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Causes of Dry Eye

Hormonal Changes

  • “AGE” Syndrome – females over age 50 represent 50% or 12 million of the dry eye sufferers in the US
  • Menopause

Autoimmune Diseases

  • Diabetes Mellitus is the most common culprit
  • Lupus, Rheumatoid Arthritis, Thyroid Disease even if controlled on medications
  • Sjogren’s Syndrome (separate section)


  • Smoking, Dry Air (“Igloo” season or subzero winter and constant forced heated air or summer with constant air conditioning inside), Dust
  • Computer Vision Syndrome – blink rate decreases with near vision tasks
    • Implement the 20/20/20 rule – every 20 minutes take a 20 second break and look at something at a 20 foot distance to break up the monotony of computer vision work
    • Parkinson’s Disease typically has a low blink rate with masked facial expression

Contact Lens Wear

  • Soft lenses act as mini-sponges soaking up tear film needed for the ocular surface
  • Contact lenses in general compete for oxygen and other nutrients needed for a healthy ocular surface
  • Extended wear or sleeping overnight in contact lenses is the highest risk to the ocular surface which can lead to infection, hypoxia, and corneal ulcers with potential loss of sight permanently

American “Fast Food” Diet

  • Low in omega 3 and high in omega 6 fatty acids compromise the ocular surface especially the oil layer composition, quantity, and quality


  • OTC antihistamines (topical, oral, nasal, inhaled) is the most common cause
  • High Blood Pressure medications second most common cause especially diuretics and beta blockers
  • Anti-anxiety medications, Anti-depressants represent the third largest culprit
  • Other medications such as those to suppress bladder problem and irritable bowel conditions can also exacerbate dry eye