Dry eye syndrome (DES), also known as keratoconjunctivitis sicca, is a health condition that occurs when your eyes don’t produce enough tears or your tears evaporate too quickly. It’s characterized by dryness, irritation, and inflammation of the eye. This can lead to damage to your eye’s surface. Each layer in the affected part of the eye has distinct functions, and disruptions in any layer can contribute to dry eye symptoms. The condition affects millions of people globally, impacting their quality of life and potentially leading to more severe eye issues if left untreated. A number of causes can lead to the development of this health condition. Understanding these root causes of DES is essential for effectively managing and treating the condition. This article delves into the primary factors contributing to DES to offer insights into the different factors that can lead you to develop DES.
Primary Causes of Dry Eye Syndrome
- Aqueous Tear-Deficient Dry Eye (ATDDE): ATDDE occurs when the lacrimal glands — the glands that make tears — don’t produce enough fluid. This can happen due to various factors, including age-related changes, autoimmune diseases such as Sjögren’s syndrome, and other inflammatory conditions. Sjögren’s syndrome, in particular, is a significant cause of ATDDE, affecting the lacrimal and salivary glands.
- Evaporative Dry Eye (EDE): EDE is primarily due to excessive evaporation of tears, often linked to meibomian gland dysfunction (MGD). The meibomian glands secrete an oily substance that forms the outer layer of the tear film, which prevents tears from evaporating too fast. When these glands are blocked or aren’t functioning properly, tear evaporation rates increase, leading to dry eye symptoms. Environmental factors such as low humidity, wind, and prolonged exposure to screens can exacerbate EDE by accelerating tear evaporation.
- Mixed-Mechanism Dry Eye: Some people experience a combination of both aqueous tear deficiency and evaporative dry eye. This mixed mechanism requires a more comprehensive approach to diagnosis and treatment to address both insufficient tear production and excessive tear evaporation.
Secondary Contributing Factors
- Hormonal Changes: Hormonal fluctuations, particularly in women, can influence tear production. Estrogen and androgen imbalances during pregnancy, menopause, or hormone replacement therapy can affect the function of the lacrimal and meibomian glands. This may increase the risk of DES.
- Medications: Some medications, including antihistamines, antidepressants, and diuretics, can reduce tear production or alter the tear film’s stability. People who are on long-term medication regimens can ask their doctors about management options for dry eye symptoms.
- Systemic Conditions: Chronic conditions such as diabetes, rheumatoid arthritis, and thyroid disorders can indirectly affect tear production and the health of the eye surface. These conditions may alter nerve function or contribute to systemic inflammation, further complicating DES.
- Eye Surgeries: Procedures like LASIK or cataract surgery can disrupt the corneal nerves, leading to decreased tear production and changes in tear film balance. Post-surgical dry eye is a common complication as well.
Dry eye syndrome is a complex, multifactorial condition that requires a thorough understanding of its underlying causes for effective management. Both internal factors, such as lacrimal gland dysfunction and meibomian gland disease, and external factors, including environmental influences, play important roles in its development. Accurate diagnosis and personalized treatment strategies are essential for alleviating symptoms and improving quality of life for people living with DES.
Resource Links
“What Is Aqueous Tear-Deficient Dry Eye?” via WebMD
“Evaporative Dry Eye: What You Need to Know” via Johns Hopkins Medicine
“Dry Eye” via Cleveland Clinic