There are two main types of dry eye disease; Evaporative (tears are of poor quality) and Aqueous Deficient (where too few tears are produced). Between these two types, we are seeing a larger increase in those with Evaporative dry eye, which is more impacted by lifestyle and diet than Aqueous Deficient dry eye.
Evaporative dry eye is typically caused by dysfunction of the tiny glands in the upper and lower eyelids - called the Meibomian Glands - which produce the top layer of the tear film, the lipid layer.
Aqueous Deficient dry eye is caused by dysfunction of the lacrimal gland which is near your eyebrow arch, and it produces the middle and main layer of the tear film - the aqueous layer.
The most common causes of DED are, age, hormonal changes; especially around peri-menopause or menopause, underlying autoimmune diseases and then a whole host of lifestyle factors especially having had refractive eye surgery, wearing contact lenses, regular screen use or living/working in a smokey/ polluted/ air conditioned or centrally heated environment (for example, kitchen-workers like chefs, hairdressers, office-workers).
Diet can certainly play a role; we now know that a diet rich in Omega 3s and anti-oxidants and staying hydrated is critical to maintaining optimal eye health. Patients report that changing their diet and water intake alone can help improve dry eye symptoms.
Lifestyle factors can certainly exacerbate any existing dry eye condition and even induce it in some cases; screen time especially is a big factor but also smoking or working particularly in smokey, windy, heated or air-conditioned environments can cause tears to be wicked away faster than they're replaced inducing dry eyes.
More and more we're also learning about the role of skincare and makeup in contributing to dry eye. Recent research has found that topical retinoids used close to the eyes, for example in eye creams, can contribute to dry eyes by damaging the Meibomian Glands.
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