Can Dry Eyes Cause Headaches or Migraines?

Having both dry eyes and migraines may not be a coincidence. Dry eyes don't cause headaches or migraines, but there may be a connection between the conditions.

Research suggests migraine attacks may be longer and more severe in people with dry eye syndrome than those without it. There are also similarities in the underlying mechanisms that cause dry eyes and migraines or headaches to occur.

Why Dry Eye Occurs

Dry eye syndrome (also known as dry eye disease) is a complex condition involving impaired tear function and eye surface abnormalities.

Dry eye syndrome is often caused by one of the following factors:

• Increased water loss from the surface of your eye
• Increased salt content in your tears
• Decreased tear production

However, there's evidence that many people have dry eye symptoms unrelated to these causes.

For example, sometimes dry eye syndrome develops due to an underlying medical condition, like Sjögren's syndrome. Incidentally, people with this autoimmune condition also have a higher incidence of migraines and headaches than those without the condition.

The Dry Eye/Migraine Link

One study looked at almost one million U.S. veterans, mainly men diagnosed with dry eye syndrome. They looked at the link between chronic pain conditions and dry eyes. The study found dry eyes were more common in those with a chronic pain condition.

The frequency of dry eyes also increased as the number of chronic pain conditions a participant had increased. This suggests that having dry eyes may be an indication of a chronic pain condition, such as migraine.

Most other studies examining the link between migraine headaches and dry eye syndrome have been fairly small, but they still provide some insight into the possible connection between the two conditions.

Amongst the most notable findings:

• Length of migraines: A study of 58 people with migraines found those with dry eye had longer migraine attacks and had been dealing with migraine longer than those without dry eye.
• Severity of migraine attacks: Some research shows that migraine attacks may be worse when you also have dry eyes, and dry eye syndrome may contribute to continuing migraines.
• Increased risk in those who experience migraine with aura: Several studies found an increased frequency of dry eye syndrome in people with migraines compared to the general population. This association seems even more significant in people with migraines with aura.
  

Theories About Causes

There's no known reasons for why dry eye syndrome and migraine are related, but several theories exist. Experts think the two conditions may share the following mechanisms:

• Genetics: A genetic component has been identified in both conditions, meaning they run in families.
• Inflammation: Inflammatory processes seem to be involved in causing both dry eye syndrome and migraine.
• Central sensitization: This occurs when your central nervous system becomes overreactive to certain stimuli, such as light, noise, touch, or sound, resulting in more intense pain and a lower pain tolerance.
• Tear osmolarity: One study measured tear osmolarity—a common test for dry eyes that shows how much salt content is in your tears—in 34 people with migraines. The researchers found a link between migraine, especially migraine with aura, and dry eyes. As the frequency of migraines increased, so did tear osmolarity. This led them to think that more salt could lead to further drying.
  
• Trigeminal nerve pathway activation: The trigeminal nerve is the largest of the 12 cranial nerves. It supplies nerves to the eyes and is involved in tear production. When activated, it can trigger migraines and aura. Dry eye symptoms may result, especially since there are dense trigeminal nerve endings in the cornea.
  

Risk Factors

Dry eye syndrome and migraine headaches have some risk factors in common. These include:

• Women primarily affected: Dry eye syndrome and chronic pain conditions like migraine are more common in women.
• Shared comorbidities: Both conditions co-occur with sleep disorders, fatigue, anxiety, depression, and other chronic pain conditions.

Symptoms Common to Migraine and Dry Eye

Symptoms are present in both conditions, but there are usually no obvious clinical signs that indicate a direct physical cause, such as nerve damage or structural problems.

Sensory issues and eye pain are common symptoms that migraine and dry eye share. Having both conditions means that these symptoms may be compounded.

Both migraine and dry eye can negatively affect your quality of life. They may reduce the ability to do activities of daily living like watching TV, reading, driving, or working on a computer.

Sensitivity and Sensory Issues

Photophobia is light sensitivity or abnormal pain that occurs when you're exposed to light. It affects about 80% of people with migraines. Most people with dry eye syndrome also report experiencing light sensitivity.

Somatosensory dysfunction is a faulty response to the way your brain perceives neural impulses. It may be present in migraine and dry eye syndrome as well. These dysfunctions include:

• Allodynia: Feeling pain from something that doesn't typically cause pain, like touch
• Hyperalgesia: Feeling more pain than usual from something that causes pain
• Hypoesthesia: Having less sensation or sensitivity to normal stimuli
  

Eye Pain

If you have migraines, pain sometimes feels like it's in, around, or behind your eyes. Dry eye syndrome can cause eye pain with a gritty, irritated, or burning sensation. You may often feel like there's a foreign body in your eye and notice that your eyes are red.

Many people with dry eye have excessive eye tearing, a symptom people with migraines may experience too.

Dry Eye Treatment

The first-line treatment for dry eyes is artificial tears. These are available over-the-counter in liquid, gel, or ointment forms. Preservative-free artificial tears may be ideal but can be costly.

Xiidra (lifitegrast) and Restasis (cyclosporine) are prescription eye drops containing medication that helps promote tear production. Your healthcare provider may give you one of these if artificial tears don't help.

Coping With Dry Eyes

Environmental coping strategies include:

• Staying away from air conditioners or heaters
• Placing a humidifier in your bedroom or workplace
• Blinking frequently when you're working on your computer or reading

When to See a Healthcare Provider

See an ophthalmologist (eye doctor) if you have symptoms of dry eye syndrome and aren't getting relief from artificial tears and environmental and lifestyle strategies.

A Word From Verywell

Remember, a link doesn't mean that one condition causes the other. Rather, a link implies a connection or relationship that may or may not have any significance for you as an individual.

That said, talk to your healthcare provider if you suffer from dry eyes with migraines or headaches. It's possible that treating your dry eyes could help improve your migraine headaches.

As people with migraines know, it often takes a variety of different strategies and therapies to minimize migraine pain and avoid triggers. Treating dry eyes has the potential to be another tool in your kit.