Cold Air of Winter and Keratoconus

Colder temperatures in fall and winter can worsen the sensation of “dry eyes”. Meanwhile, experiencing a sensation of “dry eyes” is common in adolescents and adults living with keratoconus. The progressive corneal thinning and bulging featured in keratoconus is linked to this condition, as well as the progressive worsening of eyesight. Since colder air temperatures typically lead to increased use indoor heat-generating systems, the increased indoor dryness during winter can also contribute to experiencing “dry eyes”.

The following describes symptoms linked to experiencing overly-dry eyes, and some reasons that “dry eye syndrome” is so common in people diagnosed with keratoconus. Additionally described is the typical corrective eyewear prescribed for keratoconus-afflicted people.

Corneal Cold Thermoreceptors – Their Relationship to Promoting “Dry Eyes”

The pre-corneal tear film that covers the eye in people with both normal and abnormal corneas is continuously subjected to tear evaporation (according to a medical research article in Pain). This article also notes that corneal cold thermoreceptors contribute to the sensation of irritation from “dry eyes” due to the lowering of eye surface temperature during the periods between eye-blinking. Furthermore, cold air temperature applies stress to nerve fibers of the cornea’s superficial epithelial layers.

Corneal disorders such as keratoconus can interfere with the lacrimal glands’ normal function, and the lacrimal glands regulate the eyes’ tear production. While other causes of lacrimal gland dysfunction exist, a corneal dysfunction can lessen the normal production of tears (that keep the eyes’ surface areas moist). In particular, an article in PLoS One in 2015 specified that keratoconus-afflicted people have an increased tendency toward developing “dry eyes” in tandem with eye pain.

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Contact Lenses and “Dry Eye Syndrome”

The Mayo Clinic includes the following as symptoms typically-experienced in people who have “dry eye syndrome”:

  • A sensation of having something in the eyes;
  • A stinging, burning, and/or scratchy sensation;
  • Watery eyes, as a result of eye irritation from abnormal dryness of the eyes
  • Sensitivity to light and glare

Wearing Rigid Gas Permeable (RGP) contact lenses is common in keratoconus-afflicted people to correct nearsightedness and astigmatism. Less common is wearing traditional “soft” contact lenses since these do not correct for astigmatism (which can cause blurry vision). However, both of these types of contact lenses rest on the cornea – so maybe uncomfortable for someone with “dry eye syndrome”.

One potential solution may be to switch to scleral contact lenses (since these lenses rest on the sclera, as well as incorporate a solution-filled reservoir that keeps the eyes moist). However, the learning-curve to insert and remove these contact lenses from the eyes can be much longer than the learning-curve for use of the typical small-diameter contact lenses.

Limit Time Outdoors in Freezing Winter Temperatures

One way to decrease the negative impact of cold on the eyes for people living with “dry eye syndrome” is to avoid skiing, snowmobiling, and other strenuous outdoor winter activities for more than a very short period of time. This is because cold air striking the eyes is likely to worsen sensations of “dry eyes”. For people living with keratoconus, wearing sunglasses on cold winter days with bright sunshine is also advisable to avoid worsening an experience of light-sensitivity. (Likewise, wearing sunglasses while driving at night is advisable for this same reason.)

An injury to the cornea in someone with any corneal disorder can lead to corneal ulceration and scarring. According to the National Organization for Rare Disorders (NORD), keratoconus-afflicted people are at heightened risk for corneal scarring – and corneal scarring can cause persistent eye pain. Due to the diverse predisposing factors contributing to eye pain in keratoconus-afflicted people, protecting the eyes from extreme heat and extreme cold is even more essential.

By consulting with someone at the Precision Keratoconus Center, you can learn more about keratoconus symptoms and treatment.

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