Specialty Eye Care
What Causes Dry Eye
Dry eye is caused by insufficient tear production, excessive tear evaporation, or both. Contributors include screen use, dry environments, prolonged contact lens wear, certain medications, hormonal change, autoimmune disease and previous eye surgery.
In short
Screens, climate, lenses, medication, age and gland dysfunction. Usually more than one at once.
Dry eye is rarely traceable to a single cause. Most people who have it are carrying three or four contributors at once, and improving any one of them helps while addressing the dominant one helps most.
The list below reflects the causes identified at this practice. Working out which apply to you is the point of the evaluation, because the treatment follows the cause rather than the symptom.
What to expect
- Screen and device use
- Blink rate falls by more than half during concentrated screen work, and incomplete blinks fail to spread the tear film properly. Screen related dryness is now the most common presentation in working age adults.
- Dry environment
- Low ambient humidity and air conditioning both accelerate tear evaporation. Arizona supplies both year round.
- Prolonged contact lens wear
- Lenses disrupt the tear film and, over years, can contribute to gland changes. Wearing time, material and replacement schedule all matter.
- Medications
- Antihistamines, antidepressants, blood pressure medication, diuretics, hormonal contraceptives and acne treatments all reduce tear production. This is one of the most overlooked causes.
- Age and hormonal change
- Tear production declines with age, and hormonal shifts around menopause are a well established trigger.
- Meibomian gland dysfunction
- The oil glands in the eyelids block or thicken, so the tear film loses the layer that stops it evaporating. This is the single most common underlying mechanism.
- Autoimmune conditions
- Sjogren syndrome, rheumatoid arthritis and thyroid eye disease all affect tear production directly.
- Previous eye surgery
- LASIK and cataract surgery both temporarily interrupt corneal nerve signalling, which reduces tear production during healing.
- Poor diet and dehydration
- Tear film quality is affected by nutrition, and omega 3 intake in particular has a reasonable evidence base.
Questions and answers
Which cause is most common?
Meibomian gland dysfunction, by a wide margin. It underlies the majority of dry eye cases and it is also the one most often missed, because the treatment for it is different from what most people try first.
Can my medication be causing this?
Very possibly. Antihistamines and antidepressants in particular have strong drying effects. Never stop a prescribed medication without speaking to the prescriber, but do mention everything you take at your evaluation.
Will moving somewhere humid fix it?
It would help, but climate is an aggravating factor rather than usually the root cause. Addressing gland function and screen habits achieves more than relocating.
Does drinking more water help?
Dehydration makes it worse, so staying properly hydrated matters. But drinking more water will not fix a gland dysfunction problem on its own.
Talk to someone about what causes dry eye
Appointments are scheduled two per hour, so there is time to answer questions properly. Call (480) 706-3937 or request a time online.