How to deal with dry gritty eyes?

February 14, 2018 6:23 PM

I've been having dry eye symptoms for a while: my eyes feel tired after a few hours of computer use, and I get woken up every night by grit in my eyes. I've been doing a bunch of things to alleviate it, but nothing's really helped. Suggestions?

I'm a contacts wearer who has glasses (but dislikes wearing them). I saw an opthalmologist two months ago and she recommended using cleansing eye wipes (OcuSoft), taking omega-3 nightly (1200 mg), taking breaks periodically to look into the distance, a hot compress before bed, and lubricating eye drops (Soothe XP), all of which I do pretty regularly. I've also started working from home more often so I can wear glasses.

The problem is that my job involves programming, so I'm having trouble staring at a screen for 8-10 hours a day. My eyes feel sore after 5 hours.

Also, I think the eye problems are disrupting my sleep, as I constantly wake up an hour or half an hour before I've gotten eight hours of sleep. I'm woken up because there's always this gritty discharge in the corners of my eyes and I start unconsciously rubbing it out of my eyes while I'm sleeping.

I'm unclear on the difference between dry eye and blepharitis, and wonder which one I might have (or both).

I live in an area with winter climate, so I wonder if dry heat indoors is causing problems.

I used get woken up by super itchy eyes but those symptoms have thankfully stopped.

I also apply benzoyl peroxide 2.5% to my skin twice daily, so am wondering if that's drying out my skin and somehow affecting my eyes. (I tried stopping BP a few time and my skin broke out.)

I know YANAD (I'm going to try and see an opthalmologist again, but it might take a few weeks).

posted by glass origami quicksilver robot to Health & Fitness (13 answers total)

Assuming that you are seeing your doctor as soon as you can, there are a couple of products you can use to keep your eye from getting so dry. Artificial tears are helpful, but the kind with preservatives can cause quite a bit of irritation. You should not use them more than four times a day (or whatever the label says), which is often not nearly enough, and a lot of people shouldn't use them at all. You can buy a box of thirty tiny plastic vials of artificial tears at the pharmacy, with no preservatives; each vial is good, after opening, for only a few hours. These are safe for anybody, and you don't have to worry about needing to apply them frequently.

You can buy an eye gel at the pharmacy for bedtime. You can't use this during the day because it blurs your vision a bit, but it works much better than the artificial tears for keeping your eyes from getting too dry at night.
posted by artistic verisimilitude at 6:32 PM on February 14, 2018 [1 favorite]

Certainly a bedroom humidifier is a cheap easy thing to try. You might also try an evening antihistamine.
posted by Lyn Never at 6:34 PM on February 14, 2018 [3 favorites]

What about taking benadryl or Zyrtec to rule out allergies?
posted by Hermione Granger at 6:50 PM on February 14, 2018 [1 favorite]

What is it about glasses that bothers you? Because if you could get used to wearing them for your work day or part of the work day it might make a big difference.
posted by Kriesa at 6:53 PM on February 14, 2018 [1 favorite]

I'm unclear on the difference between dry eye and blepharitis, and wonder which one I might have (or both).

Blepharitis is an inflammation of the eyelid, especially at the lashline. The type of blepharitis most associated with dry eye is caused by/correlated to something that causes dry eyes: meibomian blepharitis, associated with meibomian gland dysfunction (MGD). The meibomian glands appear at the rim of the eyelid and provide an oily film (the lipid layer) that prevents tear evaporation. The MGD-dry eye connection is complicated and nuanced, so not all dry eyes are caused by MGD. But: if your ophthalmologist didn't mention blepharitis, I wouldn't worry overmuch about it.

There's two basic types of standard dry eyes: evaporative dysfunction (the 'mix' of components of your tears or of the lipid layer is wrong, so your tears evaporate too quickly; this is by far the most common and is associated with MGD) and insufficient tear production (aquaeous tear deficiency).

The primary treatments for tear insufficiency are eye drops and punctal plugs (plastic plugs inserted into the tear ducts to prevent premature drainage of the tears), unless it's caused by an immune issue (e.g. Sjogren's). The primary treatments for MGD and evaporative eye problems are eye drops, fish oil, and hot compresses. (Sound familiar?)

OK, there's a few things you haven't tried. If the problem is caused by MGD (not guaranteed), ask if it makes sense to try to express your meibomian glands to help unplug them if they are plugged. Your lubricating eye drops are already a lipid layer-refreshing type; try switching to another lipid brand like Systane Balance (remember: look for the word 'lipid' on the box) to see which works better. You can also supplement with preservative-free eye drops that provide short-lasting relief in the moment, but maybe clear it with a doc first.

I also apply benzoyl peroxide 2.5% to my skin twice daily, so am wondering if that's drying out my skin and somehow affecting my eyes. (I tried stopping BP a few time and my skin broke out.)

It can; some of my eye problems from before my iritis outbreak were said to be caused by my dry eyebrow skin flaking down around and into my eyes. Find a non-comedogenic moisturizer to add on top of your BP. (You may also be having breakouts from your body overproducing oil to deal with dryness.)

Also: yeah, try glasses for 2 weeks. If you're having problems keeping a tear film on your eyes, don't add obstacles. Seriously, especially because contacts can cause dry eyes.

Source: I am not a doctor but had SERIOUS dry eye problems after months of steroidal eye drops/ophthalmic treatment for iritis. My ophthalmologist and I chatted a lot about this.
posted by flibbertigibbet at 7:06 PM on February 14, 2018 [5 favorites]

Welcome to my world. I’ve got ocular rosacea and Meibomian gland syndrome with a tear film that’s half what it should be, and that’s my routine, with the exception of using Systane Balance drops. Don’t know if you’ll get a similar diagnosis, but I was also told to avoid alcohol, caffeine, smokng, spicy food and cinnamon. When I get a flare up, I’m also prescribed steroid drops (Tobradex)) that make a huge difference, so if you aren’t getting any relief from these steps, especially the compresses, (seriously, I can feel the goop plugging the roots of my eyelashes melting when I use them)I’m voting for a return trip to an eye doctor. Also plus one on using the thicker gels overnight, since it won’t dissipate as quickly. Best wishes to you, I know how frustrating this is!
posted by jacy at 7:07 PM on February 14, 2018

I am allergic to a lot of everyday ingredients in products for the skin. Try none. Wash your face before bed with warm water, pat dry. You'll have to do this for a week to get everything gone. Remember whatever is on your hands will also get in your eyes, so avoid touching your face. Get polarised lenses for your work space. Make sure the room is well lit so the screen and ambient light are the same.
posted by Oyéah at 7:39 PM on February 14, 2018

A humidifier by your bedside, or on the desk at your workplace, like this little portable, might help your eyes feel more comfortable. But if something like that doesn't ease your symptoms, you should know that dry gritty eyes — and it seems like your symptoms are extreme if they're interrupting your sleep — merit a visit to the eye doctor and possibly a blood test, to make sure you're not suffering symptoms of Thyroid Eye Disease.

As for your skin, although it wasn't part of your question, you may want to know that research says hydrogen peroxide does more harm than good for your skin. If you struggle with acne, you might want to look into a BHA instead.
posted by Violet Blue at 8:00 PM on February 14, 2018

Whoops! I just reread your post, and realize you said benzoyl peroxide. Please ignore the reference to hydrogen peroxide then. But if you haven't tested BHA instead, that stands.
posted by Violet Blue at 8:03 PM on February 14, 2018

Buy some hygrometers ($8-10 on Amazon) and see how dry your environment is. My office is less than 10% humidity in the winter- for comparison the Sahara desert is 25%. I have a pretty good sized humidifier in there that runs all day and it maybe gets to 20% if I'm lucky. And most everyone else in the building has one, the outside air is just THAT dry in the winter.

My house I keep between 30-40%, which is really the minimum for human life, but I have to watch ice building up on the windows.

If I don't do this my eyeballs start sticking to the inside of my eyelids after a few hours. Forget wearing contacts in the winter too. It really helps a lot, I can go without eyedrops completely if I can maintain a constant 20% humidity.
posted by fshgrl at 9:06 PM on February 14, 2018

I have chronic dry eye and meibomian gland dysfunction. For the longest time, I was skeptical about using warm compresses, because I felt they weren't doing anything, but then I realized I was using them wrong - basically, I wasn't using enough heat, and I wasn't applying it long enough. Here is the method I found that works for me:

Quantum Heat Packs: I use one small heat pack over each eye at least once a week. I apply it until it loses it's warmth (at least 10-15 min).

I use Robert Latkany's method that he describes in his book. Basically, once the glands are loosened by warmth, you have to gently nudge them with a Q-tip to push the oil out.

Afterward, I immediately take a hot shower to further loosen the glands, and completely wash away any build up along the lash lid.

I also use eye drops (TheraTears preservative-free) and take a high quality fish oil supplement (Minami). My optometrist recommends that I take 3 grams daily. Still, the biggest difference to me always seems to be the day following when I use heat therapy. YMMV, IANAD, etc.

posted by invisible ink at 1:08 AM on February 15, 2018 [1 favorite]

Seconding Theratears preservative-free, but you may need to try a few different preservative-free brands to find the best for you. Also humidifier in your bedroom and office if at all possible. Warm compresses will help.
posted by Gnella at 3:44 AM on February 15, 2018

Do you use dailies? Or monthlies that you have to clean each night? I had dry eye problems for a while and the culprit turned out to be the multipurpose cleaning solution (Opti-Free) I was using. My ophthalmologist said that multipurpose solutions can be really harsh, and using them is like squirting soap into your eye; they break up the lipid layer on the surface of your eye the way a dish detergent would. I switched to a hydrogen-peroxide cleaning system (Clear Care) and was instantly cured. I also make sure anything else I put in my eye (saline solution, etc) is preservative-free.
posted by 826628 at 10:39 AM on February 15, 2018