Article 46: Why Do My Dry Eyes Get Worse With Drops?

Welcome to another talk with Insight Eyecare, Dr. Kyle Tate your Sapulpa Optometrist.

Today we’re going to be discussing a common question I get after restarting dry eye treatments with patients. That question is, “Why do my eyes feel worse after starting these eyedrops?” Just as review, if you have symptoms of dry eyes such as red eyes, irritated eyes, burning, stinging, itching, eyes that are bloodshot, vision that fluctuates you likely have some form of ocular surface disease which includes dry eyes. If you notice any of these signs and symptoms reach out to us at Insight Eyecare your Sapulpa Optometrist. Modern technology has given us many different forms of dry eye treatments so you do not need to suffer from these symptoms anymore.

Before we answer the question, it’s important to understand a little bit about dry eyes and ocular surface disease. As your Sapulpa Optometrist, we are trained to evaluate and treat all the different signs and symptoms of dry eyes. I want you to know that any of the above issues can be in a combination. We have patients that seek out there Sapulpa Optometrist with eyes that are miserable from burning and stinging but they see great. We also have patients who seek us out that have vision that is constantly blurry for changes from ocular surface disease. So it can really be a mixture. There is not a set of symptoms for dry eyes. There is also no specific treatment plan.

Generally treatments will start with over the counter lubricating drop and many patients will try this on their own. However, you need a Sapulpa Optometrist to evaluate the type of ocular surface disease and recommend the specific formulation of tears that will do the best for you. If using a simple over-the-counter tear twice a day is not effective then a dry eye prescribed medicine needs to come into play. This will produce all the signs the doctor sees on the eyes and the symptoms the patient feels. Very popular ocular surface disease prescription medications are Xiidra and Restasis. Both of these work in different ways but the overall goal is that they reduce inflammation on the eyes.

Why does inflammation on the eyes cause dry eyes? I use this analogy with my patients; if your knee is always irritated and hurting then eventually you will be worn down, tired, unable to move and walk as well and easily as you should. The same thing happens with the surface of the eye. The eye is covered in hundreds of mucous glands, around 120 oil glands in the eyelids, twice as many fluid glands on the eyelids. There is also a large lacrimal fluid gland above the eyes. When all these glands get irritated from chronic inflammation they do not do their job as well as they could, just like if your knee is always hurting. Medications like Xiidra and Restasis target this information to help prevent the glands from not producing as well due to inflammation.

Now that you have a good understanding of why inflammation is the cause of dry eyes, the symptoms of dry eyes, and the medications used to treat dry eyes, we can answer the question “Why do my eyes get worse when I begin these treatments?” Some patients come to see us with eyes that are so dry and irritated that the nerves have actually shut down due to all the inflammation. This is not a healthy thing because the same nerves help regulate tear production and let you know when there’s a problem with your eyes. So when somebody who is not getting any dry eye treatments but has blurry vision or surface damage on the eyes begins treatments, it is often a month or two before these nerves start to feel again and the patient becomes miserable for a short period. If they will trust their Sapulpa Optometrist and meet with us to discuss how they’re doing, we can explain to them that this is actually signs the eyes are improving. If we can just bear through for another month or two things should continue to improve and the discomfort that is now present should go away. Often times that is a hard message to communicate to someone. Let’s put ourselves in the patient’s point of view for minute. If you come see your Sapulpa Optometrist with blurry vision and eyes that are comfortable, usually you are thinking you need a different glasses prescription. We do testing to see if that is the case which feels frustrating for the patient because all the options we try and give do not improve vision. Then we prescribed medication that costs them money and explain why we cannot give them a glasses prescription to fix their vision. They trust us and begin using the treatment which makes their eyes more uncomfortable. Coming from that point of view it is very easy to understand why patients get frustrated when their eyes feel like they got worse when using eyedrops.

It is of utmost importance that we can communicate with our patients to explain why they need to continue using the drops. One aspect we have not discussed today is the fact that with most dry eyes there is surface damage called Superficial Punctate Keratitis, which is abbreviated as SPK. This damage on the front surface of the eye, if left long-term, can cause a hazy scar permanently blurring vision which glasses cannot improve. As your Sapulpa Optometrist that’s one of things we point out and explain to our patients. This is why we’re treating their dry eyes.

If you know somebody that has dry eye symptoms such as itching, stinging, burning, red eyes, bloodshot eyes, vision that’s blurry or fluctuating, please refer them to us at Insight Eyecare. Treating dry eyes is just one small part of our focus to help improve every life in every encounter. I hope you found this article interesting. Please look for our other articles as there are many about dry eyes and other eye disease. This is Dr. Kyle Tate with Insight Eyecare and I wanted to thank you for your time. God bless and have a great day!

Scroll to Top