prevented?

Probably not, But you can take steps to stop your eyes from getting drier:

  • Use a humidifier in your house during dry weather.
  • Wear glasses (or sunglasses) with side shields to protect your eyes from the wind when you're outside.
  • When you're inside, stay out of the breeze created by ceiling fans or portable fans.
  • Be aware of how often you blink. Try to do it more, especially if you're looking at a computer screen. It's easy to forget.
  • Don't smoke. Steer clear of people who do smoke and smoky rooms.

 

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on June 18, 2019

Sources

SOURCES:

The Ocular Surface: "The Definition and Classification of Dry Eye Disease: Report of the Definition and Classification Subcommittee of the International Dry Eye Work Shop (2007)."

National Eye Institute: "Facts About Dry Eye."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers About Sjögren's Syndrome."

American Academy of Ophthalmology: "Dry Eye Syndrome PPP - 2013."

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