Millions of people around the world have dry eye syndrome (DES), when the tear film doesn’t sufficiently hydrate the eyes. DES leads to red, itchy, sore, irritated eyes that, in severe cases, can damage your cornea and permanently impact your vision.
While most cases of dry eye syndrome are caused by problems with the tiny oil glands in the eyelids, dry air or spending too much time in front of a digital screen, DES can also be a symptom of several autoimmune diseases.
At Manhattan Vision Associates in New York City we treat all forms of dry eye syndrome, including DES caused by an autoimmune disease.
What is an autoimmune disease?
A healthy immune system helps keep your body safe by fighting infections that enter your body. If you have an autoimmune disease, your own immune system incorrectly identifies your natural cells as invaders, attacking your body’s healthy cells and tissues. This can lead to many symptoms, including fatigue, joint pain, rashes, fever – and dry eyes.
While doctors aren’t exactly sure why the immune system misfires, they know women are twice as likely as men to develop autoimmune diseases, which are more common today than they were a generation ago. Even more worrying, 19%-31% of people with certain autoimmune disorders are likely to develop DES.
Autoimmune diseases that can cause DES include:
- Rheumatoid arthritis causes inflammation, swelling and pain of the joints. As the disease progresses, the pain can spread from the fingers and toes to the wrists, knees, ankles, elbows, hips and shoulders.
- Sjogren’s syndrome affects tear production by reducing the volume of tears the eyes can produce, and can be a secondary condition of another autoimmune disorder like rheumatoid arthritis or lupus.
- Psoriasis is an inflammation of the connective tissues of the body and affects the conjunctiva – the thin mucus membrane that lines the front of the eye and inside the eyelids – leading to eye redness and pain.
- Crohn's disease is a bowel disease that causes inflammation and swelling in the digestive tract. This causes abdominal pain, diarrhea, fatigue and weight loss.
- Diabetes makes it difficult or impossible for the body to produce sufficient insulin to break down the sugars and carbohydrates we eat. Nerve damage can lead to dry eyes, while the formation of fragile blood vessels in the eyes can harm the retina.
- Multiple Sclerosis (MS) causes the immune system to attack the protective sheath (myelin) that protects all nerve fibers of the body. This harms communication between the brain and the rest of the body. Eventually, MS can cause permanent deterioration of the nerves, including the optic nerve, which is the only connection between the eyes and the brain.
- Lupus is an inflammatory disease that can affect many different body systems, including your joints, skin, kidneys, blood cells, brain, heart, lungs and eyes. Approximately 20% of people with lupus also have secondary Sjogren’s syndrome.
What should you do if you have DES?
If your eyes are dry, your first step is to make an appointment for a dry eye exam with an eye doctor to evaluate the quantity and quality of your tears. Tell your eye doctor about any other symptoms you may be experiencing. Based on your exam results and medical history, your eye doctor may refer you to your family doctor and/or a doctor who treats autoimmune diseases.
If you have an autoimmune disease, treating the disease could alleviate dry eye symptoms. But it’s still crucial to see an eye doctor experienced in treating DES, who may prescribe eye medications and in-office treatments to relieve your symptoms and prevent them from worsening.
Regardless of the cause, chronic dry eye can result in complications ranging from double vision to corneal ulcers, even if it’s not autoimmune-related. Be proactive! The benefit to your overall health is more than meets the eye.
To schedule a dry [eye exam], contact Manhattan Vision Associates in New York City today.
Our practice serves patients from Manhattan, Queens, Brooklyn, and the Bronx, New York and surrounding communities.
Frequently Asked Questions with Dr. Arkady Selenow
A: You’re more likely to develop dry eye syndrome if you’re female, over the age of 50, take certain medications like antidepressants and antihistamines, live in a dry, windy or hot environment and have autoimmune diseases. Speak with your eye doctor about your individual risk factors; this will help determine the best preventative measures for long-term healthy and comfortable eyes.
Q: What does dry eye syndrome feel like?
A: The most common symptoms of dry eye syndrome include having eye redness, dryness, irritation, grittiness, light-sensitivity, watery eyes, stinging eyes and crustiness or stringy mucus around the eyes or eyelids. People with dry eyes may also find it difficult to wear contact lenses or drive at night. Symptoms can be persistent, chronic, or sporadic depending on eye hygiene, your environment and other factors.