A Watery Dry Eye

A Paradox

Gritty, sandy, scratchy… watery? Can all those words be used to describe dry eyes? In short, yes! Dry Eye Syndrome is a mystery for patients because the symptoms can be variable! Paradoxical Dry Eye is what eye doctors call Dry Eye Syndrome in patients whose main symptom is constant tearing. So, grab your tissue, and let’s dive into why this happens!  

The Healthy Tear Film

On the surface of a healthy eye, there’s a tear film made of oil and water. Just like in your salad dressings, oil and water don’t mix. The oil layer keeps the water from evaporating into the air on the eye. 

The water layer is produced by a gland that sits just under your eyebrow bone, called the lacrimal gland. The water is released when the brain signals to the gland. Finally, the oil layer is produced by multiple smaller glands located within your eyelids. These glands in the eyelids are called meibomian (MY-BO-ME-IN) glands. The oil is released from the meibomian glands every time you blink.

Two Types Dry Eye Syndrome

So, there are two different types of Dry Eye Syndrome! One type is caused by a deficiency in the water portion of your tears (hello sandy, gritty feeling!), and the other type of dry eye is caused by a deficiency in the oil portion of your tears. When the oil portion is absent and the eye begins to feel dry, then the only thing the brain can do is signal to the lacrimal gland to make more water! But remember that the oil is only released from the meibomian glands when you blink! This leads to constant watering and paradoxical dry eye! 


What Causes this in the First Place?

When oil fails to release from the glands, the oil stagnates. Oil stagnation inside the glands results in the oil becoming thick, pasty, and unable to release during a blink. Eventually, the stagnation can lead to permanent damage to the glands. This is called Meibomian Gland Dysfunction (MGD). 

Finding the root cause of MGD is the key to the proper treatment. In short, anything that causes a reduction in blinking can lead to MGD, such as prolonged electronic device use (looking at you gamers and electronic readers!). MGD can also be caused by increasing age and even certain medications. 

Treating the Watery Dry Eye

Unfortunately, there’s no magic pill or eye drop that can fix MGD. I often have patients ask me about prescription eye drops for MGD. In most cases, the start of treatment is modifying the behaviors that led to the MGD (reduced device use, reminders to blink) and lid hygiene. Warm compresses and lid massage can also be used to help clear the glands of old oil. Over the counter, artificial tears with an oil component can also provide temporary relief to the watery, dry eye.  


If you are dealing with dry eye issues or want to learn more, call us at 800-282-3937 to schedule an appointment with one of our doctors or visit us online at EYESFL.COM.


Courtney Beaumont, O.D. is a board-certified optometrist who sees patients at the Sebring location for Eye Specialists of Mid-Florida. She specializes in dry eye treatment and pediatrics and is accepting new patients.

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