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How to deal with dry eyes

Jan 25, 2017
By Malcolm Thaler
Man rubbing his eyes in front of a computer monitor

Whether you’re staring at a screen all day, taking certain medications, or just getting older, chances are you’ve probably experienced the discomfort of dry eyes.

Although the symptoms are rarely more than discomforting, they can range from light sensitivity and difficulty driving at night, to burning and stinging and constantly feeling as though something is in your eyes. No matter how hard you blink or rub, the symptoms don’t go away.

What causes dry eyes?

Dry eyes are caused when your body produces less tears, the chemical composition of your tears changes, or your tears evaporate more quickly.

There are a number of reasons why you might be producing less tears. Tear production generally decreases as we age, and many medications can also reduce tear production; common among these are antihistamines, antidepressants and antihypertensives, but many other medications can do this as well. Some diseases, such as diabetes mellitus, hypothyroidism and a host of autoimmune disorders such as lupus and rheumatoid arthritis, can also be responsible. The one disease that is most classically associated with both dry eyes and dry mouth is Sjogren’s syndrome; you may have first heard about this when the tennis star, Venus Williams, came down with it.

The chemical composition of your tears is also altered as you get older.  Women frequently complain of dry eyes as they pass into menopause.

And of course, increased evaporation is something we have all experienced when we are outside on a sunny, windy day. But anything that causes you to blink more often, such as staring at a computer screen all day, can also accelerate evaporation.

What can I do about it?

In most cases dry eyes do not indicate that you have some horrible disease, so there is no rush to see your healthcare provider. First, consider any medications you are taking; if one or more of them might be contributing to your dry eyes, that may be your answer. Stop any over-the-counter medications that might be a problem, and if you are on any prescription drugs that can be responsible, contact your healthcare provider to see if there are any acceptable substitutes.

The next step is to try an eye lubricant. Eye drops are the most common choice because they are so easy to use. Your first choice should be artificial tears. Some have preservatives and some don’t; the former last longer and are generally less expensive, but if they irritate your eyes you should switch to a drop without a preservative. Preservative-free eye drops come in single-use vials. There are other OTC drops that contain various medications to reduce redness, but these can often worsen the symptoms of dry eye.

Some people prefer ointments to drops. They tend to provide longer relief than drops, but they also can also blur your vision. For this reason, they are best used at bedtime.

Other steps you can take include wearing sunglasses when you are outside to guard against the wind, avoid staring at your computer screen for too long without taking a break, and keeping a humidifier in your bedroom at night. And, of course, if you are a smoker, here is yet another reason for you to consider stopping!

When should I see my healthcare provider?

If the simple remedies above provide relief, there is no need to seek any further help.  But if not, then it is time to visit your primary care clinician or an ophthalmologist. They can test you for any disorders that may be causing the problem and treat the underlying condition.  If nothing turns up, they can recommend prescription medications that reduce inflammation or stimulate tear production. There are also relatively simple procedures to close your tear ducts or increase tear production. Finally, if you are a contact wearer, the most common prescription contacts can be aggravating your dry eyes.  Your eye doctor might recommend a new line of contacts that trap moisture and keep your eyes from becoming too dry.

The bottom line: Dry eyes are incredibly common, particularly as we age, and the steps above are often all you need to get relief. If they don’t do the job, then it’s time to see your healthcare provider.

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Malcolm Thaler

Malcolm enjoys being on the front lines of patient care, managing diagnostic and therapeutic challenges with a compassionate, integrative approach that stresses close doctor-patient collaboration. He is the author and chief editor of several best-selling medical textbooks and online resources, and has extensive expertise in managing a wide range of issues including the prevention and treatment of cardiovascular disease, diabetes, and sports injuries. Malcolm graduated magna cum laude from Amherst College, received his MD from Duke University, and completed his residency in Internal Medicine at Harvard's New England Deaconess Hospital and Temple University Hospital. He joined One Medical from his national award-winning Internal Medicine practice in Pennsylvania and was an attending physician at The Bryn Mawr Hospital since 1986. He is certified through the American Board of Internal Medicine. Malcolm is a One Medical Group provider and sees patients in our New York offices.

The One Medical blog is published by One Medical, a national, modern primary care practice pairing 24/7 virtual care services with inviting and convenient in-person care at over 100 locations across the U.S. One Medical is on a mission to transform health care for all through a human-centered, technology-powered approach to caring for people at every stage of life.

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