The question
My eyes hurt all the time - I wear glasses and sometimes contact lenses. It's not that I'm tired, they just sting no matter what I do. What could be causing this?
The answer
Stinging eyes is a common and irritating symptom and can be accompanied by itching, tearing or discharge from the eyes depending on the cause. The range of possible triggers is quite varied and can include:
1. Exposure to irritants: One of the most common causes of stinging eyes is irritation from chemicals or environmental triggers. Chemicals can include chlorine from swimming pools, household cleansers, or even daily use items such as your soap, moisturizers, shampoo or make-up. Environmental triggers such as dust, smoke, pollution and dry air and wind can also be very irritating to the eyes and cause stinging and discomfort.
2. Inflammation: If have redness of the eyes along with the stinging sensation, you may have something called conjunctivitis which is an inflammation of the outer layer of skin that lines the eyes. This can be due to allergies or an infection from bacteria or viruses. With allergic conjunctivitis, along with redness and irritation, the eyes can be itchy and associated with a runny nose and may be worse during allergy season or when you are exposed to allergens such as tobacco smoke, pet dander or pollens. If related to infection, you may also have cold or flu symptoms and your eyes may be sticky in the morning due to discharge.
3. Dry eyes: When the eyes are not moisturized enough, they can become gritty and uncomfortable. Eyes are naturally protected by tears which help to keep the surface of the eyes smooth and prevent infection. Dry eyes can occur if you do not produce enough tears or if the tears are poor quality and don't sufficiently lubricate the eyes. Certain medications such as those used to treat blood pressure, antidepressants, birth control pill and acne treatments such as accutane can interfere with tear production as can certain medical conditions such as diabetes, thyroid disease and connective tissue disorders. Laser eye surgery can cause a temporary decrease in tear production and wearing contact lens for long periods of time can also be irritating due to their drying effect. Sitting in front of the computer for prolonged periods of time can dry the eyes out so taking 'eye breaks' can be helpful. Finally, eyelid problems or excessive blinking can interfere with proper lubrication of the eyes and cause tears to evaporate too quickly.
4. Improper prescription for glasses or contact lens: If your prescription is not the right one, your efforts to focus may strain your eyes and lead to tired eyes that sting.
Treatment for stinging eyes will vary depending on the cause. For most, the discomfort will go away once triggers such as chemicals or smoke are identified and avoided.
For occasional dry eyes, artificial tears can help relieve symptoms or for allergies, topical antihistamines may be helpful. Using a humidifier can help add moisture to dry air and wearing glasses on windy days can prevent irritation. For potential infection, your doctor may consider treating with antibiotic drops. If it's been some time since you've had your prescription checked, a visit to your optometrist may be helpful to ensure that your prescription is still the right one for you.
In rare situations, stinging eyes can be a sign of a serious condition such as infection of the eyelids, inflammation of the deeper structures of the eye (iritis or uveitis) or an increased pressure in the eyes such as glaucoma.
These conditions may also be associated with serious symptoms such as a change in vision, pain, flashing lights, or light sensitivity. If you experience any of these symptoms, seek immediate attention from your healthcare provider to protect your eyes from potential loss of vision.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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