At some point in our lives, we’ve likely all experienced dry eye or known someone who has. In fact, millions of Americans report having symptoms of dry eye, including eyes that sting or feel scratchy. It’s an uncomfortable condition many experience daily. But did you know that dry eye and glaucoma often occur together?
In this blog, we’re talking about the connection between dry eye and glaucoma, as well as some causes and treatment options to consider.
What Causes Dry Eye and Are There Symptoms?
Dry eye occurs when the eye doesn’t produce enough tears or when the tears can’t keep the surface of the eye adequately lubricated. Although different for everyone, several factors can result in dry eye. Aging can impact your eyes’ ability to make tears, as can certain health conditions, such as Sjogren’s syndrome, rheumatoid arthritis, and collagen vascular diseases. In addition, environmental triggers, like pollution or the weather, can play a role.
While people may experience different symptoms, the most common symptom is a scratchy sensation or the feeling that something is in your eye. Other symptoms may include:
- A sandy, stinging, or burning sensation on the surface of the eye
- Excess tearing that follows dryness periods
- Eye redness that becomes worse during the day
- Blurred vision
Common prescription medications, including medication used to treat glaucoma, can also cause dry eye. Dry eye can be intensified when using eye drops, as well as by computer use or by wearing contact lenses. Similar to open-angle glaucoma, dry eye becomes more common as you get older with studies suggesting that 40-50% of glaucoma patients also develop dry eye.
The Connection Between Dry Eye and Glaucoma
Treating dry eye is very important for your comfort and for the eye’s long-term health. However, since glaucoma is the second leading cause of blindness worldwide, if you are living with glaucoma and also suffering from dry eye, your physician will likely want to treat glaucoma first.
If you find yourself suffering from dry eye, your doctor might recommend a change in glaucoma medications by switching to preservative-free eye drops or using combination drops to reduce the number of preservatives instilled in the eye. Since the treatment of both chronic conditions often includes eye drops, remembering when and how often to use eye drops can be a challenge. Research has shown that more than 90% of patients are non-adherent with their prescription eye drops for glaucoma, and nearly 50% stop taking their medications before 6 months.
Studies have also found a relationship between dry eye and the number of glaucoma medications a person is taking, with dry eye present in 11% of eyes on one eye drop compared to 39% and 43% of eyes on two and three drops, respectively. If you’re concerned about the number of glaucoma medications you’re using and the connection the condition has with dry eye, there are a number of new glaucoma treatment options that you and your doctor may consider. Today, more micro-invasive surgical options are available for patients who are interested in effective glaucoma management without having to rely solely on the continuous use of prescription medication. Adding iStent inject® W, one of the smallest medical devices known to be implanted in the human body, to your cataract surgery can provide several benefits. The device is designed to work continuously, and it can reduce the number of glaucoma medications needed (at your physician’s discretion).
Treatments for Dry Eye
If you’re living with glaucoma and also dealing with dry eye, you’ll likely need a combination of treatments to manage both conditions. There isn’t a single treatment combination that will work for everyone, so you may need to go through several options until you find the combination that is right for you.
For those dealing with occasional or mild symptoms, making simple life changes or using over-the-counter treatments may help. However, if you attempt to treat your eyes and it’s not helping your symptoms, reach out to your optometrist or an eye doctor for help. If you’re looking for some additional information, the Dry Eye Zone is a great resource to learn about the condition and ways to treat it.
Depending on the severity and cause of a person’s dry eye, the following treatment approaches can be considered:
- Preservative-free glaucoma eye drops
- Specialized combination eye drops to reduce the amount of drying preservatives
- Artificial tears to help moisturize the eyes
- Oral medications to help with eyelid swelling and improve tear production
- Corticosteroid creams or drops to decrease inflammation
- Lifestyle changes – such as using humidifiers, reducing computer eye strain, using eyelid cleansing solutions to reduce inflammation, using hot compresses, avoiding windy or dry environments, wearing sunglasses and other protective eyewear, and staying hydrated.
Stay On Top of Your Eye Health!
We understand that living with glaucoma and dry eye can be uncomfortable and irritating. We hope this blog helps clarify why you might be experiencing symptoms — especially if you are living with glaucoma — and ways to treat them. If you think you have dry eye symptoms or have noticed any changes in your vision, be sure to stay on top of your eye health and make an appointment with your eye doctor.
 Nordstrom BL, Friedman DS, Mozaffari E, Quigley HA, Walker AM. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol. 2005;140(4):598-606.