Dry eye syndrome is a common condition where eyes don’t produce enough tears, or tears are poor quality and evaporate too quickly. This causes discomfort, irritation, and various symptoms. While often temporary, severe and untreated dry eye can potentially lead to significant vision problems.
Understanding Dry Eye Syndrome
Dry eye occurs when the tear film, a protective layer covering the eye’s surface, becomes unbalanced. This film has three layers—oil, watery fluid, and mucus—all working together to keep the eye lubricated, smooth, and clear. When any of these layers are disrupted, dry eye symptoms can develop.
Common symptoms include stinging, burning, or a scratchy sensation, often feeling like something is in the eye. Other symptoms are eye redness, light sensitivity, and sometimes watery eyes as a reflex to irritation. Blurred vision and eye fatigue are also common.
Various factors contribute to dry eye. Aging is a factor, as tear production naturally decreases. Medical conditions like Sjögren’s syndrome, rheumatoid arthritis, lupus, and thyroid disorders can cause dry eyes. Environmental factors such as wind, smoke, dry air, and prolonged screen use (which reduces blinking) are common. Some medications, including antihistamines, decongestants, and antidepressants, can also lead to dry eyes.
How Dry Eye Can Affect Vision
Dry eye can impact vision, from temporary disturbances to, in severe cases, permanent changes. The tear film’s primary role is providing a smooth optical surface for clear vision. When the tear film is unstable or insufficient, light scatters as it enters the eye, leading to blurred or fluctuating vision. This temporary blurriness is common, especially after activities like reading or computer use.
Constant friction between eyelids and a dry eye surface can damage the cornea, the clear, dome-shaped front part of the eye. This can cause corneal abrasions, which are superficial scratches. Severe or chronic abrasions can progress to corneal ulcers (open sores) or lead to scarring.
Corneal scarring can result in permanent vision impairment or, in extreme cases, vision loss because scars distort how light passes through the eye. While uncommon, permanent vision loss is possible if severe dry eye is untreated and leads to significant corneal damage. A dry ocular surface also increases the risk of eye infections, which can lead to vision complications if not promptly addressed.
Addressing Vision Changes from Dry Eyes
Prompt diagnosis by an eye care professional is important for managing vision changes from dry eyes. They determine the underlying cause and severity. Treatment often begins with over-the-counter lubricating eye drops, also known as artificial tears, which moisten and soothe the eyes. For persistent symptoms, preservative-free artificial tears may be recommended to avoid irritation.
Prescription eye drops, such as cyclosporine (Restasis) or lifitegrast (Xiidra), reduce inflammation and help eyes produce more natural tears. Other interventions include punctal plugs, tiny devices inserted into tear ducts to block drainage and keep moisture on the eye’s surface. Warm compresses and eyelid hygiene, including eyelid wipes, can manage meibomian gland dysfunction, a common cause of evaporative dry eye.
Lifestyle modifications also help manage dry eye symptoms and preserve vision. These include avoiding smoke, wind, and dry environments, using a humidifier, and taking regular screen breaks to encourage blinking. If dry eye symptoms persist, worsen, or are accompanied by severe pain, redness, or a noticeable decrease in vision, seek immediate medical attention. With proper management, most vision issues from dry eyes are reversible, but severe corneal damage can lead to lasting changes.