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Causes of Dry Eye Syndrome (DES)

Dry eye syndrome is an eye condition that causes symptoms such as pain, grittiness, itchiness, and irritation in the eyes. It can be caused by several factors, including lifestyle, age, environment, genetics, medications, and underlying health conditions.

These factors can all lead to insufficient tear production or the production of chemically imbalanced tears.

Common Causes of Dry Eye Syndrome

Meibomian Gland Dysfunction (MGD)

MGD is the leading cause of dry eye syndrome. It’s caused by a blockage in the meibomian glands, which are located in the eyelid margins and produce oils that coat the tear film. This condition prevents the glands from releasing oils that maintain tear quality, leading to dry eye.


Blepharitis is an inflammation of the eyelids, usually at the base of the eyelashes. It causes the eyelids to swell and appear red, and can cause them to produce infected debris called scurf. This can trigger dry eye.

Certain medical procedures

Complications from medical procedures such as eye surgery and radiation therapy can cause DES. Radiation therapy damages the lacrimal glands, which decreases tear production. Eye surgeries such as LASIK and cataract can also cause dry eye due to increased corneal sensitivity.


Diabetes can cause dry eye due to nerve neuropathy, which occurs when the nerves that control the tear ducts stop functioning properly, resulting in decreased tear production. It can also cause loss of corneal sensitivity, which can worsen DES symptoms.

Sjogren’s Syndrome

This autoimmune disease affects the nerves and can prevent tear ducts from producing enough tears.

Thyroid disorder

Both hypothyroidism and hyperthyroidism can cause DES. This is because when the thyroid is off-balance, the eye’s metabolism can be negatively impacted.

Certain medications

Several medications can reduce the functionality of the tear ducts and lead to dry eye,
such as:

  • Ibuprofen (Advil)
  • Lortab (acetaminophen and hydrocodone)
  • Diuretics
  • Decongestants
  • Antihistamines
  • Anticholinergics
  • Antidepressants
  • Hormones
  • Hypertension medication
  • Dermatological agents

Hormonal Changes

Sharp changes in hormone levels often cause an inflammatory response that results in dry eye. These changes happen during pregnancy, while taking oral birth control, and during menopause.

Seasonal Changes

Seasonal changes can produce a high amount of pollen and allergens in the air, and some people develop an autoimmune response to these allergens, often resulting in ocular inflammation and dry eye.

Wind and Dryness

Dry and windy environments can also cause dry eyes by stripping the eyes of their moisture.


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