Surprising Symptoms of Dry Eye by Puneet Panda, M.D.

May 21, 2020

Dr. Puneet Panda is a comprehensive ophthalmologist at the Marietta Eye Clinic who specializes in cataract surgery, dry eye, cornea, and LASIK and refractive surgery.

It’s not uncommon to see signs of dry eye in patients who aren’t even aware they suffer from it. This is because dry eye can present itself in different ways from patient to patient, and people often don’t associate the symptoms they experience with dry eye. In the majority of cases, dry eye causes discomfort. In severe cases, dry eye can lead to infection and scarring that may permanently affect your vision. Despite the many ways dry eye presents itself, it’s not something you have to live with. It can be treated.

What is Dry Eye?

Dry eye refers to a condition in which eyes either do not produce enough tears or do not produce the correct composition of tears. Tears have three layers: an oil layer, a water layer, and a mucin layer. Each layer serves a specific purpose, and together they make up the tear film. If any layer of the tear film is imbalanced, the tear film will not do its job, which is to keep the surface of the eye smooth and clear. An imbalance of the tear film results in dry eye.

  • The oil layer is the outside layer and keeps tears from evaporating too quickly.
  • The water layer is the middle layer. It washes particles out of the eye.
  • The mucin layer is the inner layer, and it helps spread the watery layer over the surface of the eye; also, it helps tears stick to the eye.

Symptoms of Dry Eye

Dry eye can manifest as a variety of symptoms, even ones not commonly associated with dry eye. Some of them are even counterintuitive.

  • Dry eyes may become red and irritated. This is especially common when your eyes are exposed to wind or smoke.
  • Your eyes may sting, burn, or itch.
  • Dry eye may cause blurry vision. This may be helped temporarily by blinking because blinking spreads the tear film across the eye.
  • Your eyes may feel scratchy or gritty, or you may feel like you have something in your eye.
  • Strings of mucus in or around the eyes or a feeling of stickiness may be a sign of dry eye. This is different from the normal accumulation of mucus in the corners of your eyes when you sleep (sometimes called “sleep crust”). With dry eyes, mucus may accumulate even during waking hours, and it may be difficult to clear out of your eyes.
  • You may find it uncomfortable or even painful to wear contact lenses.
  • Excessive tears may also be a sign of dry eyes. When dry and irritated, your eyes may overproduce tears to compensate for dryness.

What Causes Dry Eye?

Due to hormonal changes, most people tend to produce less tears as they get older. This is especially common in women who have gone through menopause. However, there are many other causes of dry eyes.

  • Systemic diseases (e.g., Rheumatoid arthritis, Sjogren’s syndrome, Graves’ disease, Lupus)
  • Swollen eyelids, also referred to as blepharitis
  • Entropion or ectropion, conditions in which the eyelids, respectively, turn inward or outward and prevent the eyelid from closing completely
  • Dry climate
  • Smoke
  • Excessive wind
  • Reading or looking at a computer screen for a long time, or any other activity that reduces the rate of blinking
  • Wearing contact lenses for a long time
  • Refractive eye surgery (more common in LASIK than in PRK)
  • Certain medications (e.g., diuretics, beta-blockers, allergy and cold medications, sleeping pills, antidepressants, heartburn medication)

How Do You Treat Dry Eye?

Treating dry eye is complex. Your ophthalmologist will want to prescribe the least invasive treatment option that gives satisfactory results, and treatments will vary depending on what is causing dry eye. If symptoms are minor, your eye doctor may recommend artificial tears —  over-the-counter drops that can be used as frequently as needed to remoisten the eyes. If artificial tears do not provide adequate relief, your doctor will likely suggest other options. You may be recommended to use prescription eye drops or ointments, warm compresses, eyelid massage, eyelid cleanser, or tear duct plugs. Additionally, your eye doctor will recommend preventative measures, such as avoiding hair dryers, drinking more water, using a humidifier, avoiding smoke, wearing protective eyewear if exposed to wind, or adding foods containing omega-3 fatty acids to your diet. In addition, your provider may recommend therapies such as anti-inflammatory eye drops, amniotic membrane lenses, or eyelid treatments such as Lipiflow or IPL.

No matter how dry eye affects you, always remember that relief is within reach! Contact us to schedule a comprehensive dry eye evaluation.

More About Dry Eye Specialist Puneet Panda, M.D.

Dr. Panda is an ophthalmologist at the Marietta Eye Clinic who specializes in dry eye, cataracts, LASIK, and cornea, in addition to offering comprehensive ophthalmic care. Dr. Panda graduated from Cornell University with an undergraduate degree in biological and environmental engineering. He received his medical degree from the State University of New York at Buffalo and completed his residency at Mount Sinai Hospital in New York. He completed his fellowship in Cornea and Refractive Surgery from the Wilmer Eye Institute of Johns Hopkins University. He is a member of both the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgeons. Read more about Dr. Panda here.

References and Additional Resources

The American Academy of Ophthalmology (AAO) is the world’s largest association of eye physicians and surgeons. It describes itself as a “global community of 32,000 medical doctors who protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public.” Its website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (AOA) describes itself as the leading authority on quality care and an advocate for our nation’s health, representing more than 44,000 doctors of optometry, optometric professionals, and optometry students.

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