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What are the actual causes of Dry Eye?

What causes Dry Eye

Are you at risk of developing dry eye?

Around one-third of the UK adult population has dry eye disease according to a recent study published from the University of Aston. That is around 17 million people, more people than who report having asthma, diabetes, back pain or even high blood pressure. The problem is now so big it is on the radar of the World Health Organisation (WHO), who have called for dry eye not to be overlooked when considering eye disease.

So what are the causes of this increasingly common chronic, progressive ailment which affects so many lives? Dry Eye Zone took a closer look ….

What exactly is dry eye?

Dry eye is one of the most common eye conditions in the world, and it results in symptoms of dry, tired, sore gritty or red eyes (sufferers describe their symptoms is many ways, this list is far from complete, it even includes watery eyes!). A global panel of dry eye experts have developed a definition of dry eye which has been adopted by eye care professionals everywhere:

‘‘Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.’’

If left untreated it can result in permanent damage to the ocular surface. Read on to discover who is at risk ……

Getting older

The UK, like many developed nations, has an aging population. We are all aging, and with age the quantity and quality of the tears we produce diminishes. This is due to irreversible changes to the surface of eye’s microenvironment, many important cell types no longer function as they used to, resulting in a significant increase the incidence of dry eye. You might not be surprised to learn that the number of dry eye patients doubles in the over 80s compared to 20 years earlier.

Being female

If you are female you are 2.4 times more likely to be diagnosed with dry eye disease than if you are male. This is because of the impact of the female sex hormones such as oestrogen. Surges in the level of these hormones, during normal monthly menstrual cycles and at the menopause, can bring disruption to the production of tears. There have been many scientific studies linking changes in hormonal levels with shifts in the severity of dry eye symptoms.


It is not just older people who are at risk. The digital world in which we work and live is resulting in dry eye symptoms appearing even in children! This is due to long hours spent looking at screens, these extended periods of concentration cause your blink rate to slow. Every time you blink you are washing the surface of the eye with fresh tears. Less tears means your eyes are more likely to dry our and digital eye strain result.

This latest research also indicated that prolonged periods (four-hours or more) of outdoor time, either for leisure or work, increased your risk of developing dry eye symptoms by x2.4. This was due to exposure to the elements such as wind, sun, heat and air pollution.

Not enough sleep

The role of sleep in both physical and mental health is increasingly becoming a focus. Dry eye is no exception with those getting less than 6-hours a night putting themselves at increased risk of dry eye. Interestingly, dry eye itself can lead to disrupted sleep so make sure you get those Zzzzzzs in.

Certain medications

If you are taking medication for another condition then it is essential you follow your doctor’s instructions. But also be aware that some widely used medicines will also make dry eye worse. So, if you are taking HRT, isotretinoin (acne), antihistamines, antidepressants, Parkinson's medications and even ibuprofen you may be making your dry eye worse. You might want to mention this to your doctor and eye care professional

Other medical conditions

The researchers at Aston University also noted that there were many diseases which as well as being a problem in their own right also make you more likely to experience dry eye symptoms. You can check out the list for yourself here, they include hypertension, asthma, eczema, any allergy, rheumatoid arthritis, migraine and irritable bowel syndrome. The physiological reasons for these links will vary from one condition to the next – but the bottom line is you need to take extra care of your eyes too. If in doubt ask your eye care professional for advice.

If you are experiencing dry eye symptoms then you should ask the advice of your eye care professional. Why not book your next eye examination with an independent optician today.


Vidal-Rohr M, Craig JP, Davies LN, Wolffsohn JS. The epidemiology of dry eye disease in the UK: The Aston dry eye study. Cont Lens Anterior Eye. 2023 Jun;46(3):101837. doi: 10.1016/j.clae.2023.101837. Epub 2023 Mar 30. PMID: 37003925.,are%20positive%20predictors%20of%20DED.

Office of National Statistics. Dataset: UK health indicators. Contact: Geeta Kerai, Ireoluwaposi Onadeko, Emma Bannister and Tim Vizard. Release date: 29 March 2022

The World Health Organisation (WHO) World Report on Vision 2019. Executive Summary. Page 4.

Jennifer P. Craig et al. TFOS DEWS II - Definition and classification,%27%27

Kitazawa K et al. Impact of aging on the pathophysiology of dry eye disease: A systematic review and meta-analysis. The Ocular Surface, Volume 25, 2022, Pages 108-118,

ISSN 1542-0124,

Barabino, S. Is dry eye disease the same in young and old patients? A narrative review of the literature. BMC Ophthalmol 22, 85 (2022).

WebMD. Is Your Medication Causing Dry Eye?

Medically Reviewed by Dr Whitney Seltman, July 10, 2023 Written by WebMD Editorial Contributors

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