Menopause, Lack of Sleep, Anxiety Medications Linked to Dry Eye Disease

Woman applying eye-drops into her eye
Woman applying eye-drops into her eye
Anxiolytic medication use and other lifestyle factors can put patients at a greater risk for dry eye.

Dry eye disease (DED) is independently associated with the use of anxiolytic, menopause, and sleep hours per day (P <.026 for all), according to findings published in Contact Lens and Anterior Eye.

Researchers conducted a cross-sectional study using 120 participants (all White, between the ages of 18 and 89 years). The study assessed participant medical history, environmental considerations, and lifestyle information. Assessment tools included the Ocular Surface Disease Index (OSDI), Dry Eye Questionnaire-5 (DEQ-5), non-invasive tear breakup time (TBUT), tear film osmolarity testing, and obtaining ocular surface staining parameters. All factors were assessed in a single clinical session to allow DED diagnosis based on guidelines of the Tear Film and Ocular Surface Society Dry Eye Workshop II Diagnostic Methodology Report. The data was analyzed using a multivariate logistic regression model.

The study found that 57.7% of participants had DED, and that more of the participants with DED were women (P =.008). Although the study did not provide a conclusive independent association, the following were identified as potential DED risk factors: female sex, anxiety, systemic rheumatologic disease, daily medication, ocular surgery, poor diet quality, more ultra-processed food in diet, not drinking caffeine, and hours of exposure to air conditioning per day. 

“Participants who used anxiolytic medication were 5.7 times more likely to suffer from DED,” the report explains. While past literature has reported that drinking caffeine increases tear production, the present study found otherwise, noting that: “in the present study this factor did not reveal an independent association with DED, although the univariate analysis showed that participants who did not drink caffeine had 1.7 times more probability to suffer from DED (P =.023).”

Study limitations include the fact that dry eye classification subtypes were not considered in the analysis of the self-reporting of some participant factors and its single center design. 


García-Marqués JV, Talens-Estarelles C, García-Lázaro S, Wolffsohn JS, Cerviño A. Systemic, environmental and lifestyle risk factors for dry eye disease in a mediterranean caucasian population. Cont Lens Anterior Eye. Published online November 14, 2021. doi:10.1016/j.clae.2021.101539.