Where did my tears go?

Originally Published: March 18, 2011 - Last Updated / Reviewed On: May 9, 2014
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Dear Alice,

For the last year or so, I haven't been able to cry anymore. And when I do, absolutely no tears come out. My eyes just water up, but there are no tears. Is this normal? Should I be worried?

—Confused

Dear Confused,

Crying as an emotional response (rather than to clear out debris and moisten the eyes) is a uniquely human phenomenon. Some evolutionary biologists think this function developed as a distress call of sorts. Human beings can "fake" all other emotions, but crying is more likely to be reflective of genuine emotion. Tears often stimulate a nurturing response in others, which, for a creature as socially interdependent as people are, can be a key to survival. Tears are also necessary for the lubrication and nourishment of our eyes, and they protect our eyes from infection.

So what's going on when someone can't cry? There are a few possible explanations. You mentioned that your eyes water up, but there are no tears. It’s possible that your tears are evaporating too fast. Environmental conditions like smoke, wind, and dry climates can make tears evaporate more quickly than normal. When a person isn’t producing enough tears or has poor quality tears, he or she may be suffering from dry eye syndrome.

This condition, known as keratoconjunctivitis sicca, can be the result of many factors. Experiencing dry eyes is actually a natural part of the aging process and most people over 65 show signs of dry eye syndrome at some point. Women are more likely to develop dry eye syndrome because of hormonal changes from pregnancy, use of oral contraceptives, and menopause. For both men and women, research has shown that certain types of medications, such as antidepressants and antihistamines, can sometimes lead to dry eyes. In addition, people with certain health conditions, such as diabetes and rheumatoid arthritis, are often more prone to dry eyes. Other causes can include the use of contact lenses and certain refractive eye surgeries such as LASIK. All of the above factors can lead to reduced tear production, which can then lead to dry eyes.

Another potential cause of tearlessness is a condition known as Sjögren's syndrome. This is an autoimmune disease in which the body's white blood cells attack moisture-producing glands like tear ducts. What causes Sjögren's is unclear, but it occurs most commonly in women over 40 and onset is usually triggered by a major bacterial or viral infection. Symptoms can include dry and itchy eyes, dry mouth, dry skin, arthritis, and fatigue. While there is no cure for Sjögren's, it is manageable. If you notice any of the symptoms mentioned, you’ll probably want to consult a health professional as soon as possible. The syndrome can put you at risk for more serious conditions such as chronic yeast infections and liver problems.

Before visiting a health care provider, you might want to make a list of any symptoms in addition to lack of tears that you may be experiencing. You mentioned that not being able to cry is a recent change. Have you noticed other changes along with the decrease in tear production? Have your eyes felt dry in general? Have you experienced dry mouth in addition to tearlessness? Have you experienced a shift in your emotional state? These are all questions a health care provider might ask you when attempting to figure out what's going on. Making an appointment to address these concerns may be your best bet in this situation. If you’re a Columbia student, you can make an appointment at Medical Services (Morningside) or the Student Health Service (CUMC).

Best of luck unraveling the mystery of your tearless peepers!

Alice