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Causes for Dry Eye Syndrome

The causes of dry eye syndrome are usually multifactorial. Although certain causes can exacerbate symptoms acutely, there is usually a summation effect that is gradual over time

Older eyes

As we have more birthdays, the consistency of our tear film changes and the oil component decreases. Older patients also have some of the same problems as noted below, which can compound the problem.

Meibomian gland dysfunction

This is a common cause. For a variety of reasons (incomplete, infrequent blinking or bacterial/Demodex mite infection), the oil becomes more viscous and doesn’t excrete properly.


With the increased popularity of smartphones, tablets, computers etc., we tend to stare at the screens for extraordinary lengths of time, resulting in the eye drying out.

Contact lens use

Though technology has made great advances in contact lenses, they are still foreign bodies and cause irritation. Some contact lenses are better than others for dry eyes. For severe cases, contact lenses are best avoided altogether.


Many medications have anticholinergic side effects and can cause dry eyes and dry mouth. Common culprits are antihypertensives, antidepressants, antihistamines, oral contraceptives, and pain relievers.


Windy, dry, cold conditions may exacerbate dry eyes.


Menopause is a common cause in middle-aged women. Changes in progesterone and estrogen can frequently cause a sudden exacerbation in symptoms. Low testosterone is a less common cause in men.

Systemic diseases

Autoimmune diseases can often cause dry eyes, especially if they are associated with Sjögren’s syndrome. These include rheumatoid arthritis, lupus, psoriatic arthritis, and others. Diabetes and thyroid disorders can also cause worsening dry eyes.


Any intraocular surgery, including refractive surgery, can cause dry eyes. The mechanism is unknown, though it could involve injury to the corneal nerves. Lid surgery can also cause exacerbation of dry eyes by increasing exposure.