the Impact of Stress on Dry Eye Syndrome

Q: the Impact of Stress on Dry Eye Syndrome

Hello： Stress and emotional fluctuations can indeed impact eye health, including exacerbating dry eye syndrome. <br>This may be related to hormonal imbalances or autonomic nervous system dysregulation. <br>For treatment, I recommend that your wife consider the following suggestio

Possible causes of exacerbation of dry eye syndrome?

Hello, doctor! I would like to ask you about my wife.
Last year, I was in a car accident that required her to take time off work to care for me.
During that period, she experienced a lot of stress, which resulted in a corneal abrasion.
Although she has undergone many examinations by an ophthalmologist and has been diagnosed with mild dry eye syndrome, she still feels her eyes are very dry when she sleeps.
Even with the use of artificial tears and eye drops, there hasn't been much improvement.
Sometimes, her eyelids stick to her cornea, and this situation severely affects her sleep as she has to constantly monitor her eye condition.
I would like to understand if the stress from the car accident could have caused hormonal imbalance or autonomic nervous system dysfunction, leading to her persistent dry eye syndrome.
If that is the case, what treatment options could we explore? Thank you.

Jieson, 30~39 year old female. Ask Date: 2024/02/28

Dr. Gao Pilin reply Ophthalmology

Hello: Stress and emotional fluctuations can indeed impact eye health, including exacerbating dry eye syndrome.
This may be related to hormonal imbalances or autonomic nervous system dysregulation.
For treatment, I recommend that your wife consider the following suggestions:
1.
Lifestyle adjustments: Ensure adequate sleep, maintain a balanced diet, and stay properly hydrated.
This helps maintain internal body balance and may improve dry eye symptoms.
2.
Eye moisturization: Use lubricating eye drops or artificial tears frequently as needed to relieve dryness and discomfort.
Consider preservative-free formulations to avoid irritation from long-term use.
At night, it is advisable to use ointments specifically for dry eyes to prevent eyelids from sticking to the cornea.
3.
Environmental adjustments: Avoid prolonged exposure to electronic screens and ensure the environment maintains adequate humidity.
Using a humidifier can help alleviate eye discomfort.
4.
Pharmacological treatment: If symptoms persist, an ophthalmologist may consider prescribing topical or oral anti-inflammatory medications to reduce eye inflammation.
5.
Warm compresses: Gently applying a warm eye mask or a warm, damp cloth can help increase blood circulation to the eyes and alleviate discomfort.
I hope she recovers soon.

Reply Date: 2024/02/28

More Info

Stress can have a significant impact on various aspects of health, including eye health. In the case of your wife, who has developed persistent dry eye symptoms following a stressful event, it is essential to understand the potential connections between stress, hormonal changes, and dry eye syndrome.

Dry eye syndrome (DES) is a multifactorial condition characterized by a loss of homeostasis of the tear film, resulting in ocular symptoms and potential damage to the ocular surface. Stress can exacerbate dry eye symptoms through several mechanisms. First, stress can lead to hormonal imbalances, particularly affecting the production of tears. The body’s response to stress often involves the release of cortisol and other hormones that can influence various bodily functions, including tear production. This hormonal fluctuation may contribute to the worsening of dry eye symptoms.

Additionally, stress can affect the autonomic nervous system, which regulates involuntary bodily functions, including tear secretion. The sympathetic nervous system, which is activated during stress, can inhibit tear production, leading to dryness and discomfort. This is particularly relevant for individuals who already have a predisposition to dry eyes, as stress can amplify their symptoms.

In your wife’s case, her experience of dry eyes, even with the use of artificial tears and eye drops, suggests that the underlying issue may not solely be related to tear production but also to the overall health of the ocular surface. The fact that she experiences symptoms that interfere with her sleep indicates that her condition may require a more comprehensive approach to treatment.

Here are some strategies that may help alleviate her symptoms:
1. Lifestyle Modifications: Encourage her to maintain a balanced diet rich in omega-3 fatty acids, which can help improve tear quality. Staying hydrated is also crucial, as dehydration can exacerbate dry eye symptoms.

2. Stress Management: Since stress can worsen dry eye symptoms, it is essential to incorporate stress-reducing techniques into her daily routine. This could include mindfulness practices, yoga, meditation, or even engaging in hobbies that she enjoys.

3. Environmental Adjustments: Ensure that her environment is conducive to eye comfort. This includes using a humidifier to maintain moisture in the air, taking breaks from screens to reduce eye strain, and avoiding direct airflow from fans or air conditioning.

4. Regular Eye Care: Since she has a history of corneal issues, regular follow-ups with an eye care professional are crucial. They can monitor her condition and adjust her treatment plan as necessary. If her symptoms persist, her doctor may consider prescribing anti-inflammatory medications or other treatments specifically designed for dry eye syndrome.

5. Use of Eye Ointments: At night, using thicker eye ointments or gels can help keep her eyes lubricated while she sleeps, reducing the likelihood of her eyelids sticking to the cornea.

6. Consideration of Punctal Plugs: If her symptoms remain severe, punctal plugs may be an option. These are small devices inserted into the tear ducts to reduce tear drainage, thereby increasing tear film stability.

7. Consultation with Specialists: If her symptoms do not improve, it may be beneficial for her to see a specialist in dry eye management or a corneal specialist who can provide more targeted therapies.

In conclusion, while stress can indeed contribute to the worsening of dry eye symptoms, a multifaceted approach that includes lifestyle changes, stress management, and appropriate medical treatment can help improve her condition. It is essential to maintain open communication with her healthcare providers to ensure that her symptoms are adequately addressed and managed.

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