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Itchy, dry eyes can point to many different things — from simple tiredness to an autoimmune disease. Here’s help finding the root cause for you, so you can get the relief you need.
You probably think of tears as a sign that something bad has happened. But when it comes to eye health, it’s a lack of tears that should concern you: When your eyes don’t make enough tears to stay wet, or when your tear glands don’t work correctly, you have a condition called dry eye. The symptoms: Your eyes may feel scratchy, itchy, or light-sensitive, and you may even have vision problems.
“I like to say that everyone has dry eye; they just don’t know it yet,” says Robert Africano, O.D., an optometrist and clinical preceptor at North Carolina Primary Vision Care Associates inside America’s Best Contacts & Eyeglasses in Charlotte, North Carolina. In fact, dry eye affects nearly 16 million Americans, according to the National Eye Institute (NEI).
The tricky part about dry eye is that it’s usually caused by a combination of factors. “Very rarely can I say, ‘It’s this one thing that’s to blame,’ even though there may be factors that play a larger role,” Dr. Africano says. That said, these are the most common causes — plus steps you can take to combat them.
1. Long Hours on the Laptop
When it comes to dry eye, staring at screens is a major culprit. That’s why it’s best to limit screen time, and take short breaks every 20 to 30 minutes. And keep in mind, long stretches in front of the TV can be as bad as too much computer use. Two reasons: First, we tend to blink less when we stare at screens, says Dr. Africano, and less blinking means the eyes aren’t getting coated with tears as often as they should.
Second, when you’re sitting in front of a computer or TV, the screen tends to be at eye level. Compare that to reading a book or magazine: We hold those lower, “so we have some lid protection from tear evaporation,” Dr. Africano says.
One way to know if screen time is a big factor for you: Your eyes tend to feel driest toward the end of the day. If you can’t spend less total time on your screens, at least be sure to take frequent breaks.
One simple trick that’s easy to remember: Every 20 minutes, look up from your screen and focus on something that’s at least 20 feet away for 20 seconds. This is what eye doctors refer to as the 20-20-20 rule, says Dr. Africano.
2. A Parched Environment
It makes sense that if your surroundings are dry, your eyes will be too. If you live in a dry climate, or if you simply spend most of your day in rooms with fans or air-conditioning, you might be susceptible.
Some patients wake up with dry eyes in the middle of the night. This tends to happen if your eyelids don’t close all the way or if you sleep with a fan in your bedroom, Dr. Africano says.
Nighttime dry eye is also common in people who wear a CPAP (continuous positive airway pressure) machine for sleep apnea. Typically, that’s due to an incomplete nose seal, which allows the machine’s air to seep out and blow directly into the eyes. Dr. Africano says that he often looks for corneal irritation or damage as an indication that a patient’s lids don’t close completely while they sleep or that air is blowing into their eyes.
To add moisture back into the air and lessen the effect, try running a humidifier in your home and office space.
3. Skimping on Sleep
Sleep deprivation affects the body as a whole — and your eyes are no exception. Healthy eyes depend on a minimum of five hours of shut-eye (literally, eyes closed!) in order for their natural lubricants to have enough time to adequately remove irritants like allergens and dust.
Regularly clocking fewer than the seven to nine hours of sleep you need per night could disrupt the function and relationship between the various layers of your eyes. “If those layers aren’t being built appropriately, and if they’re not working well together, that’s when we’re going to have some of those symptoms of dry eyes,” Dr. Africano explains.
4. Medication Side Effects
Many medications cause changes to one or more of the layers in your eyes, which ultimately affects how well your eyes can produce tears. The effects vary depending on the medication. Common culprits include medications that treat colds, allergies, depression, and high blood pressure, says the NEI.
Check the information inserts on your medications (prescription and over the counter) for potential side effects, or bring a full list of what you take to your pharmacist or eye doctor. It may be possible to switch to effective medications that don’t cause dry eye.
Read more about the ways different medications can impact your eye health here.
5. Autoimmune Disorders
An important note of caution: Something more serious than lifestyle factors could be causing your dry eye. The condition is a common symptom of many autoimmune disorders, such as rheumatoid arthritis, lupus, and Sjögren’s syndrome. With these conditions, your immune system attacks your eyes, preventing normal tear production.
6. Hormonal Havoc
Women face a higher risk of dry eye than men do, largely thanks to hormonal changes throughout their lifetime. In particular, pregnancy, using oral contraceptives, and menopause can cause you to produce fewer tears, according to the American Optometric Association.
How to get relief from dry eye
While you can’t change your hormones or where you live, there are some easy-to-try fixes that can help anyone with dry eye.
Artificial tears: Usually, the first thing to try is over-the-counter (OTC) eye drops. They help bolster your tear film “so the tears can do their job a little better,” Dr. Africano says. Look for drops that say “lubricating” or “lubricant” on the label, and ask your optometrist to recommend a specific brand that’s right for you.
Warm compresses: Using a warm, moist compress can help build the outer layer of your tear film and slow tear evaporation, according to Dr. Africano. Plus, they can feel soothing to dry, irritated eyes. Try it in the evening before going to bed and again in the morning.
Eyelid scrubs: These gentle cleansers help break down bacteria on your lashes that can cause inflammation and worsen dryness, Dr. Africano says. You can find eyelid scrubs at many drugstores. Use this product once or twice a day, and as recommended by your optometrist.
If it turns out an autoimmune condition is causing your eye irritation, you’ll need a higher level of treatment. “People with autoimmune disorders typically present with a more severe amount of inflammation and dryness, and they also don’t typically respond to first-line therapies as well as someone who’s presenting with an environmental cause of dry eyes,” Dr. Africano says.
For those patients, treatment might involve anti-inflammatory steroid eye drops, gels, or ointments to lower inflammation and irritation. You can get them in OTC and prescription form. It may take a little trial and error, but chances are good that you’ll find something that works for you.