Many people experience eye problems as one of the early signs of multiple sclerosis (MS). The most common eye problems associated with MS are optic neuritis (inflammation of the optic nerve), diplopia (double vision), and nystagmus (involuntary eye movements). Other people may experience droopy eyelids or a electric-jolt sensations when they move their eyes. These are all often associated with changes in your vision.

Although watery and dry eyes aren’t among the most well-known symptoms of MS, that doesn’t mean they’re unrelated. In fact, several MyMSTeam members have shared experiences with eye irritation and discomfort. “I woke up Sunday morning with red, sensitive, watery eyes and a slight headache,” one member shared.

Another said, “Right now the last two days have been miserable with the burning, watery eye.”

Regarding dry eyes, one member shared, “I’m doing good but my eyes have been very dry, itchy, and sensitive.”

Dry eyes can interfere with daily life in significant ways. One member shared that their eyes had become so dry, they could no longer wear contacts. “I’m wearing glasses full time now!” they wrote.

If you’re experiencing dry eyes or watery eyes and wondering if they’re connected to MS, here’s what you need to know.

Are Dry Eyes a Symptom of Multiple Sclerosis? What About Watery Eyes?

Dry eyes and watery eyes aren’t directly symptoms of MS, but they could be indirect symptoms. There are several ways that MS could cause dry or watery eyes. A small study from Turkey found that dry eyes may be significantly more common in people with MS than would be expected by chance.

How MS Could Be Connected to Dry Eyes

While multiple sclerosis hasn’t been connected directly to either dry or watery eyes, nerve damage from MS can affect the body in complicated ways. When you live with MS, your body’s immune system attacks the outer layer of your nerves, called the myelin sheath. This can make it hard for those nerves to communicate with your brain. This can lead to damaged nerves, which might affect your eye health.

Cornea Changes

MS can cause changes to part of the eye called the cornea. These changes could lead to dry eyes because you might not be able to produce as many tears as your eyes need.

Issues With Eyelids

MS can also lead to problems controlling your eyelids. If you can’t fully close your eyes, you may not be able to blink effectively, which can also cause your eyes to dry out.

Changes in Tear Production

Finally, MS can cause problems in the glands that produce tears. If the nerves that help control these glands are affected, your body may have problems with tear production.

How MS Could Be Connected to Watery Eyes

Watery eyes, on the other hand, may happen as a result of dry eyes from MS. Sometimes, when your eyes are dry, your body is able to recognize it. As a result, it can produce too many tears instead of too few, leading to leaky, watery eyes.

Conditions Related to MS and Dry or Watery Eyes

There are other conditions that can manifest more often in patients with MS and be responsible for dry eyes, with watery eyes possibly resulting from the dryness as mentioned above.

Sjögren’s Disease

Sjögren’s disease is another autoimmune disease that can lead directly to dry eyes and a dry mouth. If you’re diagnosed with Sjögren’s, it means that your immune system is attacking the glands in your body that produce both tears and saliva. Without enough of these fluids, you end up with a dry mouth and dry eyes.

While some people with an MS diagnosis also qualify for a diagnosis of Sjögren’s disease, researchers don’t know if there’s a direct connection between them. However, if you’re experiencing dry eyes and a dry mouth, you should talk to your neurology provider about being tested for Sjögren’s.

Diabetes

Diabetes is another medical condition that can lead to dry eyes. It’s estimated that 54 percent of people who have diabetes experience dry eyes. Diabetes is more common in people living with MS than the general population.

Thyroid Disease

Thyroid problems are also more common in people diagnosed with multiple sclerosis and can cause both dry and watery eyes.

Thus, if you have dry or watery eyes, it might be time to get tested for some of these other medical conditions so you can get the right treatment for your needs.

MS Medications and Eye Symptoms

Certain immunosuppressants used as disease-modifying therapies (DMTs) for MS may cause dry or watery eyes in some people. Some MyMSTeam members taking interferon beta-1b (Betaseron) have reported eye symptoms like dryness or watering, although these are not officially listed among the medication’s common side effects. “I have been on Betaseron for over four years, and I get watery eyes often,” one member said.

Occasionally, healthcare providers may prescribe medications called anticholinergics to help people with MS who have bladder problems. Anticholinergics are directly associated with dry eyes. However, these medications aren’t always recommended for people with MS because they can worsen other symptoms.

Other Causes of Eye Symptoms in MS

It’s also possible that your eye symptoms are caused by factors or conditions that aren’t associated with MS.

Watery eyes are commonly caused by:

• Allergies
• Cold weather
• Smoky environments
• Something getting stuck in your eye (like an eyelash)
• Bell’s palsy
• Blocked tear ducts

Dry eyes may be caused by:

• Getting older
• Medications not connected to MS
• Other health conditions like lupus or rheumatoid arthritis
• Problems associated with wearing contacts or having laser eye surgery

Talk to Your Doctor

If you’re diagnosed with MS and dry eyes or watery eyes, talk to your doctor. They may send you to an eye doctor (like an ophthalmologist) who can help you get to the bottom of what’s causing these issues. Once you know the root cause of what you’re experiencing, you and your neurologist can work together to find a treatment option that fits your body and your needs.

Don’t let dry or watery eyes go. Dry eyes, especially, can lead to long-term problems with your eyes and even to vision problems. Watery eyes aren’t as dangerous on their own, but should be checked out since they can be a symptom of dryness. Even if you don’t end up with serious complications, dry or watery eyes can significantly affect your quality of life.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. There, members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Do you experience dry eyes or watery eyes with multiple sclerosis? How do these eye symptoms affect your daily activities or quality of life with MS? Share your experience in the comments below, or start a conversation by posting on your Activities page.