The symptoms of dry eye aren’t always what you may expect. Many patients are often surprised that the vision or eye problems they’re experiencing are in fact due to dryness of the eye’s surface. As the eye care profession’s knowledge of dry eye syndrome continues to grow, we’re beginning to understand more and more that dry eye is a multi factorial condition subject to a whole host of underlying factors and contributors, both environmental and genetic. Understanding that dry eye disease is much more than simply insufficient fluid on the eye is also helping to shape and develop dry eye treatment in a way that addresses not only the presenting symptoms of dry eye but also its underlying causes. But the first step in treating any disease is, of course, identifying it. So, what are the symptoms of dry eye?
Symptoms of Dry Eye
Contrary to popular belief, dry eye syndrome doesn’t always present with feeling that the eyes are dry. Here are some other common but less well-known symptoms of dry eye.
- Red eyes: The official definition of dry eye syndrome by the International Tear Film and Ocular Surface Society makes specific mention of inflammation of the ocular surface as playing a significant role. As redness is one of the hallmark signs of any sort of inflammation, many dry eyes often present with redness of the sclera (the whites of the eye) and/or the eyelid margins. As many find this cosmetically unappealing, some patients turn to eye drops for red eyes, which contain vasoconstrictor drugs to whiten the eye, when the best relief for their red eyes should really be in the form of appropriate dry eye treatment.
- Foreign body sensation: This is another term for describing the feeling of something in the eye, such as an eyelash or a grain of sand. This ranks highly among the common symptoms of dry eye, though many patients are convinced there is actually something stuck in the eye and will even attend the hospital emergency department for treatment.
- Burning, scratchy, gritty eyes: Dryness isn’t the only adjective that can describe a dry eye. Burning, scratchy, and gritty are more easily recognizable symptoms of dry eye as the tear film that usually covers and protects the sensitive surface of the eye is compromised, leading to exposure of the delicate cornea to the environment. Some patients may describe the sensation as stinging, or even the sensation of a fleeting pinprick.
- Filmy, sticky eyes: The eyelids are lined with sebaceous glands known as Meibomian glands. The function of these glands is to produce an oil that forms part of a healthy tear film that covers the corneal surface, but quite commonly these glands become blocked or the composition of their secretions is altered by bacterial colonization from the skin. Even hormonal changes can affect the quality of Meibomian secretions, resulting in poor quality oils. The effect can be a filmy, mucky feeling of the eyes and vision, which can fluctuate with blinking. The eyelids may also feel a bit sticky from the excess poor quality oils.
- Watery eyes: The sensation of the eyes feeling watery or teary is probably the most counter intuitive symptom of dry eye syndrome yet is surprisingly common. As the surface of the cornea dries and is exposed to the surrounding environment, a reflex is triggered which causes an increase in tear production in an effort to lubricate and protect the eye. This is similar to situations where the eye waters to flush out a foreign particle that may have fallen in. Some patients may notice the wateriness is worse in certain conditions, such as outdoors in the cold or the wind – two environmental factors that can exacerbate dryness of the ocular surface. Although it may seem odd to be looking at dry eye treatment to alleviate wateriness, it can in fact be the answer to reduce bothersome tearing of the eyes.
- Tired eyes: A tired sensation in the eyes can arise from a number of causes, one simply being that the body is tired and it’s time to rest. In some cases, tired, fatigued eyes can also be a sign of dryness due to inadequate lubrication over the cornea. This creates greater friction between the surface of the cornea and the underside of the upper eyelid, leading to an increased effort required with each blink. By the end of the day, an eye that has had to exert a greater amount of force to blink the eyelid over a dry ocular surface will feel more fatigued.
One of the interesting observations that has become more apparent with deepening understanding of dry eye syndrome is that the symptoms of dry eye don’t always correlate with the clinical signs seen by the eye care provider. It is now recognized that dry eye can be present without the patient feeling any sort of discomfort or symptoms at all and conversely, that a patient may present complaining of terribly dry, gritty, sore eyes but with only very mild signs of dryness seen on examination.
A comprehensive eye examination to classify the category of dry eye syndrome as well as identify what factors may be contributing to the dryness is the best way to direct dry eye treatment strategies. Though lubricant eye drops off the shelf at the chemist or supermarket may provide immediate short-term relief, there are now a significant number of more effective, targeted dry eye therapies available upon the advice of your eye care provider.
Having problem with you dry eyes and need professional treatment? You are welcome to call us on (03) 9070 5753 to organize your initial consultation. Book your appointment by phone or online.