Dry Eyes and Celiac Disease

For the last few months, my left eye has been very dry. It burns, itches and is very irritated, I have had this on and off for years but it has just become more frequent in the last few months. I went to see my optometrist and he mentioned my eyes look perfectly healthy and that it could be that I moved from a humid climate to a dry climate. I decided to do a bit more digging because the drops he gave me did not correct the issue completely and it only happens some days and not others. Because I have an autoimmune disease (celiac disease) I tend to see if any of the ongoing symptoms I have could be related to this condition. And sure enough, dry eyes can occur with someone who has celiac disease.

The Facts:

It is estimated that half of celiac patients not only show digestive issues but also other symptoms throughout the body. They vary depending on age at onset, gender, the strength of the immune system, and the genetic predisposition of the individual. There is a heap of medical evidence that the condition may not only effect the gastrointestinal tract (GI) but also affect the reproductive system, central nervous system, brain, and skin.

Can Celiac Disease affect vision?

In short, yes. According to recent studies, there is a strong connection between celiac disease and eye health. “The ophthalmic manifestations are within the extra-intestinal manifestations, and can be divided into autoimmune disorders and absorptive disabilities. The manifestations related to malnutrion are correlated to the low levels of vitamin A, vitamin D and calcium. It could cause retinopathy, cataract, dry eye and pseudotumor cerebri,” from the article, ‘Ophthalmologic manifestations of celiac disease.’

Celiac Disease and Sjögren’s Syndrome

Sjögren’s syndrome is one of several autoimmune disorders that can go hand-in-hand with celiac disease. Whereas celiac disease primarily affects the small intestine, Sjögren’s syndrome mostly affects lacrimal and salivary glands. These are glands responsible for producing tears and saliva in your eyes and mouth respectively. 

Relating this to myself, I ate a muffin one weekend when I was away on a course. It was gluten free but soon realized it most likely was cross contaminated. Shortly after eating that muffin I began to get all the symptoms of celiac disease and the worst one that weekend was brain fog. A new symptom that occurred that weekend was a very dry mouth and really dry eyes. This of course started to scare me because I have never experienced this before and no matter how much water I drank I could not help my dry mouth. My eyes were burning that weekend, and even with keeping them closed for extended periods at a time, they were very dry. This thankfully went away after a few days.

According to the National Institute of Neurological Disorders, about 1-4 million North Americans have Sjögren’s syndrome, 90% are women over 40 years of age. The body of a person with Sjögren’s syndrome, cannot produce adequate moisture, which can cause havoc on your eyes. This condition is said to be a secondary autoimmune disease which is triggered by celiac disease. In worst cases, it can lead to extensive eye damage and even vision loss.

The symptoms of Sjögren’s syndrome can vary from person to person, however the most common symptoms is a dry mouth and eyes. Other symptoms that can occur are: joint pain, rashes, fatigue, and sometimes vaginal dryness. The eyes not only become dry but can also have a burning sensation.

Dry eye syndrome and Celiac Disease

Dry Eye Syndrome is a condition where the lacrimal glands cannot produce enough tears or the eyes are not able to maintain a normal tear layer to cover the surface. This can be a problem because the eyes cannot get rid of germs, dust, and other irritants that may come their way. This can cause a dry eye, burning sensation or feeling as though there is something lodged in your eyes. There can also be an array of other symptoms such as redness, pain, burning and stinging.

Some medical studies have shown that celiac disease may cause dry eye due to the inability to absorb nutrients from the small bowel. One important nutrient is vitamin A, this is essential for eye health. Decreased amounts of vitamin A can cause a drastic change to squamous cells (the outermost layer of the skin) and a loss of goblet cells (found in the respiratory and intestinal tracts, which secretes the main component of mucus). Both of these cells are important for the overall function of the eyes epithelium. Over time, acute deficiency of vitamin A can lead to dry eye syndrome and a list of other vision impairments such as night blindness.

In conclusion, celiac disease does not just affect the gastrointestinal tract, it can have an array of other symptoms that can affect all other systems within the body. Other autoimmune conditions can occur as a result of celiac disease or vice versa, such as Sjögren’s syndrome. I do not believe that I personally have Sjögren’s syndrome because these symptoms only occur when I have accidentally eaten gluten or something that was cross contaminated with gluten. It seems that once I begin to heal my gut, symptoms of dry eyes and mouth seems to go away. However, my TTG levels (blood test for celiac disease) are currently still higher then they should be, so malabsorption of vitamin A along with other essential vitamins can be causing ongoing symptoms. Regardless of what it is that you are experiencing, you should always consult a healthcare professional to reach a diagnosis or make a plan on how to get you feeling your best.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768497/

https://www.imaware.health/blog/the-connection-between-celiac-and-eye-health

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