Burning

Several conditions can cause burning eyes, lids, and eye lid margins

In addition to acting as the top layer of the tear film that prevents evaporation, meibum secreted by the meibomian glands acts as a lubricant to the lid margins and tissues of the eye. When there is inadequate meibum, or the meibum is of poor quality, the lid margins and conjunctiva are not sufficiently lubricated, which leads to a burning sensation.

Burning may also be caused by sensitivities or allergies to preservatives and other ingredients in topical eye drops, ointments, and other medications applied to the eye area. Drops may feel good at first, and over time they may cause extreme burning, or other discomfort, that can last for a short time, or for many hours. It is usually best to avoid putting anything in or around the eye that causes burning, unless absolutely necessary, to treat a disease.

Allergies to pollen and fumes of almost any kind, including cooking fumes and perfumed soaps, can cause burning.

Epiphora, a condition where there are too many tears, can cause burning when the tears overflow and touch the lid margin or the delicate skin around the eye. Even a tiny drop of tear film on the lid margin can cause severe burning and discomfort.

Poor quality meibum, made of poor quality fatty acids, can react with the tear film and cause frothy or soapy tears, a condition known as saponification. A similar reaction can take place with the carcasses of demodex mites and the bacteria they release. The soapy tears can feel like soap in the eyes and cause burning.

Conjunctivochalasis can feel like a burning sensation in the eyes.

Poor (incomplete closing) or infrequent blinking while reading, driving, using a computer, or performing other activities that require focus with opened eyes, prevents the much needed lubricating meibum from being adequately secreted and spread across the eye surface. The lid margins may not be covered with adequate meibum and not enough meibum is secreted into the eye to lubricate the conjunctiva. The result is a burning sensation in the eyes and on the eye lid margins.

Reflexive tears are aqueous tears that are secreted by the lacrimal gland when the eyes are injured or are kept open too long without blinking. These are also the tears that are secreted when an eye lash or other foreign body lands in the eye. Reflexive tears tend to be caustic because the secretion is intended to wash away foreign bodies, bacteria, or other toxins, and protect the eye from infection. Frequent or high-volume reflexive tearing can irritate the conjunctiva, lid margins and, if they overflow (epiphora), the delicate skin around the eyes, causing a burning sensation.

Punctal cautery (even after healing) or punctal plugs may be the root cause of burning if tear outflow is inadequate of if they cause tear overflow (epiphora). If the tear flow is inadequate, poor-quality tear film that is stagnant can exacerbate the burning sensation. Epiphora causes burning when the tears touch the lid margins or the delicate skin around the eyes.

Bacterial, fungal, and viral infections can cause burning.