How Do I know I have Dry Eyes?
We see a lot of patients who we can tell have dry eyes based on clinical exam but they had no idea their eyes were dry, until we begin to ask questions. The thing about your eyes is you should just USE them not THINK about them. Your eyes are there for you to SEE with, they should not be blurry and they certainly should not hurt. That being said, as we get older, things change. Things wrinkle, things sag, stuff turns grey, other stuff doesn’t work like it used to and we ALL get some degree of dry eye.
Dry Eye Syndrome can be broken down into MILD, MODERATE and SEVERE. Obviously if you have moderate or severe dry eyes, you know it. It’s the mild dry eye that patients have trouble grasping and want to believe it is something other than what it is.
If you think about the function of the tear film which is to keep the eyes lubricated, then the symptoms of NOT keeping them lubricated makes sense. Most symptoms are better in the morning and worsen in the evening, mainly because you’ve been using your eyes all day. The symptoms also get worse when you’re concentrating like reading, on the computer or watching TV. When we concentrate, our blink reflex drops in HALF. Because our tears are insufficient anyway, not blinking as much causes rapid evaporation of the tear film and worsening of symptoms.
Here is a list of dry eye symptoms:
- Intermittent Blurry Vision – Caused by unstable tear film. As the tear layer fluctuates so does your vision.
- Tearing (watery eyes) – reflex tearing is apart of a neural pathway. When the nerves on the surface of your eyes are irritated they tell your brain to make more aqueous tears.
- Burning/stinging – especially when reading, watching TV or on the computer/tablet
- Scratchy or foreign body sensation – kind of like an eye lash is in the eye, but it’s not
- Light Sensitivity – caused by the inflammation associated with DES.
- Stringy mucus build up
- Becoming more and more contact lens intolerant – Contacts soak up the existing tear film and unless kept constantly lubricated, will become painful if worn too long.
- Trouble with nighttime driving
- Eyes feeling “tired” – especially in the evening
- Pain / Soreness – from the inflammation
- Red Eyes – From the constant irritation and inflammation.
Some patients ask if itching is a symptom of dry eyes. Itching is ALWAYS the sign of an allergy. Dry eyes and allergies do go hand in hand, but when itching is involved then there is an allergy component.
The symptoms can be rare, intermittent, frequent or constant. There can be just one, a few or many of the symptoms all together depending on the cause and severity of the dry eyes. The most common early symptoms are intermittent blurred vision and tearing.
Symptoms are generally worse in the evenings and in dry environments. Since you’ve been using your eyes all day long, they are exhausted towards the end of the day so they feel “tired” especially when trying to read or focus for any length of time. Th winter months tend to be worse because the humidity is much lower and when we turn the heater or fireplace on, it tends to “suck” all the remaining moisture out of the air.
Anything blowing towards your face such as a fan or the vents in the car will cause the symptoms to ramp up especially the tearing.