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Dry Eye
Dry eye reflects tear quality, eyelid glands, inflammation, hormones, and blink rate. We look at omega-3 status, autoimmunity, screens, and the nervous system.
What you may be noticing
Eyes that feel gritty, sandy, burning, or tired by afternoon. Blurry vision that clears when you blink. Strangely, your eyes may water excessively, because irritation triggers reflex tearing. Screens, air conditioning, wind, and contact lenses make it worse.
Sudden vision loss, a painful red eye, light sensitivity with eye pain, or seeing halos needs urgent eye care.
Why it is rarely one thing
A healthy tear film has three layers: oil, water, and mucus. Most dry eye involves the oil layer, produced by meibomian glands along the eyelid margins. When these glands become blocked or inflamed, tears evaporate too quickly.
Many factors contribute. Screen use reduces blink rate dramatically, so the eye surface dries between blinks. Low omega-3 status may affect the quality of the oil layer, though trial results on supplements are mixed. Hormonal changes, especially falling androgens and estrogen in perimenopause and menopause, influence the glands. Autoimmune conditions such as Sjogren syndrome, rheumatoid arthritis, and thyroid eye disease cause dry eye. Some medications, including antihistamines and certain antidepressants, reduce tear production. Inflammation keeps the cycle going. Not only dry, but inflamed and under-supported.
Patterns we look for
- Blink rate and screen habits.
- Meibomian gland function and eyelid inflammation.
- Omega-3 status and dietary fat quality.
- Sex hormone changes.
- Autoimmune markers, including Sjogren syndrome.
- Thyroid function and thyroid eye disease.
- Medications that reduce tears.
- Inflammation and histamine patterns.
- Autonomic balance, which influences tear secretion through parasympathetic nerves.
- Vitamin A and vitamin D status.
How I evaluate it
The comprehensive functional neurological exam includes cranial nerve testing, blink reflexes, eye movements, and convergence, which can reveal visual strain contributing to symptoms.
Functional labs may include a thyroid panel, sex hormones, vitamin D, omega-3 index, inflammatory markers, and autoimmune markers such as antinuclear antibodies and Sjogren antibodies when indicated. I coordinate with your eye care provider for tear film and gland evaluation.
How we address it
- Coordinate with your eye care provider for diagnosis and in-office treatments.
- Restore blinking with the 20-20-20 habit: every 20 minutes, look 20 feet away for 20 seconds, and blink fully.
- Support the oil glands with warm compresses and gentle lid hygiene.
- Improve dietary fat quality with omega-3 rich foods.
- Address hormone patterns, autoimmunity, and thyroid function.
- Review drying medications with your prescriber.
- Humidify your environment and reduce direct airflow toward your face.
Dry eye is often the first visible sign of a broader autoimmune or hormonal pattern. When it appears alongside dry mouth, joint pain, or fatigue, it deserves a closer look rather than drops alone.
Comfortable eyes make screens, reading, and time outdoors far more enjoyable.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.