Why do your eyes burn? It could be dry eyes.
The tears are made of water, oil and mucus, which are produced by different glands on the eye surface and the eyelids.
Any deficiency in the production or the quality of any of these components will lead to dry eyes.
Blinking spreads the tears all over the eye surface, and the tears normally drain through the canals that are located near the nose on the eyelids; the tears then flow through the nasolacrimal ducts into the back of the nose, which also connected to the mouth. This is why sometimes, when we place drops on our eyes, we can taste the medication.
The function of the tear film is to lubricate the ocular surface, protect the eye from infections, wash away foreign particles and provide nourishment to the ocular surface.
For clear vision to occur, it is important to have a smooth surface that is created by the tear film. Any abnormality in the tear film may lead to blurry vision.
Eye burning is a common complaint when the eyes are dry. Furthermore, having dry eyes is a common problem that can occur at any age but usually manifests or worsens as we age.
Some of the signs and symptoms of dry eyes also include blurry vision that improves after blinking, grittiness, scratchy feeling, redness, light sensitivity, tearing, foreign body sensation as if sand or an eye lash is stuck on the eye, difficulty wearing contact lenses and even pain.
Dry eye is a multifactorial disease; it can be due to a physiological response in which there is less production of tears or problems with the quality of the tear film.
Women are more prone to dry eyes than men due to hormonal changes.
Dry eyes can be due to inflammation in the anterior ocular surface, environmental issues, evaporation of the tears, or systemic conditions like Sjogren’s syndrome or rheumatoid arthritis.
Vitamin A deficiency can lead to dry eyes among other problems.
Skin disorders like acne rosacea can also affect the ocular surface and cause dry eyes.
Smoking and exposure to wind, smoke or dry environments can cause evaporation of the tear film, causing or exacerbating dry eye symptoms.
Likewise, when we are focusing on a task, like watching TV, reading, working on the computer or driving, we tend to blink less, which causes tear evaporation and can cause dry eye symptoms.
Eye dryness could also occur as a side effect of certain medications like antihistamines, decongestants, acne medications or birth control pills among others.
Laser refractive surgery, like LASIK, can cause or worsen dry eyes, although the symptoms are for the most part temporary.
The routine treatment of dry eyes involves using over-the-counter artificial tears of different viscosities ranging from watery to gel-like type tears.
There are also ointments that can be used to lubricate the eyes, but these are mainly used at bed time since they will blur the vision but keep the eyes moist throughout the night while sleeping.
Sometimes, patients feel that when they wake up they have sticky, irritated eyes with foreign body sensation and burning and even get crusty eyelids. This could be due to the eye being not fully closed while sleeping. Some people sleep with the eyes a little open and this creates an opening where air will dry the eyes.
In these cases, it is particularly important to apply artificial tear-lubricants in ointment form before going to sleep.
Another case in which the ointment can help while sleeping is in those patients that use a CPAP/sleep apnea machine to help with breathing while sleeping.
These machines tend to blow air onto the face which can dry the eyes.
Additionally, silicone punctum plugs can be implanted in the ducts that drain the tears into the nose to aid prolong the time that the tears are in contact with the ocular surface, thus ameliorating the symptoms of dry eyes.
Reports suggest that increasing oral consumption of omega-3 fatty acids/fish oil can help in the management of dry eyes.
In some cases, eyelid disease such as blepharitis or acne rosacea can contribute and worsen dry eyes. It is also advisable to do warm compresses and use lid scrubs or cleaning the eyelashes with baby shampoo and water to help decrease the inflammation along the eyelid margin and help with the production of the components of the tear film.
It is important to wear sun glasses to protect the eyes from the drying effects of the wind and the sun. If the dry eye symptoms are moderate to severe, wraparound sunglasses are more appropriate.
Also, try to increase the humidity levels in your home or workplace so that the eyes don’t dry that easily.
Currently, there are two prescription drugs for the treatment of dry eyes: Restasis and Xiidra.
Restasis is an immune suppressant eye drop that helps control the inflammatory response that contributes to dry eyes.
Xiidra is another prescription eye drop that helps block the secretion of inflammatory molecules that cause dry eyes.
You should talk to your eye doctor if you have any signs and symptoms of dry eyes that are not ameliorated by the use of artificial tears because you may benefit from punctum plugs or medications such as Restasis or Xiidra.
Dr. Ho and Dr. Vaccari are ophthalmologists at Atlantic Eye MD, specializing in cataract surgery, multifocal lens implants, laser surgery, diabetic eye disease, glaucoma and macular degeneration as well as the full spectrum of vision disorders.