Dry Eyes With Immune Disorders

Too many late nights. Too much screen time. Long flights. Menopause. Lots of things can cause your eyes to feel dry, gritty, and sore.

But dry eyes can also be related to a medical condition that affects your immune system like diabetes, lupus, or HIV. And sometimes dry eyes are the first sign of a deeper problem.

Inflammation Can Be a Root Cause

There are more than 80 autoimmune diseases. They're called that because your immune system attacks your healthy tissue by mistake instead of invading germs and viruses. One thing all these diseases have in common is inflammation, which can lead to pain, swelling, and other trouble.

This inflammation can show up almost anywhere in your body. Sometimes that's far away from a disease's main target of, for example, your skin or your joints.

Inflammation can damage your tear glands, so they don't make enough fluid. Or it can target oil glands in your eyelids; without oil, your tears evaporate too soon. Either way, your eyes get dry.

Type 1 and Type 2 Diabetes

Most people with diabetes know that it can cause eye problems like retinopathy, cataracts, and glaucoma. While infrequent, people with diabetes may have dry eyes, as well.

That's because the nerve damage that causes you to lose feeling in your hands, legs, and feet -- so you don't notice cuts and sores -- can also affect your eyes. Severe dryness that's not treated can damage your cornea, the dome that covers the front part of your eye.

If you have diabetes, get your eyes checked regularly, perhaps every year, including the corneas. If you don't have it and you have dry eyes, especially if your vision is blurry and you're often thirsty, too, you may want to get tested for diabetes.

Rheumatoid Arthritis (RA)

This type of arthritis can target almost any part of your body, including your eyes. Some people with RA have a second autoimmune disease called Sjogren's syndrome, which dries out both your eyes and mouth.

Lupus

Having lupus makes you more likely to get many eye problems, but the most common is dry eye. Inflammation damages your tear-making glands, so they can't make enough moisture to keep your eyes healthy.

Continued

Graves' Disease

The inflammation with this thyroid disease pulls and stretches the muscles around your eyes, so they bulge out a bit. When you can't shut your eyes tight, your tears will evaporate too fast.

Treatment

How autoimmune problems are treated depends on the disease, but keeping inflammation under control is key. If you have very dry eyes, you may need long-term anti-inflammatory eye drops or punctal (tear duct) plugs to prevent drainage.

You can also do a lot on your own to ease symptoms:

  • Use artificial tears during the day and ointments at night. (But eye drops that prevent redness make dryness worse.)
  • Avoid sitting next to air conditioners and heaters.
  • Use a humidifier in your bedroom at night.
  • Don't smoke.
  • Take frequent screen breaks.
  • Blink often.
  • Eat more fish, or ask your doctor about taking fish oil pills. Omega-3 fatty acids in salmon, tuna, and sardines help block inflammation and may make your eyes feel better.

 

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on July 04, 2019

Sources

SOURCES:

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

American Family Physician: "Ocular Manifestations of Autoimmune Disease."

Journal of the American Optometric Association: "Dry eye among males infected with the human immunodeficiency virus."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Understanding Autoimmune Diseases."

Review of Optometry: "Dry Eye: Master the Science Beneath the Surface."

Journal of Ophthalmic & Vision Research: "Dry Eye Syndrome."

National Eye Institute: "Facts About Diabetic Eye Disease."

Eyeworld: "Dry eye in diabetics."

American Diabetes Association: "Diabetes Symptoms."

Baer, A. "Joint Pain and Sjogren’s Syndrome," Johns Hopkins University School of Medicine.

Hospital for Special Surgery: "Eye Problems in Lupus."

Cleveland Clinic: "Thyroid Eye Disease."

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