Dry and watery eyes

Our eyes are our windows to the world, and we rely on them every waking minute. The surface of the eye is covered by a thin membrane called the cornea – see-through to allow light and images to shine through to the back of the eye, where they’re transmitted as messages to the brain. This surface is constantly exposed to the elements, so can be easily irritated by dust or chemicals in the air.

Dry eyes, watery eyes – two sides of the same coin?

Your eyes need constant lubrication to clean them and prevent irritation. This is provided by a film of tears. While you may only associate tears with crying, in fact a film of tears is being constantly produced by your eyes. This spreads over the surface of your eye when you blink, removing tiny specks of dirt. So it’s hardly surprising that if you don’t blink or you aren’t producing enough tears, your eyes feel dry.

It's natural to assume that watery eyes are the result of too much tear production. In fact, perhaps bizarrely, it’s often caused by dry eye – which means that eye lubricants can often be the solution to watery as well as dry eye.

What causes dry eyes?

Dry eye is really common – symptoms include discomfort, irritation and burning. Sometimes there’s an underlying problem with your eye. Medical causes of dry eye include:

• Inflammation of the surface layer due to allergy or infection.
• Blepharitis – inflammation of the eyelids.
• Conditions which stop you being able to close your eyes fully at night.
• Sjogren's syndrome. This condition affects your body’s ability to produce fluids such as tears and saliva, leading to dry eyes, dry mouth and swollen salivary glands.

Other, non-medical causes of dry eyes can also lead to watery eyes.

What causes watery eyes?

Lifestyle factors can also make you prone to dry eye. Because watery eye is often caused by your eye reflexively producing more tears in response to dry eye, these can also result in watery eyes. Lifestyle factors include:

• Wearing contact lenses.
• Spending a lot of time in centrally heated or air-conditioned environments.
• Being in a dry, dusty or windy area.
• Taking certain medications, such as some antidepressants or blood pressure medications.
• Too much computer use. Almost half of computer users have symptoms of dry eye (including discomfort, irritation and burning). This is largely because you blink much less often when you’re using a computer.

Hay fever and your eyes

The medical term for hay fever is 'allergic rhinitis', which means inflammation of the nose due to allergy. It’s caused by allergy to pollen. You’re most likely to develop symptoms:

• From early to late spring if you’re allergic to tree pollens.
• From late spring to early summer if you’re allergic to grass pollen (the most common reason for hay fever symptoms).
• Right through from spring to autumn if you’re allergic to weed pollen.
• At any time of year if you’re allergic to house dust mites or tiny scaled shed from animal skin or hair, called dander.

But while the medical name suggests hay fever symptoms only affect the nose – and indeed itchy nose, sneezing and blocked or runny nose are common with hay fever – many people with hay fever also suffer from itchy and watery eyes.

When should I worry about dry or watery eyes?

It's worth knowing the 'red flags' to look out for, which might mean you need medication from your GP or referral for a specialist:

• Painful red eye. If your eye is painful rather than just dry, itchy or sore, you should see a doctor promptly.
• If you have a red eye and it hurts to look at the light, or you have a severe headache and feel sick, you should always seek emergency medical help.
• Changes in your vision. If you have sudden loss of vision, flashing lights or changes to your sight like wavy lines, you should always seek emergency medical help.
• If you have symptoms of possible Sjogren's syndrome (severe persistent dry eye and dry mouth), see your doctor.
• Also see your doctor if your dry or watery eye symptoms do not settle down within a few weeks.
• If you have any abnormality of your eyelid (for instance, your eyelid is an unusual shape or you cannot close your eye properly), see your doctor.
• If you are taking medication, look at the patient leaflet or ask your pharmacist if dry eyes could be a side effect.
• If you have just itchy eyes but not an itchy nose, you could have allergic conjunctivitis. See your GP.

What is the treatment for dry or watery eyes?

The treatment for dry or watery eyes very much depends on the cause and the symptoms you’re having. If you don’t have any of the red flag symptoms above, there is still lots that you can do to relieve your symptoms.

• Take regular breaks from using your computer.
• Lower your computer screen to below eye level, so your eyes are less wide open when you’re looking at it.
• Avoid smoking and smoky environments.
• Turn down central heating or air conditioning.
• If you wear contact lenses, wearing them for shorter periods and taking them out when symptoms are bad can help. You may also want to consider changing the type of lens or contact lens solution you use – your optician can advise.
• Use regular lubricant eye drops. Examples include Optrex Double Action Drops for Dry and Tired Eyes.
• If you have hay fever, ask your pharmacist about eye drops designed to relieve hay fever symptoms. These include Optrex Hayfever Relief eye drops, which contain sodium cromoglycate.

Date of preparation: May 2020. RB-M-03986