Dry Eyes (Xerophthalmia)
What Is Xerophthalmia?
Xerophthalmia is the medical term for dry eyes. People may describe burning, soreness, a gritty or “foreign body” feeling, or blurred or fluctuating vision. It is a common symptom in Parkinson’s Disease.
Understanding Your Tear Film
Every time you blink you spread a thin tear film across the surface of your eye. This tear film is essential in keeping surface of the eye healthy to protect against infection and keep your vision clear. The watery layer of tear film is made by the lacrimal glands. The lacrimal glands are turned on mainly by the parasympathetic nerves traveling through the facial nerve.
Why Do Dry Eyes Happen in Parkinson’s Disease?
Dry eyes in Parkinson’s Disease come from TWO separate problems working together:
1) Less tear production: Parkinson’s Disease can impair the parasympathetic nerve signals that tell the lacrimal gland to make tears, so less of the watery layer of tear film is produced.
2) Reduced blinking: Parkinson’s Disease classically slows down eye blink rate. Since blinking spreads the tear film evenly across the eye, reduced blinking results in tear film break down and evaporation, leaving dry spots on the surface.
This combination can leave the eye surface under-protected in those with Parkinson’s Disease. In severe, long-standing cases, chronic dryness can damage the cornea (the clear front window of the eye) and raise the risk of infection and lasting visual problems.
Treatment Strategies
Non-Medication Strategies
– Make a conscious effort to blink fully and more often, especially during tasks that reduce blinking such as reading or screen time.
Medication Options
– Over-the-counter artificial tears are first-line treatment. They replace the missing watery layer, soothe the surface, and can be used as often as needed.
– Punctal plugs may be considered for more severe or stubborn cases. These are tiny plugs placed in the eye’s natural tear-drainage openings so that your own tears and artificial tears stay on the eye longer.
Author Mick Reedy, MD, is a Movement Disorders Specialist with
Inova Parkinson’s and Movement Disorders Center (IPMDC)