Why Eye Drops make Eyes Drier in Chronic Dry Eye Syndrome
Why eye drops don’t always work for chronic dry eyes?
You have been diagnosed with chronic dry eyes. The majority of available treatments are eye drop based. I am sure that you have tried one or all of the following:
- Over the counter eye drops
- Preservative free eye drops
- Eye drops that are thicker to provide longer lasting relief such as gels
- Eye drops that have balanced electrolytes
- Tried prescription cyclosporine drops
- Tried tear thickening oily capsules
- Used either an eye mask or thick eye gel at night.
Of all the eye drops, decongestant eye drops, are the worst. they work by constricting blood vessels in your eye to take the red out. Long-term use can cause your eyes to become dependent on these eye drops, and when you stop, the blood vessels become even larger, making red eyes worse.
After all this, your eyes are still dry, irritated, red, sometimes painful, and your vision is blurred. It is even possible to develop corneal ulcers from prolonged chronic dry eye conditions.
So why don’t drops work for my chronic dry eye?
The answers resides in our tear composition and tear secretion glands:
1. Lacrimal Glands- This gland produces the bulk of your tear and creates tear volume
2. Mybomian Glands- This gland secretes thickening agents (proteins, lipids, and mucin) to prevent tear evaporation and protects the eye
Our body requires that the tear volume and tear thickness be balanced and secreted evenly over time in order to provide eye comfort. Most of the treatments listed above address either one or the other requirements, but not both:
- Eye drops – compensate for the lack of tear volume
- Oily eye capsules – compensate for the lack of tear viscosity (thickness)
The common experience with any kind of eye drops are “My eyes are dry 10 minutes after putting drops in”. Over time, the more one uses eye drops, the drier the eyes get. The reason is eye drops wash away the lubricating thickening agents that your Mybomian Glands produce and eventually train your eyes not to secrete tears. It becomes a conditioning reflex.
Overuse of eye drops usually constitutes more than 4-5 times/day. A good analogy of this would be if you washed your hands repeatedly. The outcome? You would have overly dry and cracked hands. The same principle is applied to the eyes. Strip away the natural mucin your eyes are creating with drops will eventually lead to drier eyes.
Last edited by Rebecca Petris; 16-Dec-2010 at 10:30.
Reason: removed promotional info
Dr. Lily C. Yang
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