Causes of dry eye syndrome can be external factors, systemic health factors, or ocular anatomy/tear film factors.

EXTERNAL FACTORS:

  • Environment:
    • Working outdoors in the wind and exposure to allergens on a daily basis
    • UV exposure from the sun
    • Working in a dusty environment or poor air quality/exposure to toxins and chemicals such as pollution or hair products, cleaning agents
    • Low humidity and high altitude
    • Cigarette smoke and/or second hand smoke

HEALTH ISSUES AND MEDICATION SIDE EFFECTS:

  • MEDICATIONS that cause increased dryness:
    • Glaucoma drops- the medication as well as the preservatives can cause inflammation and dry eyes
    • Allergy medications (especially antihistamines) are meant to dry out the sinuses and can dry out the eyes
    • Diuretics (often used for high blood pressure or bladder problems) flush fluids out of the body and cause dry eyes
    • Cholesterol lowering drugs
    • Anti-depressants, anti-anxiety medications, anti-psychotics, sleeping pills, and pain pills (such as hydrocodone) cause dryness
    • Hormones or lack of hormones can cause increased dryness
    • Acne medications can cause severe dry eyes. These medications dry the skin which targets the similar oil glands in the eyelids affecting the oil layer of the tear film.
    • Prostate medications such as Flomax (tamsulosin) can cause "floppy eylid syndrome" causing the lids to become loose and open while sleeping and drying the eyes out
  • SYSTEMIC CONDITIONS associated with dry eye syndrome:
    • Auto-immune diseases (such as Sjogren's, Lupus, Rheumatoid arthritis, Psoriatic arthritis, Crohn's disease, Ulcerative colitis)
    • Thyroid disease (especially Grave's disease)
    • Dermatology conditions such as rosacea, dermatitis, psoriasis
    • Eating disorders/dehydration
    • Pregnancy and breastfeeding causes hormone changes leading to dryness as well as dehydration
    • Poor diet and dehydration can lead to the inability to produce healthy tear film
    • Sleep apnea causes disrupted sleep which leads to dry eyes, using a c-pap can cause dry eyes when the c-pap shifts in the night causing air flow to blow directly on the eyes

EYELID ANATOMY

  • LAGOPHTHALMOS, INJURY or SCARRING of the eyelids affects the ability to blink or close the lids completely. This can cause the eyes to become extremely dry and increases risk of scarring of the cornea and vision loss if not treated aggressively.
  • BELL'S PALSY or STROKE can paralyze the lids and cause exposure side effects leading to scarring and vision loss.
  • Incomplete blink- often when we are on the computer or reading, we don't blink completely. Partial blinking leaves the bottom half of the ocular surface exposed causing dry spots and "cracking" like chapped lips.
  • Floppy Eyelid Syndrome- loose lids from changes in the anatomy of the plate that gives the upper lid structure can cause the lids to easily open while sleeping. This exposes the eyes overnight causing severe dryness and injury to the eyes.