Some parts of your body must be wet to function properly. Take your eyes, for instance. (Though we can’t blame you if you were thinking about somewhere farther south.) Feeling like something has sapped your eyes of all moisture can get pretty old pretty quickly. Here’s what you need to know about why your eyes get so damn dry sometimes, plus how to relieve your symptoms.
Every time you blink, you spread a moisturizing tear film across your eyeballs to keep them lubricated and comfortable. There are three distinct layers of this film, according to the National Eye Institute (NEI):
- First up is a lower mucous-based layer that keeps your eyes wet by adhering to the water in your tears. This layer comes from some of the goblet cells your body needs to produce mucus. Are you now thinking of tiny goblets splashing slimy stuff around in your body? Cool, us, too.
- Then there’s a middle layer that’s made by the lacrimal glands under your eyebrows. This layer consists of water and over 1,500 water-soluble proteins that sustain your corneas (your eyes’ transparent, dome-shaped exterior) and conjunctiva (the mucous membranes that cover the whites of your eyeballs and insides of your eyelids).
- Finally, the oily outer layer made by the Meibomian glands in your eyelids keeps your tears from evaporating too fast.
It’s easy to see why your eyes can get parched if something goes wrong with any of these integral layers. When that happens, you’re dealing with something known as...wait for it... dry eye. Basically, your eyes are thirsty as hell.
You may deal with some of these additional signs of dry eye:
- Excessive tearing, which can happen in response to the dryness
- Pain
- Stinging
- Itchiness
- Burning
- Scratchiness
- Stringy mucus leaking from your eyes
- Sensitivity to light
- Redness
- Feeling like something is in your eyes when nothing is
- Difficulty wearing contacts
- Trouble driving at night
- Blurry vision
- Eye fatigue (basically feeling like your eyes ran a marathon)
This is dry eye that is situational. That means it only happens when you’re in a certain environment, like a windy beach, Mina Massaro-Giordano, M.D., co-director of the Penn Dry Eye & Ocular Surface Center and a professor of clinical ophthalmology at the University of Pennsylvania, tells SELF. Very dry or smoky air can wick moisture away from your eyes, too.
Situational dry eye can also happen if you stare at your computer or some other point of focus for hours on end. When you do this, you blink less often, so you’re not replenishing your eyeballs’ moisture frequently enough, according to the Mayo Clinic.
Additionally, certain health conditions that affect your eyelids like ectropion (when your eyelids turn out) can expose your eyeballs to more air than usual and make your tear film evaporate, the Mayo Clinic explains.
Experts call this decreased tear production, and it can happen for a few different reasons. One is simply aging—the older you get, the more likely your tear production is to decline, the NEI explains. In fact, dry eye most commonly impacts people 50 and older.
Then there are certain health conditions that can make your body less likely to produce enough of a tear film, like Sjogren’s syndrome, an autoimmune condition that tampers with your mucous membranes and the glands that produce moisture in your eyes and mouth. Sjogren’s syndrome sometimes shows up alongside conditions like rheumatoid arthritis and lupus, which is why people with those conditions are often more prone to having dry eyes.
On a related note, women are more likely to get dry eye in part because they’re more at risk for autoimmune conditions, according to the NEI. Another factor is the hormonal fluctuations that come with pregnancy and menopause, two conditions that have been linked with dry eye.
Beyond that, some medications can lower your tear production, like antihistamines, anti-anxiety drugs, antidepressants, birth control pills, decongestants, and hormone replacement therapy, along with those for high blood pressure and Parkinson’s disease, the NEI explains.
Sometimes simply trying to see better can mess with your tear production. Laser eye surgery can have this effect, although it’s typically temporary, and using contact lenses puts you at more risk of dry eye, too. This is in part because a foreign body in your eye can be irritating, but using contacts that don’t fit properly or that you don’t take care of well increases your risk even more.
Even having a deficiency in vitamin A, a nutrient that is essential for the health of your conjunctiva and cornea, can decrease your tear production, the Mayo Clinic explains.
One thing that can cause this is blepharitis, which happens when your eyelids become inflamed. Another is rosacea, which you may know of as a skin condition that causes redness, but which can also lead to eye inflammation. Both of these conditions can plug up your Meibomian glands so they can’t supply the level of oil your eyes need.
The treatment your doctor suggests depends on what’s behind your dry eye, Vivian Shibayama, O.D., an optometrist and contact lens specialist with UCLA Health, tells SELF, so it’s important that you get an evaluation rather than just self-diagnosing.
If your doctor suspects that your dry eye is situational, they may recommend tactics like taking breaks from your screen time during the day, Dr. Massaro-Giordano says. The 20-20-20 rule is a good one to practice: Every 20 minutes, divert your eyes from your screen to look at something 20 feet away for 20 seconds. Or they might suggest you wear wraparound shades when you’re in windy weather, quit smoking, or otherwise get a handle on whichever environmental factor is doing away with your tears.
On the other hand, let’s say your issue is that your tears are screwy because of a condition like rosacea or blepharitis. In that case, your doctor may recommend that you use warm compresses to loosen up any gunk that’s blocking your Meibomian glands from producing enough oil.
And if your eyes simply aren’t making enough tears, your doctor will try to get to the bottom of what’s causing that, whether it’s a health condition like Sjogren’s syndrome or a medication you’re taking, then see which treatment course makes sense.
No matter the cause of your dry eye, your doctor will likely recommend that you use artificial tears to add moisture to your eyes when symptoms flare up. Sometimes you can’t totally fix the root cause of your dry eye, so always having your eye drops on you is a really smart idea. (Bear in mind that eye drops promising to relieve that bloodshot look can actually just make dry eye symptoms like redness and irritation worse over time.)
If none of those potential fixes get rid of your dry eye, your doctor may take the next step and prescribe a medicine to disrupt the way dry eye works in your body. For instance, some antibiotics can relieve eyelid inflammation that blocks your Meibomian glands, according to the Mayo Clinic. Other drugs, like corticosteroids, can tamp down on corneal inflammation that exacerbates dry eye. There are even medications known as cholinergics that are supposed to boost the amount of tears you can produce, and there are also medical procedures for severe dry eye cases. These can include plugging up your tear ducts with tiny silicone devices or unblocking your Meibomian glands with a tool that gives you a targeted eyelid massage, according to the Mayo Clinic. Sounds kind of fancy?
With all of that said, keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.
The point is, if you have dry eye, you shouldn’t feel doomed to those dehydrated eyeballs forever. See your doctor to at the very least start a conversation about how to manage your condition.
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