I was writing headlines for my college newspaper one night in 2011, when I could no longer make out the bold, black words on my computer screen. “I can’t see,” I announced to the newsroom. I took out my contacts and put on my glasses. My vision became even more blurred.
Two weeks later, an ophthalmologist presented me with a surprising diagnosis: A combination of dryness and poor contact lens hygiene had led to tiny abrasions all over both of my corneas. I would need to moisten my eyes with prescription drops and to stop wearing contacts — for an entire year. Or else, the doctor warned, “you may need a corneal transplant.”
My eyes soon recovered, and now, nearly 10 years later, I’m diligent about using eye drops and wearing daily disposable contact lenses.
My case was extreme, says Vatinee Bunya, MD, MSCE, an associate professor of Ophthalmology in the Perelman School of Medicine at the University of Pennsylvania. But dry eye is a common condition — affecting nearly half of U.S. adults at some point during their lives — and yet often overlooked as a serious ailment.
“Many of our patients have told us that it’s the worst medical problem that they suffer from. Even though dry eye in itself won’t cause you to completely lose your vision, it can really be debilitating,” said Bunya, who co-directs Penn’s Dry Eye and Ocular Surface Center with Mina Massaro-Giordano, MD, a professor of Clinical Ophthalmology.
As more of us are spending increased hours staring at a computer screen, and masks have been associated with dry eye, it’s likely that you might be suffering from the condition for the first time in your life.
I talked to Bunya about signs to look out for, how to treat it, and when it can be a symptom of a more serious condition.
‘Dry’ Eye Can Be a Misnomer
Causes of dry eye are wide ranging, and the condition is often multifactorial, Bunya says. People with dry eyes either do not produce enough tears, their tears are of poor quality, or a combination of both. This commonly happens as people — especially women — age. The condition can also be a medication side effect, as well as the result of allergies, or a genetic problem.
Some patients, Bunya says, don’t even realize they have “dry” eyes, since that classic symptom isn’t always present.
“Many patients don’t actually feel a lack of moisture. They can actually have excess tearing,” Bunya says. Called “reflex tearing,” your eyes can overproduce watery, poor-quality tears in response to an irritant or when your corneas are too dry.
Ranging from a nuisance to crippling pain, symptoms may also include grittiness, blurred vision, and a tired, heavy feeling in the eyes.
You Can Find Relief
One of the first steps that Bunya takes for treating her patients’ dry eyes is to recommend artificial tears twice daily. The most effective over-the-counter eye drops are preservative-free and are sold in single, one-use vials. For more severe dryness, there are highly effective prescription drops, as well as some more high-tech solutions. For example, punctal plugs are tiny devices placed in the tear ducts of the eyelids which stop fluid from draining from the eye.
For daily relief, Bunya recommends using warm compresses and taking regular breaks from the computer screen. Taking a “holiday” from your contact lenses for a few days, or even a few months, can also be beneficial, she said. Certain contact lenses — like ones that are daily disposables — are specially formulated to lubricate the eye and are made of more breathable materials than traditional lenses.
“For the most part, we can help the majority of patients feel better, which is really rewarding,” Bunya says. “There are a lot more treatment options available today than there were even 10 years ago.”
It Could Be a Sign of a More Serious Disorder
While dry eye is a common problem, it can signal a more serious medical issue, Bunya says. One example is Sjögren's syndrome, an autoimmune disorder which dries out the eyes and mouth, as well as other parts of the body. Left untreated, Sjögren's syndrome symptoms can intensify, and patients have an increased risk of developing lymphoma.
At Bunya’s clinic, she developed a questionnaire for all dry eye patients in order to screen them for the disease. If the patient’s answers signal a problem, then she can test their blood for the presence of the antibodies that are common in Sjögren's syndrome.
“We are very proactive about screening,” Bunya says. “If you’re experiencing problems, it’s important to get checked out. No one should have to live in discomfort.”