Dry eye disease is more common than you might think—over 20 million people in the U.S. experience it, facing issues like insufficient tear production or tears that evaporate too quickly.
Various factors can contribute to this discomfort. Things like dry air, wind, certain autoimmune conditions, medications (especially antihistamines), exposure to screens, a lack of vitamin A, and even contact lenses can play a role.
Dr. Ashley Brissett, a board-certified ophthalmologist at Kelly Vision in New York, has pointed out an often overlooked cause of dry eyes: tiny mites that live in eyelashes and eyebrows, known as Demodex. While these mites are typically harmless and nearly everyone has them, they can become problematic if they overgrow.
Brissett mentioned that these pests, which are about 0.4 mm long, like to mate on your face while you sleep. It might sound unsettling, but it’s usually manageable unless their numbers get out of control. Unfortunately, poor hygiene, certain skin conditions, and even sharing towels or cosmetics can encourage their growth.
How do you get eyelash mites?
Surprisingly, most of us harbor small numbers of these mites in the hair follicles of our eyelids. While it’s kind of gross to think about, it’s not a major health concern unless their population increases excessively.
What damage can they do?
Symptoms of an infestation can include redness and itchiness of the eyes or eyelids, discomfort, and even issues like eyelash loss. Brissett warns that these mites can cause flaking in eyelash follicles, leading to lashes falling out, which can be distressing for many patients.
Moreover, if the condition persists, it can lead to recurrent issues—ugh, right?
How do mites lead to dry eyes?
The meibomian glands are responsible for adding an oily layer to your tears—this helps keep your eyes lubricated. An overgrowth of mites can inflame the eyelids and compromise these glands’ functions, ultimately leading to dry eyes. Brissett explains that inflammation affects both tear production and the even distribution of tears, exacerbating the discomfort.
Many people report sensations of stinging or burning, redness, and even blurred vision. Factors like air conditioning and environmental allergens can make matters worse.
What treatments are available?
One solution is a prescription eye drop called Xdemvy, which can help eliminate these mites over the course of about six weeks, with daily usage. Brissett emphasizes the importance of daily eyelid hygiene, suggesting that a good cleanser can help keep these pests—and the bacteria they feed on—at bay.
She recommends using a purifying foam cleanser specifically for eyelids, noting that consistent cleaning is essential to preventing future issues.
Other surprising causes of dry eye
- Stress and high cortisol levels
- Malnutrition, particularly a lack of omega-3 fatty acids
- Certain medications like antidepressants and anti-anxiety drugs
- Hormonal changes, such as those during perimenopause
- Eye surgeries like blepharoplasty
- Specific types of makeup and skincare products
- Prescription retinol
