Can Dry Eyes Cause Blurriness?

What is Dry Eye Disease?

Dry eye disease is a common condition that occurs when your eyes don’t produce enough tears or when the quality of the tears is poor. Tears are essential for maintaining the health of the surface of the eye and for providing clear vision. When the quality of your tear film degrades it can cause the light to disperse unevenly as it enters your eyes. This can cause blurry vision that may feel inconsistent like you can ‘blink the blurriness away’ as well as other vision problems. If you are struggling with intermittent blurriness it’s important to speak with your optometrist as there are many solutions for dry eye relief.

What Causes Dry Eyes?

Many factors contribute to dry eye disease; some factors are largely beyond our control, such as age, genetic predisposition, the environment, medical conditions (especially autoimmune, inflammatory conditions and hormone disorders), eye surgeries (cataract, LASIK, etc), and medications (oral-contraception, antihistamines, anti-anxiety medications, anti-depression medications, etc)

Smoking exacerbates dry eye symptoms by impacting the moisture levels in the eyes.

Extended use of digital devices is also a contributing factor. Since we tend to blink about 60% less while staring at screens, prolonged usage without breaks can result in dryness and eye fatigue.

Wearing contact lenses can worsen dry eye symptoms as well. They restrict the amount of oxygen that reaches the cornea, and they can also absorb tears. Overusing contact lenses can lead to increased redness and sensations of itchiness and irritation.

Although eyelash extensions have gained popularity, they can also cause eye irritation, styes, eye infections, and more. The lashes and adhesive can block the meibomian glands, leading to increased bacteria in and around the eyes. Unfortunately, Health Canada does not regulate who can apply lashes or the products used, and many adhesives contain or release small amounts of formaldehyde, which can be harmful.

Blurry Eyes and Other Symptoms

Dry eye disease presents a variety of symptoms, ranging from those commonly associated with it to lesser-known ones.

The more common symptoms are redness, irritation, itchiness, burning/foreign body sensation, blepharitis, and styes/chalazions. Nevertheless, it can also lead to feelings of eye fatigue, fluctuating or diminished vision, a sensation of pulling or pressure in or behind the eye, and even excessive tearing.

One common misconception about watery eyes is that they can’t be dry due to the abundance of tears. However, excessive watering actually indicates an unstable tear film.

The tear film consists of three components, each supplied by different parts of the eye. The outermost layer, known as the lipid or “oily” layer, is provided by the meibomian glands located in the upper and lower eyelids. This layer plays a crucial role in maintaining tear stability and reducing evaporation.

Next is the middle layer, called the aqueous or “watery” layer, which is supplied by the lacrimal gland situated behind the eye. Its primary functions include flushing away debris, bacteria, and toxins, while also delivering nutrients to the cornea.

The innermost layer is the mucin or “mucus” layer, originating from goblet cells in the conjunctiva. Similar to the aqueous layer, this component safeguards the cornea from bacterial invasion and ensures a clear refractive surface.

When the three tear film components are not in harmony, the eye attempts to compensate by increasing the flow of the aqueous part of the tears. If the lipid and mucin layers fail to balance the aqueous layer, the watery component has no way to adhere to the eye, causing the excess to be expelled.

This imbalance is usually referred to as Meibomian Gland Dysfunction (MGD) and is the more predominant form of dry eye disease.

Conversely, Aqueous Deficient dry eye occurs less frequently and stems from the lacrimal gland’s insufficient production of the watery component of the tear film

How to treat Dry Eyes?

Treatment options vary depending on the type of dry eye disease present. For those with Aqueous Deficient dry eye disease, prescription medications targeting the production of the aqueous layer, along with artificial tears typically provide relief.

In contrast, for Meibomian Gland Dysfunction (MGD), treatments target the meibomian glands to increase the lipid layer of the tear, resulting in a more stable, efficient tear film. These treatments range from at home routines to in-office procedures such as Intense Pulsed Light (IPL) and Radio Frequency (RF).

Four essential products, known as the “CORE 4,” are recommended for managing dry eye disease symptoms at home. These comprise a warm compress mask, eyelid hygiene wipes, preservative-free artificial tears, and Omega-3 in the Re-esterified Triglyceride (rTG) form.

Consistency is key in the at-home routine, with most individuals finding it most effective when performed daily, often before bedtime. Before beginning the routine, it’s essential to remove makeup and thoroughly wash your face and hands.

To begin, a warm compress is used to heat the meibomian glands aiding in the breakdown of any blockages within. Opting for an eye-specific compress is preferable over a washcloth as these masks are designed to retain heat for approximately ten minutes, which is the recommended duration of use. Certain compresses containing rice and wheat may also harbour molds and bacteria, rendering them unsuitable for use near the eyes. After using the warm compress,  gentle massaging of the upper and lower eyelids help expel the oils from the meibomian glands. In a healthy eye, the oil should have the colour and consistency of olive oil. However when the glands are impacted, the oil may appear thicker and more milky. When massaging, it is crucial not to apply excessive pressure to avoid potential damage to the eye over time.

Following the massage, a preservative free eyelid hygiene wipe is used along the lash margin, both upper and lower lids, and in between the eyelashes. Accumulation of debris like dirt, dandruff, oils, bacteria, dander and allergens, particularly at the lash base, can lead to eye irritation and worsen dry eye symptoms.

Preservative free artificial tears can be applied as often as needed since there is no risk of the eyes reacting to the preservatives. Using them in the morning and before bedtime is a convenient and beneficial schedule for many.

The last crucial product is Omega-3 supplements in the Re-esterified Triglyceride form. Omega-3 oil, known for its natural anti-inflammatory properties, has been shown to reduce inflammation and its related symptoms in Dry Eye Disease.

Beyond improving eye health, Omega-3 also contributes to cardiovascular wellness, enhances cognitive function, supports mental health, aids in bone and joint health, and offers a range of other systemic advantages. Given the abundance of Omega-3 supplements available, it is crucial to select the most suitable supplement for your needs. The ratio of components, daily dose, and formulation all differ greatly. Visit our post about the importance of Omega-3s to learn more.

 

Written by our Ocular Hygienists, Holly & Lesley