Desert Storms and Watering Eyes

Have you ever witnessed a downpour in the desert? On occasion as a young child, my family and I would sit out on our back porch and watch the lightning strike and listen to the thunder clap as the rain pelted the surrounding parched ground in the southern Utah desert of Ivins, Utah. I loved the smell following a fresh rain and still do. Despite the ferocity of these desert storms, it seemed to me the rain would quickly soak in and run off and the land would quickly parch over again.

I frequently get asked by patients why their eyes water so much. If you have dry eyes, it doesn’t make sense that they should always be watering, unless you consider the analogy of the desert storm and the parched ground. In general, there are two main causes for watering eyes: allergies and dry eyes. When someone has eye allergies, their eyes may be red, itch and water. With dry eyes, symptoms are similar. They may be red and feel dry, scratchy, gritty, irritated or burn and they may water excessively. And, of course, there is nothing that states that a person will have only allergies or only dry eyes. Both may be at work.

Dry Eye Syndrome is a chronic condition typically with one of two main causes: either you are not producing enough tears or you produce sufficient tears, but your tears evaporate from your eyes quickly resulting in insufficient moisture being retained by the eye. Evaporative dry eye is responsible for 80% of dry eye complaints. In this situation, the eye will become dry and send a signal for more tears. The problem is the tears come in the wrong proportion and your eye waters. Associated underlying causes of dry eye may include poor blinking, heavy reading or digital device use, living in dry environments such as southern Utah, prolonged contact lens wear, medications (especially from allergy drugs, diuretics, beta blockers and birth control pills), LASIK surgery, diets poor in essential fatty acids or anti-inflammatory foods, certain health conditions such as diabetes, arthritis, lupus and Sjogren’s syndrome and tear glands just not producing tears or oil glands being plugged.

If you have dry eyes, how can you manage it? First, check your medications. Talk to your doctor to see if your meds may be causing your dry eye symptoms. Second, consider your nutrition. What are you taking into your body? Eat healthy and sensible meals and snacks. Stay hydrated with water. Avoid caffeinated drinks. Balance your hormones. Eat healthy whole grains, less sugar and fewer processed foods. This will help control blood sugar and insulin levels and keep inflammation under control. Third, properly care for your contact lenses and maintain moisture in your eyes while wearing them. Keep them clean and replace them on schedule whether that be daily, every two weeks or monthly depending on the lens. When you first put contacts on they tend to be very comfortable, but as they day progresses, they act like a sponge. As the fluid from the lens evaporates, it draws in the surrounding tears which also evaporates resulting in dry eyes. Fourth, use artificial tears as needed to maintain moisture in your eyes. Fifth, Blink! We tend to ‘forget’ to blink when we are on the computer or other digital device. In fact, studies show that we blink less when working on the computer. Blinking is a key component of a good functioning tear film. Even when you do blink, if it is not a complete blink, you may still have chronic dry eye symptoms.

Many people tend to self-diagnose and self-treat dry eye symptoms. In a study commissioned by Allergan in 2011, 48% of American adult survey responders indicated they experience dry eye symptoms. Of these survey responders, 69% who experienced dry eye symptoms never visited their eye doctor for treatment. Nineteen percent of adults use over-the-counter eye drops at least 5 times each week. Of adults using over-the-counter eye drops, 63% say the drops are not effective or only somewhat effective. Though many of us may only experience what we consider mild dry eye symptoms, if not addressed appropriately, these dry eye symptoms can progress into a chronic, visually debilitating dry eye condition that can affect overall day-to-day comfort and quality of life functioning. If you are experiencing dry eye issues, it’s always a good idea to get your eyes evaluated by your eye doctor to help determine the underlying cause of dry eye so the appropriate treatment may be prescribed.

Just as the desert is dependent on the moisture produced by repeated summer thunderstorms, relief of dry eye symptoms comes from repeated, appropriate treatment. Like the refreshing, clean smell of fresh air following these desert thunderstorms, dry eye patients can find relief.

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