Dry Eye and Glaucoma: What’s the Connection?

Dry eye commonly causes symptoms, including itchiness, burning, and pain. Alternatively, glaucoma is an eye condition that often has no symptoms until it affects a person's vision.

More than half of people who have glaucoma also have dry eye. Both conditions become more common as people age, but there’s also a more causal connection: the treatments for glaucoma can make dry eye worse.

Read on to learn more about the connection between dry eye and glaucoma and why it’s important to treat both proactively.

Dry Eyes and Glaucoma: A Unwelcome Pair 

Dry eye affects about 16 million people in the United States, but it is more common in people with glaucoma. Estimates suggest that 40%-60% of people with glaucoma also have dry eye.

In part, this is because the same people are at risk for both dry eye and glaucoma. For example, both conditions are more common in older people and people with diabetes. 

However, dry eye can also be triggered by the pressure-lowering eye drops used to treat glaucoma. These often contain benzalkonium chloride (BAK), a preservative that can damage cells on the surface of the eye and lead to dry eye.

Glaucoma is considered the more serious condition since it can lead to permanent vision loss. However, dry eye often has more invasive day-to-day symptoms and causes more discomfort. 

What Causes Dry Eyes in Glaucoma Patients 

Dry eye has various causes, leading to the eye surface not being sufficiently moisturized. This may be due to not producing enough tears, having tears that drain too quickly, or having tears that don’t do a good job of lubricating the eye.

In addition, laser eye surgery, which can be used to treat glaucoma, is a risk factor for dry eye.

Environmental factors can also cause dry eye in people with glaucoma. Dry eye can be made worse by:

• Dry, hot, or windy environments
• Screen time, which leads to less blinking
• Hormonal changes, including menopause

Treatment for Dry Eyes and Glaucoma 

If you’re dealing with dry eyes and glaucoma, work with your healthcare provider to treat both.

Since glaucoma can lead to irreversible vision changes or blindness, most providers prioritize treating glaucoma. However, dry eye can be unpleasant and lower one's quality of life. Remember, there are ways to treat both conditions, so insist on creating a treatment plan to address dry eye in addition to glaucoma.

Dry eye treatments for people with glaucoma can include:

• Switching to preservative-free eye drops
• Using combination eye drops to reduce exposure to preservatives
• Using laser treatments to reduce the amount of eye drops needed

In addition to the treatment options above, people with glaucoma can follow the typical treatments for dry eye, including:

• Using “artificial tears” eye drops (these are safe to use alongside glaucoma drops, but talk with your provider about the best timing)
• Reducing screen time
• Wearing sunglasses outdoors
• Using a humidifier indoors
• Using tear duct plugs to keep tears in the eye for longer
• Taking medications to reduce inflammation in the eyelids

Finding the right combination of medications can take some trial and error. Communicate openly with your provider, and remember that you’re working together towards finding the best treatment plan.

Summary

Dry eyes and glaucoma can frequently occur together. Therefore, it is important to treat both conditions to preserve the best quality of life and vision. Treatment options include specific types of eye drops, laser treatments, and surgery.

A Word From Verywell

Learning that you have glaucoma can be scary. Experiencing dry, itchy, or painful eyes at the same time can feel overwhelming. Remember that dry eye and glaucoma are commonly treated together. There are treatment options available to protect your eyes from glaucoma long-term while also reducing dry eye symptoms. Talk with your healthcare provider about a treatment plan that will leave you both healthy and comfortable.