Dry Eye Has Numerous Risk Factors, Including Diabetes, Low Humidity: Nicole Bajic, MD

Nicole Bajic, MD, ophthalmologist and assistant professor at Cleveland Clinic's Cole Eye Institute, spoke about how dry eye presents itself in patients with the condition, as well as the risk factors of dry eye.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

How would you define dry eye and dry eye disease?

Dry eye disease is much more complex than what you think of as just an eye that is dry. Just like you have dry skin that might require lotion, dry eye can be a little bit more complex than that because it's essentially an imbalance of the very complex tear layer. The tear layer is not just water; it's actually a complex mixture of various layers and important proteins and things like that in our tear layer that covers the surface of the eye. It's composed of 3 main components.

Number one is the aqueous layer. That's the watery component of tears that we think of when we cry. Then we have the oil layer, and that comes from the meibomian glands that line the eyelids. Then we also have the mucin layer, and so that is mucus that comes from goblet cells. We require a balanced mixture of all 3 of those in order to have a good quality of tear film so that our eyes are comfortable and that we see well, and when we have an imbalance, that's when the problems start.

What are the risk factors for dry eye?

In addition to low humidity, screen use is a risk factor, [as well as] poor sleep, makeup use, [and] poor diet, potentially. Medications [are] a big one, too. Antihistamines, especially around allergy season, when people are loaded up on antihistamines, they can really suffer from dry eye too, and then they get really frustrated. Antidepressants can also contribute, contact lens use, potential topical medications for the eyes, and then age is a big one.

Certain ethnicities, including East Asians, can be more prone to have dry eye. Females, the gift that keeps on giving. And then with certain disease states, [such as] Sjogren [disease], connective tissue diseases, migraines potentially, mental health disorders, and then diabetes and androgen deficiencies can also be risk factors.