By The Eye PracticePublished On: 23 January 20173.9 min read

Suffering from the debilitating effects of dry eyes? You’re not alone; approximately 17% to 30% of the average population is prone to dry eyes at some point in their lives. But what causes this unpleasant condition?

This post looks at some of the most common underlying causes as well as a few less common ones.

Dry Eyes are often multi-factorial. In other words there are multiple factors that are contributing, and this is where it gets really tricky.

What’s normal?

Every person has a thin layer of tears coating their eyes to keep their vision normal and their eyes feeling comfortable at all times.

When this tear film is stable and undamaged, it keeps the eyes from becoming dry, inflamed or irritable. Dry eye syndrome occurs when the tear film is compromised – either because there are not enough tears or the quality is poor resulting in evaporation.

What are the usual causes of dry eyes?

Dry eye syndrome can occur at any age and in people who do not have any other health issues. Twenty years ago, it used to be more prevalent in older populations, especially post-menopausal women, due to hormonal changes as well as changes to the anatomy of the eye (such as loose eye lids). But since the dawn of the digital age, we see it in all age groups and in men as often as women.

Here are some of the leading causes:

Aqueous deficiency

due to poor production of watery (aqueous) tears in lacrimal glands, which can be a result of age, hormone changes or autoimmune diseases such as lupus, arthritis or Sjogrens syndrome.

Prescription medications

are a big factor, especially antihistamines, antidepressants, diuretics, beta-blockers, oral contraceptives, etc. In the case of antihistamines, it is very unfortunate, as some dry eyes are associated with allergy, and these drugs would be an ideal choice if it were not for the fact that they are known to worsen symptoms.

Decreased Blinking

over an extended time can also be the culprit, especially when engaged in certain activities such as watching TV, sitting in front of a computer screen or reading.

This may also occur in special cases such as Bell’s palsy.

Blink rehabilitation is an important part of the management of your eye condition. The Eye Practice has vast expertise in this treatment. This might be the first time you have heard of this, but we feel it is imperative.

Blepharitis

or inflammation and crusting of the eye lid margins, is closely associated with dry eyes. A biofilm of bacteria builds up along the inside edges of the eye lids and blocks the flow of oil into your tear film.

Meibomian Gland Dysfunction

is where the oil producing glands in the eyelids become congested at first and ultimately die off if not treated effectively.

Climate conditions like increased dry air or excess winds can also play havoc with the eyes delicate tissues.

This is most pronounced on long haul flights and in air conditioned offices, but even the air conditioner in your car can cause symptoms of dryness and irritation.

Eye Surgery

can sometimes lead to dry eye symptoms, especially laser surgery or cataract operations. This is usually temporary, but not always. It is important to discuss your symptoms with your surgeon so they can best to address the tear film issues before surgery.

A number of ophthalmologists will refer patients prior to any surgery to have their dry eyes treated as the success of the surgery can depend on it.

Eyelid Problems

such as entropion – where the eyelid turns inward and especially lagophthalmos, where the eye lids do not completely close, are more susceptible to dry eyes.

Dietary

It is thought that the Western diet, with its high proportion of omega 6 fatty acids (compared to omega 3s) can contribute to Meibomian gland dysfunction and ultimately, dry eyes.

Addressing this imbalance with a high quality Omega 3 supplement of flaxseed oil can sometimes help with the underlying causes of your symptoms.

Skin creams

containing retinols improve the appearance of your skin by shrinking the oil producing glands. Unfortunately, they have a similar effect on the specialised oil-producing meibomian glands of the eyelids.

Always leave a big margin around the eyes if applying these creams.

Roaccutane

is an oral medication (available on prescription) for the treatment of acne. Like the retinol creams above, it can cause the oil producing glands of the eyelids to shrink and die off. This drug is commonly associated with dry eyes.