Decreased Tear Production
What Causes Decreased Tear Production?
Various factors can lower tear production, from natural aging to specific health issues and lifestyle habits. Understanding these causes can help you and your eye doctor identify why your eyes may feel dry.
As you get older, tear glands can shrink or work less efficiently, producing fewer tears. This is a primary reason why decreased tear production is more common in people over 50, with studies showing millions of adults are affected by age-related dry eye.
Certain health problems can damage tear glands and reduce tear flow. These include autoimmune diseases like Sjögren’s syndrome and rheumatoid arthritis, as well as diabetes, thyroid disorders, and inflammatory conditions like blepharitis or ocular rosacea.
Some common medicines, such as antihistamines, decongestants, antidepressants, and blood pressure drugs, can lower tear production as a side effect. Additionally, environmental factors like dry air from heating or air conditioning, wind, and smoke can cause tears to evaporate faster.
Hormone shifts that occur during menopause, pregnancy, or due to thyroid disorders can affect tear gland function and lead to less tear production. Because hormones help regulate tear glands, any imbalance can disrupt the process and contribute to dryness.
The oil glands in your eyelids, known as meibomian glands, can become blocked. When this happens, the tear film becomes unstable and evaporates too quickly, causing a type of dry eye even if your tear quantity is normal. This is a very common contributor to dry eye symptoms.
Additional causes of decreased tear production can include a range of issues that affect the eyes or the body's overall health.
- Previous eye surgeries such as LASIK or cataract surgery
- Nerve damage affecting tear secretion, for example from facial nerve palsy
- A deficiency in Vitamin A, which is essential for eye surface health
- Chronic inflammation of the eyelids or the surface of the eye
Symptoms of Decreased Tear Production
When your eyes do not produce enough tears, you may notice a range of uncomfortable signs. Recognizing these early can help you find relief faster and prevent further irritation.
You might feel a gritty, sandy, or scratchy sensation in your eyes, along with redness, stinging, or mild pain. Vision may become blurry, especially when reading or using a computer, and you may notice increased sensitivity to light.
Dry eye symptoms can make everyday activities difficult and tiring. You might find it hard to drive, work on a computer for long periods, or wear contact lenses comfortably, leading to eye strain and fatigue.
Sometimes, eyes respond to significant dryness by producing an excess of watery tears. This reflex tearing is the body’s attempt to lubricate the eyes, but these tears lack the proper composition to provide lasting relief and often do not resolve the underlying dryness.
If you experience sharp pain, constant eye redness, discharge, or vision that does not clear with blinking, you should seek professional help. These symptoms can indicate a more serious issue, such as an infection or damage to the eye's surface.
How is Decreased Tear Production Diagnosed?
Eye care providers use simple, painless tests and a review of your history to measure tear flow and check eye health. These quick steps help guide the most effective treatment plan for you.
A basic eye exam using a slit lamp can show dry spots on the eye’s surface. Your doctor may use special dyes like fluorescein to see how well tears cover your eye. The Schirmer test uses a small strip of paper placed under your lower eyelid to measure tear amount.
In addition to quantity, your tear quality is important. A Tear Film Breakup Time (TBUT) test measures how quickly your tears evaporate after a blink. Your provider may also examine the oil and mucus layers of your tears under a special light to see if the tear film is stable.
Sharing details about your overall health, medications you take, and your daily work or home environment gives your provider important clues about the potential cause of your dry eyes. This discussion helps ensure your diagnosis and treatment plan are comprehensive.
Treatment Options for Decreased Tear Production
Many effective treatments can boost tear production, add moisture, and protect your eyes from further dryness. Your eye care provider can recommend options ranging from simple home remedies to advanced medical procedures.
Artificial tears are a safe and easy first step for mild dryness. Brands like Refresh, Systane, or TheraTears mimic natural tears to provide relief. Choosing preservative-free drops is recommended for frequent use to prevent irritation.
For more persistent dryness, prescription medications can help. Eye drops like cyclosporine (Restasis) or lifitegrast (Xiidra) reduce inflammation to help your glands produce more natural tears. A nasal spray called varenicline (Tyrvaya) stimulates a nerve to increase tear production.
Small changes can make a big difference. Using a humidifier, taking frequent screen breaks, applying warm compresses to your eyelids, and wearing wraparound sunglasses outdoors can all help reduce tear evaporation and ease symptoms.
For more severe cases, your doctor may suggest advanced options. Punctal plugs are tiny devices inserted into the tear ducts to block drainage and keep tears on the eye longer. Custom scleral contact lenses or autologous serum eye drops made from your own blood can also be used to protect and hydrate the eye surface.
Preventing Decreased Tear Production
Adopting healthy eye habits can lower your risk of developing dry eyes and help keep your vision comfortable. Simple daily practices and awareness of triggers are key components of prevention.
Blink fully and frequently, especially when using a screen. Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. Staying well-hydrated by drinking enough water also supports overall tear production.
Eating a balanced diet can support your eye health. Incorporate foods rich in omega-3 fatty acids like salmon and flaxseeds to improve oil gland function. Also include leafy greens and eggs for vitamins A and D, which support the health of the ocular surface.
Protect your eyes from environmental irritants. Try to limit exposure to smoke, dust, and dry, windy conditions. Using a high-quality air purifier indoors and choosing hypoallergenic makeup can also help reduce irritation around the eyes.
Seeing an eye care provider for yearly comprehensive eye exams is crucial. These visits help catch the early signs of dryness, allowing for timely intervention and helping you maintain healthy, comfortable tear production for years to come.
Frequently Asked Questions
Here are some common questions about decreased tear production to help you understand and manage this condition with confidence.
Decreased tear production is a main cause of dry eye syndrome, but it is not the only one. Dry eye can also happen if your tears evaporate too quickly due to poor tear quality. Both conditions cause similar symptoms, and an accurate diagnosis is key to targeting the right treatment.
Over-the-counter drops offer immediate, temporary relief, while prescription treatments like Restasis or Xiidra may take several weeks to a few months for their full effect to be felt. Lifestyle changes can begin to help within a few days.
Yes. Staring at digital screens significantly reduces your blink rate, which speeds up tear evaporation and can worsen dry eye symptoms. Taking regular breaks and consciously blinking can help mitigate this effect.
Preservative-free artificial tears are recommended if you need to use drops more than four times a day or if you have sensitive eyes. Preservatives can cause irritation with frequent use, so preservative-free options are safer for long-term management.
Yes, refractive surgeries like LASIK can temporarily disrupt the corneal nerves that signal tear production, often leading to temporary dryness. For most patients, this resolves within a few months, but some may require ongoing dry eye management.
Meibomian gland dysfunction (MGD) occurs when the oil glands in the eyelids are blocked or produce poor-quality oil. This oil is essential for preventing tear evaporation. MGD is a leading cause of evaporative dry eye and is often treated with warm compresses and lid hygiene.
Contact lenses can absorb natural tears and disrupt the tear film, which can worsen dryness. If you have dry eyes, your provider may recommend daily disposables or special lenses designed for dry eye sufferers to improve comfort.
Staying properly hydrated is important for all bodily functions, including producing tears. While drinking more water alone may not resolve chronic dry eye, dehydration can certainly worsen symptoms, so maintaining adequate fluid intake is beneficial.
Allergies cause inflammation that can disrupt tear gland function and worsen dry eye symptoms. Antihistamines used to treat allergies can also have a drying effect. Managing allergies effectively can help improve eye comfort.
You should seek immediate medical attention if you experience sudden severe eye pain, significant vision loss, or a thick discharge from your eyes. These could be signs of a serious infection or corneal damage that requires prompt treatment.
Taking Care of Your Eyes
With the right care, most causes of decreased tear production can be managed effectively, allowing you to enjoy clear and comfortable vision. Talk with an eye care provider to find the best options for your needs and keep your eyes healthy.