Causes
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Causes of Dry Eye
People usually begin experiencing dry eye symptoms as they age, but the condition can also result from certain medications, conditions or injuries. Dry eye tends to affect women more often than men, due to the hormonal changes that take place during pregnancy or menopause. Oral contraceptives can also affect the consistency of tears. Dry eye is more common in people over the age of 50. Other causes/contributors of dry eye may include:
- Recent eye surgery (ie. LASIK/Blepharoplasty)
- Previous eye injury
- Long-term contact lens use
- Abnormal eyelid anatomy
(ie. ectropion/entropion/blockage of tear duct) - Environmental exposure such as wind, air conditioning, and dry climates
- Increased screen time and not enough blinking
- Inflammation of the conjunctiva or cornea
- Medication such as antihistamines/decongestants, antidepressants, acne medication, and hormone replacement therapy medications
- Medical conditions such as rheumatoid arthritis, diabetes
- Thyroid eye disease
- Smoking or second-hand exposure to smoke exposure
These factors can affect the stability or consistency of tears, both of which can lead to dry eyes. Our natural tears require a certain chemical balance in order to efficiently moisturize the eyes.
Demodex
Another common contributor to dry eye is Demodex, which is a microscopic mite that can overpopulate within the eyelash follicles. Demodex mites are common on human skin, eyelids and lashes. They can cause red, inflamed, itchy and crusted eyelids (blepharitis) and promote recurring bacterial infections of lash follicles (styes) and well as meibomian gland dysfunction (MGD). Recent studies even indicate that over 42% of individuals with blepharitis also have an infestation of Demodex. Treatment for demodex blepharitis includes lid exfoliation with ZEST therapy or lid hygiene products, especially those containing tea tree oil.
Ocular Rosacea
Rosacea is a chronic inflammatory skin condition caused by hypersensitivity to environmental stimuli, affecting the face and sebaceous glands (oil glands). It leads to a reddish complexion due to dilated blood vessels and can cause scarring if untreated. Affecting up to 5% of the population, rosacea is most common in middle-aged individuals, particularly Caucasians with fair skin, and more frequently diagnosed in females. Ocular Rosacea can occur without facial rosacea and is frequently under-diagnosed. Ocular Rosacea impacts the eyelids and eyes, and is often accompanied by dry eye, meibomian gland dysfunction, and blepharitis. Symptoms include swollen and/or red eye eyelids, burning/stinging eyes, and recurrent styes. Proper identification and treatment are essential to manage symptoms and prevent vision and comfort issues. While there’s no cure, various treatments can help manage ocular rosacea effectively, including Intense Pulsed Light (IPL) therapy.
The wearing of masks since COVID-19 pandemic may also be contributing to an increased incidence of MGD-related dry eye in addition to increased rates of other MGD-related conditions such as chalazion and hordeolum (styes). Masks can direct exhaled air across the ocular surface thus drying it out further.