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DRY EYE SYNDROME Causes and symptoms What is it? Dry eye syndrome is a disorder of the tear film due to tear deficiency or excessive evaporation, which causes the eyes to become dry, inflamed and uncomfortable and damages the ocular surface. There are two main causes of dry eye: firstly a condition in which the eyes can’t make enough tears, sometimes called keratoconjunctivitis sicca, and secondly where the tears evaporate too quickly. The most common cause of excessive tear evaporation is blockage and PATIENTS - FACT SHEET eye syndrome has caused visual impairment and scarring of the eye’s surface. You should therefore visit your GP as soon as possible if you have any of the following: • Extreme sensitivity to light • Extremely red eyes • Eyes that are very painful • Deterioration of vision dysfunction of the Meibomian oil glands in the eyelids, which What causes it? is also known as posterior blepharitis. Dry eye syndrome can be caused or made worse by many things, including your environment, illnesses, Who gets it? Dry eye syndrome is a common condition, with up to a third of people experiencing it at some point in their life. While anyone can develop dry eye syndrome, it is most common in people over the age of 60. The condition is also more common in women than men. What are the symptoms? side-effects of medicines, hormonal changes and simply getting older. In many cases there isn’t one single, identifiable cause – it’s often a mixture of things associated with tear production. Aqueous tear production is regulated by the lacrimal functional unit of the eye. Tear evaporation is prevented by healthy Meibomian oil gland secretion in the tear film. If any part of this unit doesn’t work properly, the whole system can break down, The symptoms of dry eye syndrome can be mild, moderate or resulting in dry eye syndrome due to one or both of severe and may include: Keratoconjunctivitis sicca: the following: • Feelings of dryness, grittiness or soreness in both • The eyes cannot produce enough tears eyes, which get worse as the day goes on • Tears evaporate quickly and the tear film is not • Redness of the eyes maintained for longer than a few seconds in • Watery eyes, particularly when exposed to between blinks. wind Blepharitis • Eyelids stuck together on waking up As you can see below, lots of things can affect tear • Eyes feel worst first thing in the morning production and evaporation. . • Burning feeling in eyelids, or itchy eyelids, red rims of eyelids Environment A wide range of environmental factors can have a drying Is it serious? Dry eye syndrome is normally not serious. There are some rare cases, however, where severe untreated dry effect on the eyes, causing tears to evaporate too quickly. These include: • Sun • Wind • Dry climate Other medical conditions that can cause dry eye • Central heating syndrome in some people include: • Warm blowing air • Atopic eczema • High altitude • Conjunctivitis Occupation Dry eye syndrome can also be caused by the following People tend to blink less often when carrying out less common conditions: activities that require visual concentration, such as • Sjögren’s syndrome reading, writing or working with a computer. This can • Rheumatoid arthritis cause tears to evaporate faster than usual, leading • Lupus to dry eyes. • Scleroderma • Previous trauma such as burns or exposure Laser surgery to radiation Many people experience dry eye syndrome after • Shingles laser-assisted in-situ keratomileuis (LASIK) surgery, • Bell’s palsy a procedure used to correct eyesight problems. However, these dry eye symptoms usually resolve Medicines after 6 - 9 months. Several types of medicine are thought to cause dry eye syndrome in some people. These include: Contact lenses • Antihistamines Contact lenses can irritate the eye and cause dry eye • Antidepressants syndrome in some people, partly due to decreased corneal • Beta-blockers* sensitivity affecting the lacrimal functional unit. Changing to • Diuretics* a different type of lens which has a lower water content, and *Often used to treat high blood pressure (hypertension). using preservative-free lubricants, can help to resolve the symptoms. Ageing We naturally produce fewer tears as we get older. This, Menopause combined with the effects of the menopause, probably The hormonal changes that occur during the explains why dry eye syndrome is particularly common menopause can lead to a reduction in tear production, among older women. resulting in dry eye syndrome. Effective treatments are available. See our other fact sheet ‘Dry Eye Syndrome - Diagnosis and Medical conditions treatment’ for more information. One of the most common causes of dry eye syndrome is blepharitis, which is inflammation of the rims of the Consult your doctor or optometrist if you think you may need eyelids. Blepharitis is associated with blockage of the treatment for dry eye syndrome. Meibomian oil glands, which causes excessive tear evaporation. Blepharitis is commonly associated with: Further information can be found in our fact sheet • Seborrhoeic dermatitis ‘Dry Eye Syndrome – Causes and Symptoms’. • Rosacea