Why do my eyes feel tired all the time?
From: https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y
First - Happy New Year! I hope 2024 is the year for great advances in dry eye care - and I want to be a part of that evolution! My contribution on these pages will continue to be my blogging efforts to educate and raise awareness - and in my dry eye specialty practice - my commitment is to continue to offer leading edge technologies and treatments. Today let’s focus on “tired eyes.”
“Tired eyes” is a common complaint among dry eye sufferers. There are several likely reasons for this and I can enumerate a few of them here. I’ll start by reposting an answer I made to a patient with “a little conjunctivochalasis” (CCH) who asked if this could cause tired eyes:
Yes - partly because of the relationship to dry eyes (which increases blink rates - a bit like running a marathon all day), partly due to the poor distribution of the poor tears (causing increased dry eye symptoms - that drain you and also cause eyes to want to close). Dealing successfully with the dry eye problems can sometimes offset the CCH-related fatigue enough, but sometimes it is still necessary to fix the CCH. I have a lot of posts on CCH on my eyethera.com/blog
Blinking is central to eye health and can occur at rates from 2-50 times per minute - as observed in human studies (Monster AW, Chan HC, O'Connor D. Long-term trends in human eye blink rate. Biotelem Patient Monit. 1978;5(4):206-22. PMID: 754827.) Remember that a key motivator to spontaneous, involuntary blinks are the “dry spots” forming on the surface of the eye - and - at a subliminal level - causing irritation to corneal nerves that become exposed by the evaporation of the tear film overlying those nerves (leading to the dry spots). Dried out cells become injured (or dead) and allow them to “stain” with some of the dyes I referenced in my dry eye testing series of blog posts. (See: https://www.eyethera.com/blog/more-on-staining-the-surface-of-a-dry-eye-and-what-it-means) When there is a problem with tear oils (too little or too poor a quality - including those oils tainted with soapy residue from germ byproducts), then the oil’s “liquid Saran Wrap” benefits are lost and the water leaves (evaporation). This means that a lack of good oil will lead to a rapid blink rate (trying to keep up with that evaporation). This in turn, is that “running a marathon” effect that can tire out the blink-muscles and make eyes “feel tired.”
The fine muscle movements required to keep eyes focused and coordinated for the myriad activities we require them to do, make eye muscles the most active muscles in our entire bodies. “Considering that we make at least 100,000 saccades alone each day, it is not surprising that many extraocular muscles are very resistant to fatigue.” (Wong, Agnes M F, 'Eye Rotations, the Extraocular Muscles, and Strabismus Terminology', Eye Movement Disorders (New York, 2008; online edn, Oxford Academic, 12 Nov. 2020), https://doi.org/10.1093/oso/9780195324266.003.0007, accessed 1 Jan. 2024.) Saccades are the back and forth eye swings - that among other things, are the swift movements we use to read text like this. We also have pursuit movements, where we cause our eyes to follow objects around (like tracking traffic while driving). Add to this the blinking and emotive muscle movements of the eyelids and you have an Ironman/Ironwoman-level of activity going on daily for most of us. An interesting treatise on blinking and exercise can be found here: more about blinking (Paśko W, Zadarko E, Krzeszowski T, Przednowek K. Relationship between Eye Blink Frequency and Incremental Exercise among Young Healthy Men. Int J Environ Res Public Health. 2022 Apr 5;19(7):4362. doi: 10.3390/ijerph19074362. PMID: 35410042; PMCID: PMC8998332.)
Another consideration is that when eyes become irritated (as from dryness), their most protective reflex is to close. As eyes dry out, they become progressively irritated and this produces a stronger urge to close (and rest) them. Forced prolonged use of eyes (as is frequent in this digital era) encourages more closures to reduce this level of strain and the closing of eyes is part of sleeping. Fatigue is a strong incentive to sleep and we can equate eye fatigue and this need to close them, as a “tired feeling.” Physical fatigue refers to the muscles getting tired. Mental fatigue has to do with reducing the ability to concentrate. When eyes become constantly irritated from dryness, this constant, annoying “buzz” at higher levels in the brain appears capable of inducing a degree of mental fatigue (and another reason for eyes -and their owners - to “feel tired.”) Following the 20/20/20 rule (see the excellent article by the American Optometric Association: https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome?sso=y) , getting sufficient sleep and taking care to make the best of tears will help ensure your eyes feel less tired at the end of these increasingly longer days, now that we’ve passed through the 2023 Winter Solstice. Here’s to a great 2024!
To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:
(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020
(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463