Why do my eyes burn? Why do my eyes itch? What causes dry eyes? Is there more than one version of dry eyes? Why are my eyes watery if my eye doctor says I have dry eyes? Is my eye doctor crazy? What can be done to help with dry eyes? Got dry eyes? These are the questions I will discuss in this article.
What causes dry eyes?
When it comes to dry eyes there are different aspects of our world that can contribute to the dryness. We have the outside environment contributing to the dryness depending on what the humidity is, how windy it is, how high the allergen level is, and what all those levels were yesterday. Also, we have our work environment contributing to the dryness by if we are staring at a computer all day, driving in a vehicle all day, or going in and out of freezers all day. We have our gender contributing to the dryness because females tend to have more dryness issues than males. Next, our genetics contributing to the dryness because thyroid disease, arthritis, sjogrens disease, and other auto immune conditions play a role. Lastly, our age contributing to the dryness because our glands die off as we get older. I think you get the picture, but this list can go on and on for days. In other words, EVERYTHING can cause dryness. But if you have got dry eyes we can help!
Is there more than one version of dry eyes?
Yes. Dry eyes can come in multiple flavors because we have multiple body parts and proteins keeping the eyes from drying out. We have the lacrimal gland that contributes the water portion of our tears. We have the meibomian glands contributing to the oil portion of our tears. Random fact about the meibomian glands is that they actually make over 90 different proteins to help keep the eye moist. We have the glands of zeis and moll contributing to the oil portion of our tears. We have the goblet cells contributing to the mucus portion of our tears.
What makes my eyes burn? And why do the eye drops burn?
When the water layer of our tears is missing and the cornea or front part of the eye gets dry it develops little nicks in it that look like the tissue has been sandblasted. Those little nicks getting exposed to air is similar to dry skin getting exposed to air and is why the eyes burn. Those nicks are also why the eyes burn when you put in artificial tears or eye drops. The pH being different in the eye drops then in your normal tears will contribute also. Again, think of dry skin on your arm and when you put lotion on the slight burn and tingle happens. The difference is the eye has more nerve fibers per square inch than pretty much every where on the body. The Roto drops are a slightly different story. Those drops were made intentionally to burn to show they are working. The company markets it more as a “tingle sensation.”
Why do my eyes itch?
Most people think that if their eyes itch then it must be allergies, but the number one cause of itchy eyes is actually dryness. Now allergies and dryness go together like lamb and tunafish…or spaghetti and meatball for the non Big Daddy movie fans. Allergens contribute to dryness by swelling tissue and swollen tissue has a harder time secreting its product than non swollen tissue. Dryness causes allergy type issues because dry tissue rubbing against dry tissue causes inflammation and allergens cause inflammation. One reason we may be rubbing our eyes is because we are trying to milk the oil glands manually. Sometimes this dryness can lead to headaches as well.
Why are my eyes watery if my eye doctor says that I have dry eyes? Is my eye doctor crazy?
The purpose of the oil layer of our tears is to keep the tears attached to our eyes. If we aren’t making enough of the oil layer then our tears are either evaporating very quickly or running down our cheeks. The way we get the oil layer naturally is by blinking. When we blink we milk the meibomian glands in our upper and lower eyelids. If those glands are clogged up (sometimes referred to as a stye or hordeolum) then we can blink forcefully and sometimes unclog them if the clog was very minor. When the clog is thicker it sometimes requires medications or surgery to get rid of the problem. If those glands have been clogged up for a long time then they may have died off an no amount of blinking can get us the oil we need. Your eye doctor can quickly look and see if the glands are clogged up during an eye examination.
What can be done to help with dry eyes?
If you have got dry eyes we can help and here is how. There are tons of things that can be done, but we need to make sure we are giving the right treatment first. After all, it doesn’t help us at all to treat the water layer when we have an oil layer problem. An optometrist can easily find the underlying problem and help you with treatment options during an eye examination. If it is a water layer problem I usually talk to my patients about artificial tears. There are thousands of artificial tears and each has its own pro and con that is too long for this article. If it is a mucus layer problem then over the counter medications won’t help much, but a prescribed medication can get things back on track. If it is an oil layer problem you can try a warm wet wash cloth, a more efficient microwavable eye mask that typically cost about $25, or some clinics have an in office treatment to help flush those glands like the Thermal 1 touch that I have.
There is actually numerous textbooks dedicated to the complexity surrounding dry eyes. Dr eyes over the last 5 years as evolved into its own specialty that most eye doctors have recommendations for and can help formulate a treatment plan for you.
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