The Overlooked Link Between Chronic Dry Eye and Your Overall Well-Being

When was the last time you thought about how your eyes feel? If you’re one of the 16.4 million Americans with dry eye, it’s probably always on your mind. Dry eye disease, after all, doesn’t just cause discomfort. It’s a chronic inflammatory condition1 with ripple effects beyond dryness and irritation.

Though dry eye can affect anyone, it’s most common2 in people with screen-heavy lifestyles and those dealing with hormonal shifts. It’s also more likely to affect women, particularly those in their midlife thanks to menopause.

Common symptoms include dryness, grittiness, burning, and feeling like something is in your eye, according to Danielle Orr, OD, MS, FAAO, assistant clinical professor at OSU College of Optometry. Many people also experience the paradox of increased tearing, as poor tear quality causes irritation, she says. “The brain interprets this as a signal to produce more tears, but they don’t help, thus creating a vicious cycle,” Orr explains. 

Over time, the condition can lead to complications2 like vision issues, headaches, mood disorders, and difficulty sleeping.

The tricky part? It’s easy to overlook dry eye disease. The symptoms “are often inconsistent in the early stages, and people usually attribute them to long hours of work, stress, or lack of sleep,” says Orr. You might also chalk them up to environmental triggers, like dust or seasonal allergies. 

Dry eye symptoms can be so uncomfortable that they mess with your ability to fall (and stay!) asleep. In fact, nearly one in two people with dry eye experience poor sleep.

For starters, the inflammatory pathways involved in dry eye can damage tear glands. This can disrupt tear quality and quantity, leading to worsening dry eye symptoms during the day, says Vicky Wong, O.D., optometrist and president of the Maryland Optometric Association. These effects can extend to nighttime tear production (which is already lower than daytime production3), causing eye discomfort during sleep.

Dry eye also makes it hard to completely close your eyelids4, causing pain and exposure to brightness. This can trigger even more inflammation and ultimately, trouble sleeping.

Dry eye can make it hard to perform daily tasks, enjoy hobbies, and simply relax, potentially increasing stress and reducing frustration tolerance.

The mood-altering effects go beyond the surface, though. “If left untreated, dry eyes can cause a chronic inflammatory response that can dysregulate the body as a whole,” explains Wong. This can lead to symptoms like chronic fatigue, stress, anxiety, depression, and even social withdrawal due to the red appearance of dry eyes, Wong says.

Studies have also linked dry eye disease with depression and anxiety5. The condition negatively affects daily functioning and quality life, which then disrupts the central nervous system.

Dry eye disease can disrupt cognitive functions, including focus and concentration. The condition often causes vision fluctuations and trouble reading2, which might be worse when you look at a computer screen. 

Plus, dry eye may trigger headaches, further shaking up your focus. This is due to inflammation, which can heighten the sensitivity of your peripheral and central nervous systems, causing headaches and migraines.

One more time for the people in the back: Dry eye is an inflammatory condition, not just a lubrication issue. The inflammation of the ocular surface1 stems from broader, more widespread inflammatory patterns.

But as dry eye progresses, it triggers molecular pathways involved in inflammation. This promotes dry eye symptoms and more inflammation1, promoting the chronic nature of the condition.

Besides, relying on OTC eye drops won’t resolve underlying inflammation and tear issues. “Without targeting the underlying problem of inflammation, many OTC lubrication eyedrops merely soothe over existing dryness rather than treating it,” says Wong.

Chronic dry eye is more than a surface-level issue. Without individualized treatment, it can negatively affect your sleep, mood, productivity, and overall health. With your eye care provider’s guidance, you can target the specific cause and find relief. It’s the best thing you can do for yourself and your peepers.