Add this to the list of unfair realities: some women are more prone to dry eye compared to men, largely due to hormonal fluctuations. “Estrogen and androgen influence the function of the lacrimal and meibomian glands, which produce tears,” explains Ashley Brissette, MD. She notes that after menopause, the sharp drop in estrogen can throw this balance off, resulting in less tear production and more evaporation.
However, beyond hormonal changes, there are various other reasons your eyes might feel gritty and uncomfortable. Here are some common culprits behind dry eyes, along with suggestions from doctors on how to alleviate your discomfort.
Potential Reasons You Have Dry Eyes
1. Your eyes’ oil glands aren’t working properly.
Meibomian gland dysfunction (MGD) is a leading cause of dry eyes. It occurs when the small oil glands in your eyelids don’t release enough oil into your tears, causing them to evaporate too quickly. “This oily layer is vital to keeping tears from drying out,” notes Arvind Saini, MD.
Inflammation of the eyelids, or blepharitis, is often associated with MGD. If you think MGD might be responsible for your dry eyes, consult your eye doctor, who may suggest various treatments ranging from in-office procedures to simple lifestyle changes like using a warm compress.
2. You’re deficient in vitamin D.
Living in areas with limited sunlight, especially during winter, can lead to a vitamin D deficiency, which can also contribute to dry eye symptoms. “Vitamin D is important since it helps reduce inflammation in the eye and improves tear quality,” explains David Bilstrom, MD. It might be worth getting your levels checked by your doctor before starting any new supplements.
3. You wear contacts.
Contact lenses can impact the natural lubrication process of your eyes. “They can disrupt the lipid layer that helps maintain moisture, and they may reduce oxygen flow to the cornea,” Dr. Brissette states. This disruption can lead to MGD. Sometimes, taking a break from wearing contacts can be beneficial.
4. You’re over 60.
Research indicates that around 20% of people over 80 experience dry eye. Aging tends to reduce tear production due to a combination of factors like decreased hormone levels and reduced gland efficiency. Older adults may also blink less or take medications that further decrease tear production.
Speaking of medications: various drugs, including antihistamines and certain antidepressants, can cause dry eye symptoms by affecting tear production or altering tear composition. If you suspect your medication may be the culprit, consider discussing alternatives with your doctor.
5. You have an autoimmune disease.
Autoimmune diseases often lead to inflammation, affecting tear production. For instance, Sjögren’s syndrome directly attacks the glands responsible for tear production. Other conditions like lupus and rheumatoid arthritis can also contribute to dry eye. If any of these conditions apply to you, your healthcare provider might suggest specific treatments.
6. You work at a desk all day.
Staring at screens for long periods can exacerbate dry eye symptoms. This is primarily because focusing on a screen reduces the frequency of blinking, allowing tears to evaporate more quickly. Following the 20/20/20 rule—taking a break every 20 minutes to look at something 20 feet away for 20 seconds—can help. Dr. Saini suggests also using artificial tears during extended computer sessions.
7. You live in a dry climate.
If you reside in arid regions or often find yourself in air-conditioned environments, this can lead to dry eye symptoms. Humid weather tends to be easier on sensitive eyes. Although you can’t control the weather, using a humidifier could help make your environment more comfortable.
8. You have a skin condition such as rosacea.
Rosacea affects facial skin and can lead to issues like blepharitis if it impacts the eyelids, making it harder for oil to flow from the glands. This can result in thickened secretions that get trapped. If rosacea is worsening your dry eyes, treatment for the skin condition may alleviate the eye symptoms.
9. You had laser eye surgery.
Procedures like LASIK can cause dryness by disrupting the nerves that regulate tear production. While these effects are often temporary, post-surgery drops can also impact the surface of the eye. Using artificial tears and following your doctor’s post-op advice are key to recovery.
How To Treat Dry Eyes
If your dry eye symptoms are mild, consider adopting some good eye care habits. “The first line of treatment includes basic practices everyone should follow for overall eye health,” Dr. Brissette emphasizes.
- Use preservative-free artificial tears daily if needed.
- Apply warm compresses to assist the meibomian glands.
- Maintain eyelid hygiene using a gentle eyelid cleanser.
- Stay hydrated and ensure a balanced diet, including adequate vitamin D and omega-3s.
For ongoing issues, in-office treatments like punctal plugs or thermal pulsation therapy can be effective options at any stage. Prescription eye drops may also improve tear production and hydration of the ocular surface. Ultimately, working with your doctor to create a tailored treatment plan based on your lifestyle and symptoms is advisable.
