Is stress worsening your dry eye?

Long work hours, little sleep, a full inbox; balancing work and a social life: Stress can pile up and have notable physical effects on the body, including the eyes. Ocular symptoms such as burning, redness, irritation, watery eyes, and blurred vision may signify the presence of dry eye disease, which affects as much as 8% of the U.S. population. These symptoms can intensify in troubling times.

“Stress can certainly exacerbate dry eye problems in a variety of ways,” says Darren Gregory, MD, professor of ophthalmology at the University of Colorado School of Medicine.

“The body experiences elevated levels of inflammation when you’re feeling stressed, and inflammation is a factor in dry eyes,” he explains. “In inflammation, white blood cells are recruited to the surface of the eye where they start releasing the inflammatory chemicals they produce, and this can make symptoms worse.”

Gregory explains why stress seems to impact dry eye and how patients can help alleviate some of the symptoms.

Intensifying stress and symptoms

Stress can increase sensitivity to pain all over the body.

“Our perception of pain is heightened, so the discomfort a person may feel in their eyes can be amplified,” Gregory explains.

There are other factors at play, too. Lack of sleep, coupled with medications used to treat behavioral conditions like anxiety, depression, and insomnia may also contribute to worsening dry eye symptoms.

“We may have difficulty sleeping or sleep less because of various demands, whether it’s work or family or whatever else is going on,” Gregory says. “This may decrease the quality and the quantity of our sleep. Just like our brains need some time to recover from the stresses of the day, so do our eyes.”

Additionally, many medications that are used to help induce sleep can intensify eye discomfort.

“We often see that these medications can cause dry mouth and dry eyes,” he says. “When I see a new patient who’s coming to the Sue Anschutz-Rodgers Eye Center with dry eye troubles, one of the first things I look at with them is their medication list, which might help explain why they’re having these worsening symptoms.”

It might not be feasible to stop those medications, Gregory adds, but it can provide some peace of mind to at least understand why the dry eye symptoms are happening.

Finding relief for dry eye symptoms

Dry eye disease can be a frustrating condition for patients because it can be difficult to manage, but being mindful of the environment and taking precautionary measures, especially when stress is elevated, may help.

“A lot of what I do is explain to patients that it’s important to take breaks from staring at the computer, use moisturizing eye drops as part of a daily routine, and make environmental adjustments to minimize the wind stress on the eyes,” Gregory says.

Actions such as remembering to stay hydrated, turning off vents or fans that may further dry eyes, and using eye drops preventively can help alleviate and prevent bothersome symptoms.

“Don’t wait until your eyes are burning to use moisturizing drops,” Gregory explains. “That’s sort of like waiting until your lips are chapped and cracked to start using lip balm. If you do a little bit of treatment more often and develop a routine, you may find that the dry eye symptoms are not as bad.”

Gregory also recommends using a warm eye compress for about five to 10 minutes and then gently massaging the eye lids or taking a few big, firm blinks. This can help disperse natural oils needed to keep the eye properly lubricated.

Finally, finding some time to destress and relax is important for ocular health.

“Our modern world is not very kind to eyes,” Gregory explains. “Taking time to prioritize your health is important. Whether it’s yoga or limiting screen time, these little improvements can make a difference and potentially help those bothersome symptoms that act up when we’re stressed.”