How Does Psoriatic Arthritis Affect the Eyes?
Dry Eyes With Immune Disorders
Too many late nights. Too much screen time. Long flights. Menopause. Lots of things can cause your eyes to feel dry, gritty, and sore.
But dry eyes can also be related to a medical condition that affects your immune system like diabetes, lupus, or HIV. And sometimes dry eyes are the first sign of a deeper problem.
There are more than 80 autoimmune diseases. They're called that because your immune system attacks your healthy tissue by mistake instead of invading germs and viruses. One thing all these diseases have in common is inflammation, which can lead to pain, swelling, and other trouble.
This inflammation can show up almost anywhere in your body. Sometimes that's far away from a disease's main target of, for example, your skin or your joints.
Inflammation can damage your tear glands, so they don't make enough fluid. Or it can target oil glands in your eyelids; without oil, your tears evaporate too soon. Either way, your eyes get dry.
Most people with diabetes know that it can cause eye problems like retinopathy, cataracts, and glaucoma. While infrequent, people with diabetes may have dry eyes, as well.
That's because the nerve damage that causes you to lose feeling in your hands, legs, and feet -- so you don't notice cuts and sores -- can also affect your eyes. Severe dryness that's not treated can damage your cornea, the dome that covers the front part of your eye.
If you have diabetes, get your eyes checked regularly, perhaps every year, including the corneas. If you don't have it and you have dry eyes, especially if your vision is blurry and you're often thirsty, too, you may want to get tested for diabetes.
This type of arthritis can target almost any part of your body, including your eyes. Some people with RA have a second autoimmune disease called Sjogren's syndrome, which dries out both your eyes and mouth.
Having lupus makes you more likely to get many eye problems, but the most common is dry eye. Inflammation damages your tear-making glands, so they can't make enough moisture to keep your eyes healthy.
The inflammation with this thyroid disease pulls and stretches the muscles around your eyes, so they bulge out a bit. When you can't shut your eyes tight, your tears will evaporate too fast.
How autoimmune problems are treated depends on the disease, but keeping inflammation under control is key. If you have very dry eyes, you may need long-term anti-inflammatory eye drops or punctal (tear duct) plugs to prevent drainage.
You can also do a lot on your own to ease symptoms:
Treatments For Chronic Dry Eye
Chronic dry eye treatments range from eye drops to surgical procedures. Lifestyle changes, natural remedies, and alternative therapies may also help.
Dry eye occurs when your eyes can't produce enough tears. This might be because your tears evaporate too quickly or due to inflammation in or around the eye.
You can experience temporary dry eye from environmental factors, like wearing contact lenses for too long or being in a dry environment. But chronic dry eye is an ongoing condition. Your symptoms may get better or worse but never go away completely.
Chronic dry eye is often due to an underlying condition. Conditions involving the eyelids, skin diseases near the eyes, nutritional deficiencies, and allergies can all contribute to chronic dry eye.
There are many options for treating dry eye, so you can find one or more that work for you.
There are many medications available to treat chronic dry eye.
Sometimes, an underlying condition or external factor may lead to dry eye, so it's best to contact a doctor to rule out any other conditions. Some medications can also cause dry eye, so you may simply need to work with your doctor to switch medications.
Over-the-counter (OTC) medicationOne of the most popular ways to treat dry eye is through OTC eye drops, also called artificial tears.
Preservative-based eye drops stay on the shelf for a long time. Preservative-free eye drops come in several disposable vials you use once and throw away.
Artificial tears moisten your eyes and may be enough to relieve moderate dry eye symptoms. Still, you may need to apply them several times a day.
You can also use ointments, but they tend to make vision cloudy. Ointments coat your eyes better than eye drops do. Because they make vision blurry, it's best to use them right before bedtime.
Avoid using eye drops that reduce redness. These may eventually irritate your eyes because they constrict blood vessels.
Eye insertsIf regular OTC tear replacement drops don't work, eye inserts might be an option. Made of dissolvable cellulose, they look like flattened grains of rice and rest deep behind the lower eyelid.
You place the inserts in the space between your eyeball and lower eyelid. The insert releases medication throughout the day to keep your eye moist.
Prescription medicationA doctor may prescribe medication to treat chronic dry eye. This could include prescription eye drops or medications you take orally (by mouth).
Most of these focus on reducing inflammation on the surface of your eye and the margins of your eyelid. When your eyelids are inflamed, they prevent your oil glands from adding oil to the outer layer of your tear film. Without oil, your tears evaporate too quickly.
Certain antibiotics stimulate oil production in the glands around the eyes. If a doctor believes inflammation is primarily causing your dry eye, they may prescribe anti-inflammatory antibiotics.
Prescription eyedrops are often anti-inflammatory as well. Common options include:
If your chronic dry eye is due to losing tears too quickly, you may find relief by wearing special contact lenses. These help protect the surface of your eye and prevent moisture from escaping.
Scleral lenses are custom-made lenses that protect the entire surface of your eye and help it retain moisture.
Doctors may also recommend bandage contact lenses to help with dry eye after a procedure like cataract surgery.
In addition to medications, a doctor might recommend certain procedures to treat chronic dry eye. These include:
Several natural treatments may help chronic dry eye. Examples include:
Always talk with a doctor before trying any natural remedy.
Researchers continue to explore several alternative treatments for chronic dry eye. These therapies often target different aspects of the disease.
Alternative therapies include:
The authors of a 2022 research review recommend trying alternative therapies only when conventional treatments don't work.
You can make some at-home changes that may improve your chronic dry eye symptoms.
Consider:
Treating chronic dry eye involves either producing more tears or conserving the tears you make. Conventional first-line therapies include eye drops and oral antibiotics. More severe cases may require special lenses or a medical procedure.
How you and a doctor choose to treat your symptoms will depend on several factors, including:
Work with your doctor or an eye specialist to find the best solution for you.
Your FAQs, Answered: Can Dry Eyes Be Cured?
Dry eyes can leave your eyes feeling itchy or irritated. Eye drops can treat symptoms, but there's no cure. In some cases, a doctor may recommend an eye procedure, such as minor gland salivary autotransplant.
Dry eyes, or dry eye syndrome, is a common condition that happens when either your eyes don't make enough tears or you're unable to maintain a layer of tears to coat your eyes. Over time, this can lead to inflammation and damage to the eye's surface.
Symptoms of dry eyes include burning, red, or irritated eyes; blurred vision; and a scratchy sensation, like there's something in your eye.
Dry eyes have many causes. Health conditions like rheumatoid arthritis or thyroid disease, hormone changes, and certain medications can lead to dry eye symptoms. In addition, people naturally tend to make fewer tears as they age.
Environmental factors like windy or dry climates, using contact lenses, and staring at a computer screen for long periods can also contribute to dry eyes.
Read on for answers to frequently asked questions about what to expect from dry eye syndrome and if this condition can be cured.
Dry eyes can be temporary, especially if your symptoms are a result of an environmental factor such as a dry climate, prolonged computer use, or overuse of contact lenses. If your dry eyes are caused by medications, you symptoms may go away when you stop taking that medication.
For some people, however, dry eyes is a chronic condition. The symptoms may improve over time with treatment, but they may never go away completely.
Chronic dry eye happens when your eyes can't produce or maintain enough tears for a healthy tear film. Chronic dry eye is often related to other health conditions like lupus, Sjögren's disease, diabetes, and rheumatoid arthritis.
Dry eye symptoms may go away once an irritant is removed. In addition, symptoms may come and go with changing seasons.
Simple lifestyle changes can also help keep dry eye symptoms at bay. For example:
On the other hand, chronic dry eye, which can be caused by other health conditions, may require treatment. In this case, the underlying health condition should also be treated to help relieve dry eyes.
Dry eyes can often be managed, but not completely cured. Some treatments can be used permanently to manage your symptoms.
Prescription medications and over-the-counter (OTC) eye drops, such as artificial tears, can help you manage this condition. While artificial tears don't treat the underlying cause of dry eyes, they do lubricate the surface of the eye. This can be effective at relieving common symptoms of dry eyes.
When artificial tears or other eye drops don't relieve your dry eye symptoms, tiny devices known as punctal plugs can be inserted to keep your tears. Inserting punctal plugs is a minor, noninvasive procedure. While punctal plugs can often help the eyes retain tears, you may still need to use artificial tears going forward.
In severe and otherwise untreatable cases, your doctor may recommend other types of procedures, such as minor gland salivary autotransplant and amniotic membrane. These procedures may help reduce signs and symptoms of dry eye in people with severe cases.
If your symptoms are mild, artificial tears may give you temporary relief right away. You may need to apply artificial tears a few times throughout the day.
If the drops contain preservatives, using them more than four times per day may irritate your eyes. In this case, talk with your eye doctor about using preservative-free eye drops. They're safe to use as often as needed.
If you need to use artificial tears frequently for symptom relief, talk with your eye doctor about prescription medications, such as cyclosporine (Restasis, Cequa) or lifitegrast (Xiidra).
If your doctor prescribes medications for dry eyes, it can take anywhere from a few weeks to a few months to start seeing an improvement with continued use.
In the United States, dry eyes very rarely leads to blindness. However, in places where medical treatment is difficult to access, severe cases of dry eyes may cause other eye conditions that can lead to blindness.
Without treatment, severe dry eyes can lead to a corneal ulcer. A corneal ulcer is an open sore that develops on the clear, dome-shaped, outer layer of your eyes, which is called the cornea. The cornea helps your eye focus light and maintain clear vision. If the ulcer isn't treated, it can spread and scar the eyeball, causing partial or complete blindness.
Dry eyes can be temporary or a chronic condition, depending on the underlying cause. Without treatment, chronic dry eye can lead to complications, like a corneal ulcer.
OTC artificial tears and certain lifestyle changes are often enough to manage mild dry eye symptoms, but if these don't work, an eye care professional can help you find a suitable therapy.
If you think you have dry eyes, talk with an eye doctor.
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