There is a particular eye complaint I hear quite often in the pharmacy.
“My eyes feel gritty.”
People describe it as though there is a tiny piece of sand trapped underneath the eyelid.
They can feel dry.
They can sting.
Sometimes they itch.
Sometimes the eyes look red.
And rather strangely, they may even start watering.
That last one always seems to confuse people.
“How can my eyes be dry when they’re watering all the time?”
Actually, it makes perfect sense.
And it is one of the things I often explain when someone comes into the pharmacy looking for something to help their uncomfortable eyes.
Your eyes need a good tear film
We tend to think of tears as something that happens when we cry.
But your eyes need a very thin layer of tears all the time.
This tear film keeps the surface of the eye smooth and lubricated and helps protect it.
Dry eye happens when the eyes don’t produce enough tears, or when the tears evaporate too quickly. (nhs.uk)
And when that protective layer isn’t working properly, the eyes can become irritated.
Hence the gritty feeling.
You may notice burning, soreness, redness, sensitivity to light or temporary blurred vision.
And then something rather odd can happen.
Your eyes start watering.
Dry eyes can make your eyes water
This sounds completely backwards.
But if the surface of the eye becomes irritated, your body can respond by producing more watery tears.
The problem is that these tears may not contain the right balance of oils and other components needed to keep the eye surface properly lubricated.
So you can have dry eyes that are also watering excessively. (nhs.uk)
I’ve had people come into the pharmacy saying:
“I don’t need anything for dry eyes. Mine won’t stop watering.”
Sometimes, paradoxically, dry eye is exactly what needs considering.
Getting older doesn’t help
Dry eyes become more common as we get older.
The eyes can produce fewer tears and changes around the eyelids and tear glands can affect how well the tear film works. (nhs.uk)
But ageing isn’t the only reason.
And this is where modern life doesn’t always do our eyes any favours.
Your phone might be part of the problem
Think about what happens when you’re concentrating on a screen.
You stare.
You read.
You scroll.
You watch.
And you don’t blink as often as you normally would.
Blinking is important because it spreads the tear film across the surface of the eye.
Long periods of computer or screen use can therefore contribute to dry-eye symptoms. (nhs.uk)
I’m not suggesting that everyone throws their phone away.
But if you spend hours staring at a screen and your eyes are becoming dry and uncomfortable, regular breaks and consciously blinking more often can make sense.
Then there are the medicines
This is where I put my pharmacist hat on.
Some medicines can contribute to dry eyes.
Antihistamines are one example.
Some antidepressants and blood pressure medicines can also be involved. (nhs.uk)
That doesn’t mean the medicine is necessarily the problem.
And it certainly doesn’t mean you should stop taking it.
If you suspect one of your medicines is contributing, speak to your pharmacist or doctor.
Sometimes an alternative can be considered.
Sometimes the medicine isn’t responsible at all.
And sometimes the benefits of the medicine are much more important than the relatively minor side effect.
It is about looking at the whole picture.
Air conditioning isn’t helping either
If you live or work in an air-conditioned environment, you may notice that your eyes become particularly uncomfortable.
The same can happen with central heating, wind, dust and dry air.
Contact lenses can also make dry-eye symptoms more likely. (nhs.uk)
This is why some people notice that their eyes are perfectly comfortable at home but become irritated after several hours in an air-conditioned office.
The environment matters.
So what can you actually do?
This is one of those conditions where some fairly simple changes can make a noticeable difference.
If you’re working at a computer, take regular breaks from looking at the screen.
Try not to sit directly in the path of an air-conditioning vent or fan.
If your home is very dry, increasing humidity may help.
If you wear contact lenses and your eyes are becoming irritated, give your eyes a break and wear your glasses for a while. (nhs.uk)
And don’t forget the simplest thing of all:
Blink.
It sounds ridiculous until you realise how little you can blink when concentrating on a screen.
What about eye drops?
This is where the pharmacy can be particularly useful.
There are artificial tear preparations available as drops, gels and ointments.
For many people with mild to moderate dry-eye symptoms, these can provide useful relief. (Moorfields Eye Hospital)
But don’t assume that the most expensive bottle on the shelf is automatically the best one.
Different products contain different ingredients and have different consistencies.
Some people need drops they can use during the day.
A thicker gel may be useful for some people, particularly at night.
If someone needs artificial tears very frequently, preservative-free preparations may be more suitable because preservatives can themselves irritate the surface of the eye. (Moorfields Eye Hospital)
This is exactly the sort of situation where asking the pharmacist is worthwhile.
A few questions about your symptoms, contact lenses, other medicines and how often you need the drops can help determine what type of product is appropriate.
Don’t forget your eyelids
Another thing people often overlook is eyelid hygiene.
Problems with the eyelid margins, including blepharitis, can contribute to dry-eye symptoms.
Gentle cleaning of the eyelids and warm compresses may help in appropriate cases. (nhs.uk)
It isn’t glamorous.
But neither is rubbing your eyes every five minutes.
And rubbing irritated eyes repeatedly isn’t a great habit.
When is it more than ordinary dry eye?
Most cases of dry eye aren’t serious.
But there are times when I would not recommend simply buying a bottle of eye drops and hoping for the best.
If your symptoms continue for several weeks despite self-care, it’s worth seeing an optician or GP. (nhs.uk)
And there are some symptoms where you need more urgent help.
A painful red eye, particularly if you wear contact lenses, needs prompt assessment because an eye infection can be serious. (nhs.uk)
Changes in your vision, severe eye pain, significant sensitivity to light or a very red eye accompanied by feeling unwell also need urgent medical attention. (nhs.uk)
Don’t assume every red or uncomfortable eye is simply dry eye.
Your eyes are worth looking after
We probably spend more time worrying about our skin than we do about the surface of our eyes.
But our eyes are working from the moment we wake up until we close them at night.
If they occasionally feel a little dry after a long day staring at a screen, a break may be all they need.
If they are regularly gritty, sore, burning or watering, however, don’t simply put up with it.
Look at your environment.
Look at your screen habits.
Think about your contact lenses.
Check your medicines.
And speak to your pharmacist about suitable eye drops if you need them.
Sometimes the answer isn’t complicated.
Your eyes may simply be asking for a little more attention.
Until next time, look after yourself.
This article is for general health information and is not intended to replace individual medical advice.
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