Is It Dry Eye Syndrome? Symptoms and Possible Causes

Could you please clarify if this is related to dry eye syndrome?

Hello, I hope you can take some time to answer, as this has been a persistent issue causing me a lot of distress...
Thank you.
In the past month or two, I have noticed numerous small blood vessels in my eyes that won't go away.
I experience shoulder and temple soreness when looking at things, and I have severe photophobia.
I have visited several ophthalmology clinics and hospitals, and the diagnoses have all been eye strain, dry eye syndrome, and allergic conjunctivitis.
My vision and intraocular pressure are normal, and I do not wear contact lenses.
I have high myopia (left eye -700 / right eye -650).
Due to eye fatigue, I took a week off from using the computer, but the photophobia symptoms have not improved.
Daylight is uncomfortable, and I do not tear up or feel discomfort from smoke or wind; I only have issues with fluorescent lights, LEDs, and screen light.
After looking at the computer or TV for just ten minutes, I get a headache and find the light very glaring.
I have been using artificial tears and ocular lubricants for over a month, but there has been no improvement.
I would like to ask if these symptoms can still be classified as dry eye syndrome, or could they be due to other factors?

I'm sorry, 30~39 year old female. Ask Date: 2018/06/20

Dr. He Jianxian reply Ophthalmology

Your symptoms sound a bit like eye strain, which can be described in layman's terms as presbyopia.
However, considering your age, it doesn't seem like the typical onset age.
Usually, if someone is a heavy user of digital devices, it is indeed possible for this condition to develop earlier.

Reply Date: 2018/06/20

More Info

The symptoms you are experiencing, including the presence of small blood vessels in your eyes, sensitivity to light (photophobia), and discomfort while using screens, could indeed be indicative of Dry Eye Syndrome (DES), but they may also suggest other underlying conditions. Dry Eye Syndrome is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and potential damage to the ocular surface. It is characterized by a loss of homeostasis of the tear film, and it can be caused by a variety of factors, including environmental conditions, prolonged screen time, and underlying health issues.

Your reported symptoms of eye fatigue, discomfort with bright lights, and the need for artificial tears suggest that your tear production may be insufficient or that your tears evaporate too quickly. This can lead to inflammation and damage to the ocular surface, which can manifest as redness (the small blood vessels you see), discomfort, and sensitivity to light.
In your case, the fact that you have high myopia (nearsightedness) could also contribute to your symptoms. High myopia can lead to changes in the eye that may increase the risk of developing conditions like retinal detachment or other complications, which could also cause discomfort and visual disturbances.
Moreover, the fact that your symptoms worsen with screen use suggests that you may be experiencing digital eye strain, which is common in our technology-driven society. This condition can lead to symptoms such as dry eyes, blurred vision, and headaches. The blue light emitted from screens can also contribute to discomfort and fatigue.

While your eye pressure and vision have been reported as normal, it is essential to consider other factors that could be contributing to your symptoms. Allergic conjunctivitis, for instance, can cause similar symptoms and may not always be easily diagnosed without specific testing. Environmental factors, such as air conditioning, smoke, or allergens, can exacerbate dry eye symptoms and lead to discomfort.

Given that you have already tried artificial tears and other lubricating eye drops without improvement, it may be beneficial to explore additional treatment options. These could include prescription medications that help increase tear production, such as cyclosporine A (Restasis) or lifitegrast (Xiidra). Additionally, punctal plugs can be inserted into the tear ducts to help retain tears on the ocular surface.

It's also crucial to adopt good eye care habits, especially if you spend a lot of time in front of screens. The 20-20-20 rule is a helpful guideline: every 20 minutes, take a 20-second break to look at something 20 feet away. This practice can help reduce eye strain and fatigue. Furthermore, ensuring that you stay hydrated and maintaining a humid environment can also help alleviate dry eye symptoms.

In conclusion, while your symptoms may align with Dry Eye Syndrome, they could also be indicative of other conditions or a combination of factors. It is advisable to follow up with an eye care professional who can conduct a thorough examination and possibly recommend further testing or treatment options tailored to your specific needs.

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