dry eye causes

There are many factors that can contribute to developing or worsening dry eye disease.

Non-modifiable risk factors of dry eye diseases are those that you cannot control for. These factors include:

  1. Aging
  2. Female sex
  3. East Asian race
  4. Having other health conditions such as Sjogren’s syndrome or diabetes

Modifiable risk factors of dry eye disease are those that you can control for by minimising our exposure or adapting to these factors. These include:

  1. Excessive digital screen use
    • Overuse of digital screens especially without regular breaks can make your dry eyes worse as you may tend to blink less frequently, causing your tears to evaporate. Your blink quality may also be affected as you do not blink fully. Be mindful of how well you are blinking when using digital screens for work or leisure.
  1. Exposure to wind or air pollution
    • Wind can make your tears evaporate more quickly, while air pollution can affect the quality of your tears. Spectacles with wind shields, those with a wrap-around design or moisture chamber goggles could help protect your eyes if these factors are affecting you.
  1. Certain oral or systemic medications
    • Certain medications can make dry eye disease worse, such as certain antihistamines, antihypertensives, hormonal replacement therapies, acne treatments or oral contraceptives. Do not stop using medication without consulting with your eye care professional / medical practitioner if you are concerned that your medications may be affecting your dry eyes.
  1. Ocular surgeries
    • Ocular surgeries such as laser refractive surgery or cataract surgery could disrupt the cells on the surface of the eyes or your nerves during the procedure. Eye care professionals aim to keep the eyes as lubricated as possible before and after these surgeries to minimise any impact on dry eyes.
  1. Insufficient exercise or sleep
    • Evidence has shown that not enough physical activity or sleep could impact dry eye disease (Stapleton et al, 2023), potentially due to heightened inflammation.
  1. Poor nutrition or hydration
    • As with sleep and exercise, poor nutrition such as those high in sugar could lead to worse inflammation in the body. Adequate hydration is also needed to replenish the fluids in your body such as your tears (Markoulli et al, 2023).
  1. Stress and anxiety
    • Inflammation in your body can also be worsened by stress and anxiety, and this has been linked with dry eye disease as well (Stapleton et al, 2023). Management of these such as through meditation and cognitive behavioural therapy may help with overall health and dry eyes.
  1. Facial or eye cosmetics
    • Cosmetic material has been shown to migrate from skin on the eyelids or face to the surface of the eyes (Sullivan et al, 2023). This may cause discomfort and stinging sensations as the chemicals react with the surface of the eyes. Avoid putting cosmetics too close to the lid margin in contact with your eyes, and make sure to clean your face of any make-up at the end of the day before sleeping.
  1. Smoking and vaping
    • Some research has shown that smoking or vaping could impact on tear film quality by increasing inflammation and damaging glands producing tears (Stapleton et al, 2023).
  1. Contact lens wear
    • Contact lenses can disrupt our intricate tear film and lead to or worsen dry eyes (Jones et al, 2023). Lubricating eyedrops and daily disposable wear of the most wettable lenses may help to alleviate discomfort.


Jones L, Efron N, Bandamwar K, et al. TFOS Lifestyle: Impact of contact lenses on the ocular surface. Ocul Surf 2023;29:175-219.
Markoulli M, Ahmad S, Arcot J, el al. TFOS Lifestyle: Impact of nutrition on the ocular surface. Ocul Surf. 2023 Jul;29:226-271.
Stapleton F, Abad JC, Barabino S, et al. TFOS lifestyle: Impact of societal challenges on the ocular surface. Ocul Surf 2023;28:165-99.
Sullivan DA, da Costa AX, Del Duca E, et al. TFOS Lifestyle: Impact of cosmetics on the ocular surface. Ocul Surf 2023;29:77-130.