When your eyes feel dry and tired, you probably reach for OTC eye drops as your first line of defense. The catch? OTC eye drops can soothe symptoms, but they don’t target the root cause.
That’s why it’s important to focus on hidden triggers that might be undermining eye drop use. As Danielle Orr, OD, MS, FAAO, assistant clinical professor at OSU College of Optometry explains, the cornea is one of the most highly innervated structures in the body. (In other words, it has a lot of nerves supplying it!) “Dry eye disease can cause changes to corneal nerves, making them highly sensitive to even ‘normal’ stimuli,” says Orr.
Here, learn about overlooked triggers of dry eye, plus when it’s time to swap OTC drops for another treatment.
1.
Excessive screen time
When you look at a screen for too long, your blink rate decreases. In fact, we blink half as much during screen time, according to the American Academy of Ophthalmology. This is noteworthy because blinking distributes tears1 over the surface of your eye, reducing tear evaporation and lubricating your eyes.
The fix:
Take regular breaks and lower your screen below eye level. This will decrease how much your eyelids need to open, helping your eyes stay lubricated. It’s also worth reducing your nighttime screen hours, which can strain your eyes. Digital detox, anyone?
“Outdoor wind and lack of humidity, as well as indoor heaters and air conditioners, can accelerate evaporation of tear film that normally coats the eye,” explains Shaleen Ragha, OD, assistant professor at Southern College of Optometry. (Airflow from car vents, radiators, and airplane cabins have a similar effect.) This tear film is essential for keeping your eyes comfortable.
However, when exposed to the aforementioned environments, the eyes may produce excess tears to compensate, though it might not be enough, according to Ragha.
The fix:
Consider wearing moisture chamber goggles, which are non-prescription glasses with silicone barriers that keep out wind. Humidifiers, including desktop versions, can also reduce the dryness of your environment.
If you’re traveling by plane, use preservative-free artificial tears throughout the flight, stay well hydrated, and limit alcohol and caffeine, as recommended by Ksenia Goman, MD, ophthalmologist at Northwell’s Manhattan Eye, Ear and Throat Hospital.
It’s also a good idea to avoid wearing contact lenses on long flights. If your dry eye is severe, use thicker gel drops or ointment before sleeping on long flights, says Goman.
3.
Medications that alter tear production
“Many common medications can worsen dry eye, such as those for anxiety, depression, or allergies,” says Orr. The same goes for diuretics (for high blood pressure) and acne treatments.
While the exact mechanisms vary, these drugs can affect the root causes of dry eye. For example, anti-anxiety and anti-depression meds can trigger symptoms by activating inflammatory pathways2, while antihistamines may reduce tear gland activity.
Additionally, “diuretics can reduce overall body fluid levels, which can lead to decreased tear volume or altered tear composition, making the eyes feel dry, irritated, or gritty,” says Goman.
The caveat is that people often don’t recognize the connection between meds and dry eye, as the latter can start gradually, per Goman.
The fix:
If you think medications are behind your dry eye, talk with your eye care provider. Though it’s not usually recommended to reduce medications for other conditions solely because of dry eye, “eye care professionals can help determine if these medications may be a factor and come up with a treatment plan,” says Orr. An individualized treatment plan may involve using prescription drops that help treat the root cause of dry eye.
4.
Lifestyle stress & sleep disruption
As for sleep? It’s not just for beauty and rest, says Ragha. Getting some shut-eye gives the eyes a break, as well as a dark environment. “When sleeping, the eyes undergo maintenance processes, which include flushing any debris to the corner of your eyes,” notes Ragha. In contrast, poor sleep can decrease tear production4 and increase sensitivity5 in the cornea, contributing to dry eye symptoms.
It’s worth noting that stress can also disrupt sleep (and poor sleep can worsen stress). Luckily, both factors can be supported by the same practices; think exercise, meditation, aromatherapy, and limiting or avoiding caffeine.
The fix:
Stress and sleep management practices can vary quite a bit—so it may take time to find a practice that works for you. If you don’t know where to start, here are a few options that have research backing their benefits:
“Mascara, eyeshadow, and eyeliner can clog the meibomian glands along the eyelids. These glands produce the oil layer of the tear film, which slows evaporation,” explains Goman.
When the meibomian glands are blocked, tears evaporate too quickly, worsening dryness and irritation, says Goman. This can also lead to chronic inflammation6, further worsening dry eye.
To top it off, “some people are especially sensitive to makeup containing preservatives, fragrances, or glitter particles,” says Goman.
The fix:
Try using products made for sensitive skin or eyes. Also, avoid lining the waterline and fully remove makeup at night, says Goman.
When it’s time to think beyond OTC eye drops
Using OTC eye drops and reducing triggers can help manage dry eye. But it’s possible to overdo eye drops, so you’ll want to be mindful of your usage.
“OTC eye drops, like artificial tears, may supplement tear film temporarily, but they do not treat the underlying cause of dry eye,” explains Ragha. So, you might find yourself reaching for those drops every hour, which can be tedious, Ragha points out. Many OTC products also have preservatives, which can cause eye irritation if you use them too often, according to Orr.
That said, “it’s time to visit a professional if OTC lubricating eye drops are not bringing relief, or if [you’re] using them more than four times daily,” says Orr.
This will ensure you get a proper diagnosis, along with alternative therapies (like prescription medications) for treating your specific type of dry eye.
The takeaway
Even if you��’re using OTC eye drops, they won’t help dry eye if you’re still exposed to daily triggers. Factors like heavy screen use, airflow, medication, and lifestyle stressors can quietly worsen dry eye symptoms, so it’s worth pinning them down.
