Are you feeling stressed out?
Let's face it: most of us encounter some form of stress in our busy lives. Whether running late to work, procrastinating until the night before a deadline, or spilling coffee on yourself before an important meeting... life can be a little chaotic sometimes. When all those intense, persistent stressful episodes are repeated and build up over time, stress can have a negative impact on your whole body health, including your eyes and vision.
How Stress Affects Your Eyes
Stress triggers the activation of your sympathetic nervous system. When you’re in “fight or flight” mode, your pupils will dilate — this allows more light to pass to your retina, so you can see any potential threats more clearly. However, if the stressful episode continues, prolonged dilation makes you more sensitive to light. Along with that, many people tense-up when they are stressed, causing the muscles in and around your eyes to tighten, which may lead to eyelid twitching and soreness.
Stress also causes the body to release hormones, particularly adrenaline and cortisol. Endogenous cortisol (produced in the body) may cause fluid to accumulate in the eye — particularly in the retina and its underlying layer, called the choroid. Another form of cortisol, exogenous cortisol, can come from corticosteroid use, such as nasal sprays and topical creams.
Stress-Related Eye Problems
Here are four eye conditions that can develop as a result of chronic stress:
+ no. 01 Eye Strain (Asthenopia)
Eye strain, also called asthenopia, is a term used to describe many symptoms that can be brought on by stress or simply just over-straining your eyes. Symptoms may include blurry vision, headaches, dizziness, and dry eyes. Eye strain can be caused by any prolonged use of your eyes for an activity, such as reading, working at a computer, playing video games, or driving for long distances. The good news is that most symptoms are temporary, won't cause permanent eye damage, and will go away once you give your eyes a break to rest with the 20-20-20 Rule.
What's the 20-20-20 Rule?
The 20-20-20 Rule is an easy way to remember to give your eyes a break during prolonged periods of intense concentration, mostly on near- or intermediate-range tasks such as computer work or reading. Every 20 minutes, take a 20-second break to rest your eyes by focusing on something in the distance (approximately 20 feet away). Add in blinking exercises to help combat symptoms of dry eye (see number 2 on the list below).
+ no. 02 Dry Eye
The same activities that can cause eye strain also cause you to blink less often, which leads to prolonged exposure of the ocular surface — simply meaning, your eyes dry out. It's not just these visual demands that can result in symptoms of dry eye; physiological and psychological stress can be triggers, too.
According to a study published in the May British Journal of Ophthalmology, chronic pain conditions elsewhere in the body and mental health issues such as post-traumatic stress disorder correlate with more intense symptoms of dry eye. This is because stress mediators, such as cortisol and dehydroepiandrosterone (DHEA), have been identified in the tear film. Another study found that sleep disorders, particularly sleep deprivation — which often occur during times of stress — induced tear hyperosmolarity, shorten tear breakup time (TBUT), and reduce tear secretion, all of which can trigger the development of ocular surface diseases.
+ no. 03 Eyelid Twitching (Myokymia)
Many people report eyelid twitching during times of stress, like when studying for final exams or during a big life change. This twitching, called myokymia, can also be caused by a lack of sleep or drinking excessive amounts of caffeine — both of which tend to go hand in hand, especially before a major deadline or event.
These eyelid spasms can range in duration, lasting anywhere from seconds to hours, or even days. Twitching most often affects the lower eyelid, but it can occur in both upper and lower lids. Most twitching caused by stress is harmless and will resolve on its own, once you reduce or eliminate the stressful factors. (Go ahead and treat yourself to some much-needed self care).
Although rare, significant twitching that lasts longer than a few days or that causes the eyelid to close completely may be a sign of an underlying neurological problem and warrants further evaluation by your eye doctor.
+ no. 04 Central Serous Chorioretinopathy/Choroidopathy
A more serious eye condition that is thought to be linked to stress is central serous chorioretinopathy (or choroidopathy). In CSCR, localized fluid causes a detachment of the neurosensory retina in the area of the macula (the part of the eye responsible for central vision). Symptoms may include distorted lines (metamorphopsia), objects appearing far away or smaller (micropsia), colors appearing washed out, and a blurry spot in the middle of your vision.
While scientists still don’t know exactly what causes CSCR, stress is a big risk factor. Research has shown that the people most likely to develop CSCR are those who experience high levels of psychological or physiologic stress, have anxious, type A personalities, and have sympathetic nervous system dominance. It commonly affects men, aged 25 to 50 years, but may also affect older or pregnant women. Fortunately, most cases clear up on their own within a few months without treatment and without permanent vision loss.
What to Do Next
If you think that your eye problems are stress-related, you can start by trying to lower your stress level. Getting plenty of rest, eating well, meditating, and practicing yoga or other forms of exercise can provide stress relief. Whatever you do, make sure it’s an effective stress-reliever for you — because what works for one person at reducing stress may not work for another person.
Thankfully, most stress-related eye issues are temporary and can resolve quickly; however, if you have a persistent issue with your eyes, no matter what is going on in your life, the problem may be a result of something more than just your stress level. Schedule an appointment with your local eye doctor if you continue to have eye trouble or become concerned about any of these eye conditions.
Ong ES, Felix ER, Levitt RC, et al. Epidemiology of discordance between symptoms and signs of dry eye. Br J Ophthalmol. 2018;102(5).
Banbury L. Stress biomarkers in the tear film [dissertation]. Lismore, NSW, AU: Southern Cross University; 2009.
Lee YB, Koh JW, Hyon JY, et al. Sleep Deprivation Reduces Tear Secretion and Impairs the Tear Film. Investigative Ophthalmology & Visual Science June 2014, Vol.55, 3525-3531.