Dry watery eyes and dry burning eyes are caused by a lack of moisture and lubrication. People who suffer from an ongoing lack of lubrication in the eyes may have to deal with constant eye irritation and inflammation that can result in scarring if left untreated.
The risk factors for developing this condition are high in people who use a computer for more than two hours a day, the elderly, and women.
The symptoms include:
- Dry eye discharge
- Tender eyelids
- Fatigued eyes
- Eye pain and headache
- Blurry vision
- Light sensitivity
Foreign body sensation, which is common with conditions such as pink eye, is another symptom associated with this syndrome.
Many people are surprised to learn that tearing eyes is another common symptom. This is because the eye’s lack of moisture on the surface can cause the eyes to produce more tears than usual as a type of protective mechanism. This process is referred to as reflex tearing and unfortunately, it doesn’t stay on the eye long enough to correct the ongoing dryness.
Aside from the symptoms discussed above, you may also experience short-term or long-term inflammation that can cause mild to severe damage to the surface of the eye. In some cases, this condition may also negatively impact the results of cataract surgery or LASIK surgery.
What Causes Dry Red Eyes?
A consistent layer of moisture on the eye’s surface is important and crucial when it comes to keeping the eyes comfortable and healthy. The tears are what cleanse the surface of the eyes, keeping them moist and washing away microorganisms, debris, dust, and other contaminants that could potentially cause damage to the eyes or result in an infection.
Tears are made up of three components:
Each of the components has an important function. As an example, the lipids are what keep the film of tears from quickly evaporating. Mucin is what spreads the tears across the eye’s surface. Each of these components is created by glands found near or in the eyes.
The meibomian gland is located in the eyelids and produces the oil in tears. The goblet cells found in the conjunctiva produce the mucin, or mucus-like component.
If there is an issue with production for any of these components then this can result in the inability to produce tears.
If your tear production is considered healthy, your doctor will first test the meibomian structure and function to determine if the oil in the tear film is able to adequately spread on the eye’s surface. If this type of gland dysfunction is caught early, it can prevent the development of chronic dry eye, as well as permanent loss of gland function.
A Chronic Condition
When this condition becomes chronic, it can have a major impact on your lifestyle and can prevent you from enjoying activities you once loved such as birding or reading.
A healthy blink rate is very important since it activates the meibomian glands, causing them to spread essential tear oil all over the eye’s surface. When the blink rate slows it can impact the functionality of the gland for the long-term.
Over time, the eye discharge and excessive tearing can lead to severe irritation in and around the eyes. Learning how to soothe irritated skin around the eyes and eyelids can help to keep the surrounding skin moist, supple, and prevent redness, dry skin, and general irritation. To learn how to treat and minimize certain symptoms related to chronic dryness, click here to read my guide on how to relieve watery eyes.
What Type of Dry Eyes Do You Have?
This condition is categorized based on which tear component is affected. As an example, if the meibomian gland isn’t able to secrete or create enough meibum the film of tears that covers the eye may quickly evaporate, resulting in a condition that’s known as evaporative dry eye. Meibomian gland dysfunction is the underlying cause of evaporative dry eye syndrome and is considered a major factor in most cases.
The type of dryness you’re suffering from determines the type of treatment needed for dry eye pain relief.
Why Excessive Tearing Doesn’t Help
One of the most common symptoms of eye dryness is excessive tearing, which can be confusing since the root cause of inflammation, pain, and discharge is a lack of moisture. But the type of tearing a person experiences with this condition involves a different type of tears. These tears are very similar to the type of tears that are produced when a foreign contaminant gets in your eyes. But they’re not like regular tears, in fact, they lack the lubricating qualities that your normal tears produce in order to protect your eyes. Called reflex tears, these tears will not protect the eyes or provide the type of moisture your eyes need.
Risk Factors for Very Dry Eyes
There are many factors that can increase your risk of developing this condition, including:
- Computers-If you spend several hours a day working on a computer, then you’re at an increased risk of developing this condition. When a person uses a computer or other type of portable digital device such as a smartphone, they tend to blink less, which can lead to increased tear evaporation.
- Contact lens use-Contact lens wearers are at an increased risk of dryness, especially if they don’t practice good hygiene and clean and soak their lenses daily, or if they wear the lenses for an extended period of time, or often sleep with their lenses in.
- Age-The elderly are more susceptible to eye dryness, especially after the age of fifty-five.
- Menopause-Women currently going through menopause are also at a greater risk.
- Environment-If you use a forced air heating system, ceiling fans, or air conditioning, this can create a very drying environment for the eyes which can speed up tear evaporation, leading to symptoms such as redness, dryness, and irritation.
- Smoking-We already know that smoking is bad for your lungs and heart, but it can also be bad for eye health as well. Smoking is linked to many types of serious eye conditions such as uveitis and macular degeneration.
- Serious health conditions-Some medical conditions can also contribute to eye dryness, including lupus and diabetes.
- LASIK-This procedure can sometimes result in chronic dryness. However, in most cases, this will only be temporary and will resolve within a couple of weeks of the surgery.
- If you use certain anti-aging products-Many of these products contain acids that can be harmful to eye health and can even promote dryness and irritation, especially when not used as directed. If you’d like to learn how to use these products safely, click here to read my guide on how to get rid of wrinkles under your eyes when you smile.
Dry Red Eyes Syndrome or Blepharitis?
If you’re currently dealing with red eyes, irritation, discharge, and pain, the only way to be sure you have this chronic condition is to meet with your physician for an assessment. Because the symptoms can vary from patient to patient, a doctor will not rely on the symptoms alone to determine whether you’re dealing with dryness, since many of these symptoms can also point toward conditions such as eye allergies or even blepharitis. Blepharitis is another chronic condition that can be difficult to treat. But how to get rid of blepharitis for good is different for everyone. Treatment that may be effective for one person may not be as effective for another. It’s the same with eye dryness. In both cases, a person may need to try a variety of treatments before finding one that’s effective.
During an exam, your doctor will determine the severity of the dryness and recommend the best treatment option that can keep your eyes comfortable and healthy.
Viral and Bacterial Conjunctivitis
Both types of conjunctivitis can cause many of the same symptoms associated with dryness including swelling, red eyes, dryness, irritation, pain, and crusting of the eyes. However, discharge associated with pink eye tends to be more severe and can actually cause the eyes to crust together during sleep. Can a cold cause eye discharge? Yes. If you have an upper respiratory infection then viral conjunctivitis can develop. This type of pink eye is highly contagious, as is bacterial pink eye. Often, the infection will begin in one eye and can easily spread to the other. Bacterial and viral conjunctivitis can affect people of all ages, even newborns. If you suspect your infant or toddler has pink eye, click here to read my article on what causes eye discharge in babies.
How Contact Lenses Can Significantly Increase Your Risk of Dry Red Eyes
As I mentioned earlier, this condition commonly affects contact lens wearers. In fact, for some, it can be so severe that it can make it almost impossible to wear their lenses. Aside from inflammation and discomfort, the excessive tearing and discharge can make it difficult for the lenses to remain in place. Most optometrists do not recommend contact lens use for people who are already dealing with chronic dryness. However, in some cases, soft contact lenses may still be an option, even for patients with a history of this eye condition. Soft contact lenses will allow oxygen to easily pass through the lenses, helping to prevent and combat dryness. The materials used to create these lenses are designed to hold water and allow the eyes to breathe. A person that’s using hard contacts will definitely benefit from making the switch to soft lenses if they have been struggling with dryness and irritation.
What is Lens Water Content?
Did you know that lenses have different levels of wetness? Lenses that have a higher wetness level may end up exacerbating the symptoms of dryness and can even draw water out of the eyes as a way to maintain the higher wetness level the contacts require. Contacts with a lower moisture level will be more beneficial for people with this condition.
Lenses made out of this material will require a lower level of moisture when compared to other types of lenses and will also easily allow oxygen to pass through, so the eyes can breathe. While these lenses are usually pricier compared to other types of lenses, they’re definitely more comfortable to wear and will even help to minimize the symptoms associated with eye dryness and irritation.
When to Replace Contact Lenses
You’ll lower your chances of infection and enjoy a more comfortable contact lens experience if you replace them more frequently than what the manufacturer recommends. If you ignore the replacement schedule for your lenses, serious problems, such as eye dryness and infection can occur. These days, most contact lenses are soft and tend to range in duration for length of wear depending on the brand.
Daily disposable-These contact lenses are used by more than forty percent of contact lens wearers. Since they’re supposed to be tossed out daily, you won’t have to worry about remembering when to replace them. This type of lens is much lighter and thinner, which also makes them less likely to cause eye-health complications. These lenses also eliminate the need for use of contact lens solution and lens cases.
One to two weeks-Lenses that can be worn for one to two weeks must be taken out daily and carefully stored in a lens case with the appropriate cleaning solution. If you can’t remember when to replace them, mark it on the calendar or set an alarm on your phone.
Monthly-Lenses that need to be replaced once a month are often the culprit behind eye infections and dryness since many wearers try to get more wear out of the contacts than what the manufacturer recommends. If you have trouble remembering when to toss your lenses out, choose an important date during the month, such as the first or fifteenth and stick to this schedule. While getting more wear out of your lenses can save you money, it’s really not worth the risk of chronic dryness or a serious infection.
Overnight wear-There are also certain brands of lenses that can be worn overnight. These lenses have a wear length of two to four weeks, depending on the brand. For some people, overnight lenses will make more sense, however, whenever you sleep in lenses you can expect some discomfort. Doing so will put you at an increased risk of damage, including corneal abrasions. It can also cause corneal infections or ulcers. Corneal hypoxia is another condition that’s common among contact lens wearers and it can lead to ulcers if left untreated. Corneal hypoxia will occur when the lenses deprive the eyes of oxygen. Without medical attention, it can cause infections and short or long-term blindness.
Pay Attention to Replacement Schedules
If you’re guilty of forgetting to wear your lenses every day, you’ll still be required to follow the replacement schedule. This is because the minute you remove the lenses from their sterile packaging they will begin to degrade, regardless of how often you actually wear them.
So, when it comes to contact lens use, if you want to avoid chronic dryness, infections, and ulcers, stick to the recommended replacement schedule.
Sleep Apnea May Be to Blame
Sleep apnea can affect several different organs in the body, including the eyes. Floppy eyelid syndrome has been linked to sleep apnea. Patients with this condition are more at risk of irritation since their eyes do not fully close like healthy eyelids do during sleep. This can lead to serious problems such as dryness. Unfortunately, this problem often persists in patients, even after they have been treated for apnea. Often, the symptoms of the syndrome are further exacerbated by apnea treatment. Air that blows directly into the eyes due to a leaky mask can cause or worsen dryness. One solution is switching the style of mask used or switching to a better fitting model.
Patients with poor Bell’s phenomenon response can experience worsening dry eye symptoms. Bell’s phenomenon is a type of reflex that causes the outward and upward movement of the eyes, when a person attempts to close them. If a person’s reflex response is poor, then their cornea can be exposed during the night. Apnea patients with a poor reflex response have a high risk of developing chronic dryness since the apnea machine will blow a constant flow of air toward the eyes.
If apnea is the underlying cause of your chronic dryness, aside from switching mask styles, you must remain on top of dryness care in the form of compresses and over the counter or prescription eye drops. Doing so can help to prevent complications further down the line. Most physicians will also recommend taking a daily omega-three supplement since omega-three provides the building blocks for eye gland oil production.
How to Treat Dry Eyes
Fortunately, there are effective treatments that can relieve symptoms immediately. For mild cases, using artificial tears and taking a five to ten-minute break from computer use may be enough to reduce symptoms. For severe dryness, your physician may prescribe medication or a procedure that will help the eyes to produce more tears, while decreasing inflammation and eye irritation.
Other Natural Treatment for Dry Eyes
Basically, this condition involves the inability to produce tears with the right consistency, or the inability to produce tears at all. People with this condition will often describe it as an aching, burning, sensation. One or both of the eyes can be affected and will appear red and slightly swollen. The presence of a stringy discharge is also common.
Fortunately, there are a number of lifestyle changes and remedies that will help to minimize the symptoms and reduce the reoccurrence of flare-ups. If these treatments are not successful, then medical attention may be necessary.
Increase Humidity for Dry Itchy Eyes
Using a bedside humidifier will help by adding moisture back into the air, which, in turn, can minimize symptoms of dryness and irritation.
In most cases, a hot compress can do wonders to reduce swelling, irritation, redness, and even discharge. However, if you’re dealing with dry itchy burning eyelids, then a cold compress may provide faster, more effective relief.
Ditching the AC and Fans
Fans and air conditioning can also lead to dryness. People with this condition should avoid standing in front of fans or air vents since exposure can immediately cause excessive tearing and increased dryness and discharge.
There are several different types of over the counter artificial tears to choose from and they can help to reduce dryness, but since there are so many different options available, it’s important that you choose drops based on the symptoms you’re experiencing.
Preservative drops are designed for mild cases of eye dryness and for users who do not have a sensitivity to preservatives. There are also preservative-free drops which are designed for people with a preservative sensitivity who are dealing with moderate eye dryness. Prescription-strength drops are available for severe cases and can help to significantly improve tear production while minimizing symptoms such as inflammation and redness.
This is another option that can work even better than artificial tears due to their thickness. However, because of the consistency, you can expect blurred vision, which is why this treatment option is usually recommended for nighttime use only.
Severe Chronic Cases
Since this condition can be caused by certain medications, if you’re taking a medication that has caused or exacerbated eye dryness symptoms, speak with your physician before discontinuing the med. In some instances, your doctor may recommend continuing the medication and will prescribe a medication that can help you manage dryness and irritation. Anti-inflammatory eye drops can be prescribed to prevent or minimize corneal damage, which may occur in severe cases.
Surgical procedures may also be appropriate if home treatment and medical intervention have both failed to provide relief. Sealing the eye’s drainage holes can work to eliminate chronic dryness for good. By doing so, the tears will remain on the surface of the eye instead of quickly evaporating or draining. These drainage holes can be closed permanently or temporarily. When done temporarily, plugs made out of collagen or silicon are inserted into the holes. The procedure itself is relatively painless and has a very short healing time.
Eyes Feel Dry and Tired-How Lifestyle Changes Can Help
- Physicians recommend cutting down on artificial sweeteners and lowering your daily sugar intake to prevent dryness. In people with diabetes, blood sugar levels should be kept within the recommended range in order to avoid worsening of symptoms.
- Increasing your daily water intake can also help. Try to drink at least eight glasses of water daily. Since smoking can aggravate and worsen symptoms, quitting can have a huge impact on eye health.
- Supplements such as omega-three fatty acids can decrease symptoms such as dryness and inflammation. These fatty acids are naturally found in flax seeds and fatty fish such as anchovies, sardines, and salmon.
Complications of Eye Dryness
Most people will experience some eye irritation from time to time, without the worry of long-term effects. But if left untreated, this condition can actually damage the corneas and cause vision loss in the future.
Other complications include:
- Chronic inflammation of the conjunctiva
- Corneal abrasions
- Corneal erosion
- Vision loss
- Corneal infection
These unsightly bumps can develop due to bacteria or a clogged gland. In some cases, excessive discharge can be to blame. Hot compress treatment four to six times a day can soothe the stye and shrink it in size. Styes are rarely concerning, however, if they become infected or if you develop multiple bumps then medical treatment may be necessary.
Corneal Erosion and Abrasions
This complication is considered the most serious and it involves the recurring breakdown or opening of the cells found on the surface of the cornea. These cells are called epithelial cells and they make up the top layer of the cornea. The layer underneath the cornea is called the Bowman’s layer and it’s what tightly binds the epithelial cells to the cornea. This layer is made out of collagen and once it becomes unhealthy or damaged the cells then fail to properly bind to the cornea’s surface, leaving behind a type of open sore that’s very similar to an abrasion.
Recurring corneal erosions are usually caused by a past injury, but it can also be caused by chronic dryness. If you fail to treat chronic dryness, it can result in a corneal abrasion, which will put you at risk of developing corneal erosion if the abrasions are recurring.
Symptoms of corneal erosions are very similar to that of abrasions. People with this complication often complain of:
- Increased light sensitivity
- Gritty, sand-like feeling in the eye or eyes
- Excessive tearing
- Blurry vision
A corneal abrasion can occur at any time, however, people who suffer from episodes of recurrent corneal abrasions often initially experience symptoms first thing in the morning, upon waking when the eye is often dry from sleep. This extra dryness will make the surface of the eye sticky, causing the eyelids to remove the epithelial cells off the eye’s surface when the eyes first open in the morning.
Corneal Abrasion and Erosion Diagnosis and Treatment
During an exam, your optometrist will measure your visual acuity by using fluorescein, a type of special yellow dye. Erosions and abrasions are made visible as the injured portions of the eye soak up the dye.
Once a doctor has determined you’re dealing with an abrasion or the beginning signs of corneal erosion, they will prescribe medicated drops. Cycloplegic drops are usually prescribed and work by paralyzing any spasming muscles in the eye, temporarily. Corneal erosions are basically open wounds they can easily become infected. Because of this, antibiotics are also often prescribed.
Bandage contact lenses may also be recommended to prevent infection and should be worn for a period of two to three days. The lens bandage works by preventing any foreign substances from coming into contact with the injured surface. If a bandage is used, your doctor may request daily visits in order to closely monitor the eye for any signs of irritation or infection.
How to Prevent Complications
Keep the eye moist by using artificial tears several times a day. Your doctor may prescribe an eye ointment, which should be used at bedtime. Since the eyes can easily dry out during sleep, the ointment will work as a type of cushion that will prevent the loss of cells upon waking. It can also prevent the eyelids from sticking to the corneas. Using an eyepatch can also help by preventing air from potentially drying out the eyes. If artificial tears have failed to keep the eyes moist, your doctor may prescribe medicated drops that can draw out any excess fluid from the cornea and keep the layers of the cornea tightly held together.
Vision loss is considered the most severe complication and one that can occur if you fail to seek treatment. This often applies to patients with corneal abrasions and erosions. Just remember, the main reason complications arise is due to a lack of medical attention when symptoms worsen. While in some cases eye dryness can be managed with self-treatment, in others, medical attention will be necessary in order to avoid permanent vision damage.
When to See the Doctor
Make an appointment with your physician if your symptoms don’t improve after three to five days, or if your symptoms worsen after three days. If you have dryness accompanied by sharp pain and excessive discharge or tearing that’s negatively impacting your vision, make an appointment with your optometrist or primary care physician immediately.
Dry and watery eyes can be caused by many things ranging from allergies and a foreign object in the eye to chronic dry eye syndrome, conjunctivitis, corneal ulcers, and corneal abrasions. Learning the underlying cause of excessive watering and dryness can make all of the difference in terms of eye health and ongoing issues with dryness, irritation, redness, and discharge. If you’ve experienced dryness and irritation for a period of three days with no relief or if your symptoms worsen, contact your optometrist or primary care physician for an assessment.