Risk Factors For Dry Eye Research Articles

Prevalence of eye dryness among the general population of the Northern Region of Saudi Arabia

Background: Dry eye disease (DED) is one of the most frequently encountered ocular morbidities. 25% of patients who visit ophthalmic clinics report symptoms of dry eye, making it growing public health. This study estimated the prevalence of eye dryness and to determine the risk factors for dry eye in the general population in the Northern Region, Saudi Arabia. Methodology: This was a cross-sectional community-based study, conducted among 384 Saudi and non-Saudi males and females of 15 years of age and above, in Arar, the Northern region of Saudi Arabia, during the period from 1 November 2018 to 31 January 2019. The data were collected by using a predesigned questionnaire. Results: The prevalence of dry eye disease in the sample was 36.5%. Reported symptoms were feeling gritty or sandy sensation in the eye 36.3%, burning sensation 40.3%, and sometimes having red-eye 44.9%. Dry eye disease was more prevalent in females 76.9% than males 23.1% (p = 0.521), there was no significant relation with age (p = 0.66) and was more prevalent in 21–30 age group (46.2%). In cases with DED, there were 13.2% who wore contact lenses and 22.2% wore glasses (p = 0.004). There was insignificant relation with osteoporosis, joint or rheumatic problems, bronchial asthma, thyroid diseases, high blood cholesterol, hypertension, diabetes, and aspirin administration; however, it was positively associated with the previous history of trachoma. Conclusion:The prevalence of dry eye disease in this sample was 36.5%, with significant positive relation with wearing contact lenses and glasses, and previous history of trachoma.

The clinical profile and prevalence of dry eye in tertiary care hospital- based population

Background: Dry eye is recognized as a growing public health problem and one of the most frequent reasons for visiting an ophthalmologist in middle and old age people. Objectives: To the best of our knowledge, very less study has been undertaken in central India on dry eye. The present study was designed to study clinical profile and to evaluate the true prevalence and risk factors of dry eye in central India. Materials and Methods: A total of 1562 participants aged 30 years or more visiting ophthalmology department in a tertiary care rural hospital enrolled in a study. Study duration was 18 months. The study design was a prospective, cross-sectional, and observational study. An ocular surface disease index (OSDI) questionnaire was administered to all participants and individuals with OSDI score greater than 12 were further evaluated with dry eye tests in sequence of tear break-up time, lissamine green staining, Schirmer-1 test, and slit-lamp examination for meibomian gland dysfunction. The participants with OSDI Score ≥13 were diagnosed to be having dry eye. The data were compiled and subjected to statistical analysis using SPSS v.17.0 software (SPSS Inc., Chicago, Illinois, USA). P < 0.05 was considered to be statistically significant. Results: Prevalence of dry eye in our study was 24.7%. Prevalence of lipid layer, aqueous layer, and mucin layer deficiency dry eye was 13.8%, 5.2%, and 7.8%, respectively. Increasing age, illiteracy, and menopause were the significant risk factors and female sex, urban habitat, and laborer and factory worker were insignificant risk factors for dry eye. Conclusion: Prevalence of dry eye in our study is higher than reported in literature in central India. Lipid anomaly dry eye was the most prevalent, followed by mucin layer deficiency and lastly aqueous tear deficiency.

Ocular allergy as a risk factor for dry eye in adults and children.

To provide an overview of the pathogenic mechanisms underlying the correlation between ocular allergy and dry eye disease (DED), highlighting how the first condition may be a risk factor for the second one. Recent advances in our comprehension of the pathogenesis of ocular allergy and DED allow identifying several pathways of interaction between these two conditions. A growing body of evidence supports the role of ocular allergy as a risk factor for DED. Ocular allergy, particularly the severe forms of keratoconjunctivitis, can impact on different key mechanisms of the DED vicious cycle, including tear film instability, ocular surface inflammation and damage, and neurosensory abnormalities. Ocular allergy and DED are two common, relevant, symptomatic, not mutually exclusive conditions affecting the ocular surface. They share some clinical and biochemical features. To better understand the complex interactions between these two conditions, it's essential to consider the very wide spectrum of clinical conditions included in the term ocular allergy and the still largely unexplored peculiarities of the pediatric ocular surface physio-pathology and DED.

Incidence and Risk Factors of Dry Eye in a Spanish Adult Population: 11-Year Follow-Up From the Salnés Eye Study.

To estimate the incidence of dry eye (DE) and to evaluate risk factors in an adult cohort in Spain. The Salnés Eye Study (SES) was a cross-sectional population-based study of 654 subjects conducted from 2005 to 2006. After 11 years, 264 individuals (65.8% response rate) participated in SES 2. The incidence cohort consisted of 209 subjects not diagnosed with DE in SES 1 [mean age (SD) 67.6 years (±10.1), range: 51-92, women 69.4%]. DE was defined as the simultaneous presence of symptoms and at least 1 sign. A Schirmer test score ≤5 mm, tear film breakup time ≤10 seconds, rose bengal staining ≥3, and fluorescein staining ≥1 were considered indicative of signs. Poisson regression models were performed to evaluate risk factors. The 11-year incidence of DE was 25.4% (95% confidence interval, 19.5-31.3) and that of symptoms was 31.6% (confidence interval, 25.4-37.8). DE incidence was significantly associated with age (P < 0.05). After adjusting for age, secondary or university studies were protective factors for DE; taking anxiolytics or antidepressants and angiotensin-converting enzyme inhibitors increased the risk of symptoms; a history of hypertension, chronic obstructive pulmonary disease, or autoimmune diseases increased the risk of signs. The annual incidence of DE, symptoms, and signs, was found to be 2.3 per 100 person-years. The incidence of symptoms was higher than that reported in similar studies. This study suggests that some factors may increase the risk of symptoms, whereas other factors may increase the risk of signs.

Demographic Profile and Risk Factors for Dry Eye

Introduction: Dry eye is a disorder of the tear film which occurs due to tear deficiency or excessive tear evaporation. It causes damage to the interpalpebral ocular surface and is associated with a variety of symptoms reflecting ocular discomfort.Materials and Methods: This was a hospital-based retrospective descriptive study conducted to study the demography of dry eye patients and associated attributable risk factors for the disease. Every patient presenting with symptoms suggestive of dry eye was given a questionnaire, as per Salisbury Eye Evaluation Study and thorough ocular examination was done along with two tests for dry eye i.e Schirmer test I measuring less than 10mm and Tear film break up time measuring less than 10 sec. Final data analysis was done using statistical tool SPSS.Results: Demographic profile revealed a female preponderance in the patients with a ratio of 1.9:1. Amongst them, prevalence of premenopausal age was 53%. Dry eye was found to be more common in age group between 30 to 40 years (29%). The modifiable attributable risk factors were urban residence (67%), exposure to air condition and computer user (52%), indoor workers (59%), and environmental pollutants (60%).Conclusions: This study revealed the patients who presented with dry eye were mostly female of premenopausal age group, and exposed to modifiable risk factors which included residing at urban areas, indoor work, and exposure to environmental pollutants. Nepalese Medical Journal. vol.1, No. 1, 2018, page: 9-11

Prevalence of dry eye in video display terminal users: a cross-sectional Caucasian study in Italy.

To estimate the prevalence of dry eye among video-terminal (VDT) users and to assess risk factors for dry eye in this population. A single-centre, cross-sectional study was carried out on subjects employed as VDT workers and on a control group. Demographic data, years spent working at a VDT, number of effective hours at VDT/day, number and hours of breaks/day were considered. All subjects underwent a complete ophthalmic examination and completed the Italian version of the computer vision symptom scale 17-item (CVSS17) questionnaire. Both groups were classified as definite, suspect and non-dry eye syndrome (DES). One-hundred and ninety four subjects completed the study; 70 (36.1%) of which represented the control group, and 124 (63.9%) represented the VDT group. Among VDT workers, 29 (23.4%) presented definite DES and 55 (44.4%) suspect DES, while among controls, only 2 (2.9%) presented definite DES and 37 (52.8%) suspect DES. In the univariate analysis, the DES group was older (p < 0.001), spent more time a day at VDT (p < 0.001), used VDT from more time (p < 0.001), instilled artificial tears (p = 0.031), and presented worst quality of life (p < 0.001). At the multivariate analysis, only age and time at VDT retained association with DES (OR 1.05; 95% CI 1.01-1.09; p = 0.01 and OR 1.57; 95% CI 1.07-2.02; p = 0.017, respectively). The global increase of VDT workers is accompanied by a higher frequency of ocular complaints. Older subjects and people spending more than 4h a day at VDT are at major risk to develop DES and should take precautions to prevent the onset of the disease.

Prevalence and Risk Factors of self-reported dry eye in Brazil using a short symptom questionnaire

To evaluate dry eye prevalence and investigate associated risk factors in Brazil by applying a short questionnaire of symptoms and risk factors. A cross-sectional study of 3,107 participants from all the five different geopolitical regions of Brazil. Overall prevalence of dry eye in this study population was 12.8%. Dry eye previous diagnosis was reported by 10.2% and presence of severe symptoms in 4.9%. Logistic regression analysis confirmed some significantly risk factors, such as female sex (Odds Ratio (OR) 1.74; 95% Confidence Interval (CI): 1.12–1.93), age ≥60 year-old (OR 2.00; 95%CI: 1.44–2.77), history of ocular surgery (OR 1.84; 95%CI: 1.30–2.60), contact lens wear (OR 1.93; 95%CI: 1.36–2.73), cancer treatment (OR 3.03; 95%CI: 1.36–6.59), computer use >6 hours per day (OR 1.77; 95%CI: 1.36–2.31), antidepressants (OR 1.61; 95%CI: 1.12–2.31) and anti-allergy (OR 2.11; 95%CI: 1.54–2.89) medications. Nevertheless, when stratified by regions, each one had its own significant factors and inherent characteristics. This is the first study about prevalence and risk factors of dry eye in a large population sample from all regions of Brazil. Dry eye is a common condition in the Brazilian population and prevalence rates varies substantially in the different geographic regions of the country, possibly reflecting climate and socioeconomic discrepancies.

Prevalence of Dry Eye in Uyghur and Han Ethnic Groups in Western China

ABSTRACTPurpose: To describe and compare the prevalence and characteristics of dry eye among Han and Uyghur persons living in Kashi, the most inland city of China.Methods: A total of 1015 residents of Kashi participated in this 2013 cross-sectional study. To evaluate clinical characteristics, each subject completed (1) a dry-eye questionnaire detailing symptoms of dry eye, (2) Schirmer’s I-test (SIT), (3) tear-film break-up time (BUT) test, and fluorescein staining of the cornea. Dry eye was defined as the existence of dry eye symptoms and at least two positive clinical signs. Data were analyzed using SPSS software. The prevalence and risk factors of dry eye were evaluated using a multivariate model.Results: Overall, 282 (27.8%) of the 1015 participants were diagnosed with dry eye (95% confidence interval (CI): range, 25.5–30.1). The prevalence of dry eye among Han persons (37.9 %) (95% CI: range, 35.8–40.0) was higher than that among Uyghurs (21.8%) (95% CI: 19.6–24.0) (p < 0.05). The prevalence of dry eye was 25.6% (95% CI: range, 23.3–27.8) among men and 28.7% (95% CI: 26.5–30.9) among women (p > 0.05). Risk factors for dry eye included ethnicity, age, occupation, arthritis, and dry mouth.Conclusions: Our study revealed a higher prevalence of dry eye among Han than Uyghur persons in Kashi. Dry eye was significantly associated with environment and ethnicity.

Effects of Aging in Dry Eye.

Dry eye affects millions of people worldwide and causes eye well recognized risk factors for dry eye. Anatomical and inflammation-induced age-related changes affect all components of the lacrimal gland functional unit, inclusive of lacrimal gland, conjunctiva, meibomian gland and compromise ocular surface health. There is increased evidence that inflammation plays a role in dry eye. This review will summarize the current knowledge about aging and dry eye, inclusive of lessons learned from animal models and promising therapies.

Interferon-gamma deficiency protects against aging-related goblet cell loss.

Aging is a well-recognized risk factor for dry eye. Interferon-gamma (IFN-γ) has been implicated in conjunctival keratinization and goblet cell loss in dry eye. We investigated the role of IFN-γ in age-related dry eye by evaluating young (8 weeks) and aged (15 months; 15M) C57BL/6 (B6) and IFN-γKO mice. Age effects on the conjunctiva and cornea epithelium were assessed with PAS staining and corneal staining, respectively. Expression of T cell-related cytokines (IL-17A, IFN-γ), chemokines (CXCL10 and CCL20), in the ocular surface epithelium was evaluated by real time PCR. A significant decrease in filled goblet cells was noted in 15M B6 mice and this was significantly lower than age and sex-matched IFN-γKO mice. Aged male B6 had significantly higher IFN-γ, and CXCL10 mRNA in their conjunctiva than female B6 mice. Aged IFN-γKO females had significantly higher IL-17A mRNA in conjunctiva than IFN-γKO males and B6 mice. Corneal barrier dysfunction was observed in 15M female B6 and aged IFN-γKO mice of both sexes; however it was significantly higher in IFN-γKO compared to B6 mice. While there was a significant increase in IL 17A, and CCL20 in corneas of aged female B6 and IFN-γKO mice compared to males, these changes were more evident in aged female IFN-γKO group.Partial resistance of IFN-γKO mice to aging-induced goblet cell loss indicates IFN-γ is involved in the age-related decline in conjunctival goblet cells. Increased corneal IL-17A expression paralleled corneal barrier disruption in aging female of both strains. IFN-γ appears to suppress IL-17A on the ocular surface.

Frequency and risk factors associated with dry eye in patients attending a tertiary care ophthalmology center in Mexico City.

PurposeThe purpose of this study was to ascertain the frequency and risk factors of dry eye (DE) among patients attending a tertiary care ophthalmology center in Mexico.MethodsApproximately 338 consecutive new patients attending a tertiary care ophthalmology center in Mexico City underwent an ocular surface examination, which included tear film break-up time, fluorescein corneal staining, Schirmer’s test, and evaluation of meibum quality. Symptoms of DE were evaluated by the Ocular Surface Disease Index and Dry Eye Questionnaire-5. Information on demographics, exposures, past medical and ocular history, and medications was also collected.ResultsThe frequency of severe DE symptoms was found to be 43% based on the Ocular Surface Disease Index and 30% based on Dry Eye Questionnaire-5. Risk factors significantly associated with increased DE symptoms included dry mouth and gastrointestinal ulcer medications. With regard to signs, aqueous tear deficiency was a less-frequent finding (22%) in our population than evaporative deficiency (94%). Risk factors associated with aqueous tear deficiency were dry mouth and diuretic use. No risk factors were associated with evaporative deficiency. Risk factors associated with meibomian gland dysfunction included old age, male sex, arthritis, and use of an antihypertensive. The only risk factor associated with corneal staining was dry mouth.ConclusionThis is the first study to demonstrate the frequency of symptomatic and clinical DE in a tertiary care ophthalmology center in Mexico. The frequency of DE ranged from 30% using a symptomatic definition to 94% using objective measures. Different risk factors were found for different aspects of DE, suggesting differing underlying pathophysiologies behind different DE subtypes.

Clinico-etiological study of dry eye in hospital based population

The aim of his study was to find out the prevalence of dry eye and evaluate various risk factors attributable to dry eye in hospital based population. In this cross sectional study, 150 patients above 21 years of age are included based on dry eye questionnaire, and various tests including tear breakup time (TBUT), schirmer's test, tear meniscus height, lissamine green staining along wih presence of strands/filaments. The prevalence of dry eye was 24.4%. It was significantly higher in females (25.5%) than in males (19.8%) and is more common in rural (23.2%) than in urban population. Excessive wind, smoking, and patients on medications (systemic or topical) are more associated with dry eye. Dry eye is a under diagnosed ocular disorder. Reduction in modifiable risk factors of dry eye is essential to reduce its prevalence.

Mechanisms and management of dry eye in cataract surgery patients.

To provide a summary of the mechanisms that may cause dry eye after cataract surgery and discuss available and upcoming treatment modalities. Development or worsening of dry eye symptoms after cataract surgery is multifactorial with corneal nerve transection, inflammation, goblet cell loss, and meibomian gland dysfunction commonly cited as underlying disorders. With increasing awareness of the prevalence of dry eye disease, current surgical techniques are being analyzed for their contribution to the issue. Although many classic interventions, such as artificial tears and anti-inflammatory drops, remain first-line treatment options, they may not adequately address abnormalities of the tear film. The trend has been to create new drugs and technologies that target meibomian gland deficiencies and restore goblet cell numbers. Therapy for postoperative dry eye symptoms should be determined based on symptom severity and which underlying cause is most prominent at a given time. Patients with high-level risk factors for dry eye should be evaluated preoperatively to determine whether they have preexisting dry eye disease or if they are susceptible to developing disease after surgery.

Dry eye prevalence and attributable risk factors in the eastern Madhya Pradesh

Background: There is increasing prevalence of dry eye in recent years. This disease is chronic and progressive and invariably leads to complications, if left untreated. Objective: To study the prevalence, incidence, and attributable risk factors associated with dry eye syndrome in eastern Madhya Pradesh region. Materials and Methods: This study included 1178 patients of which 114 patients were found to have dry eye. After detailed history, complete work up, and investigations patients were categorized into mild, moderate, and severe grades. Result: In this study, the prevalence of dry eye in hospital-based population in eastern Madhya Pradesh was 9.6%. Dry eye was more common in women (66.6%). Most patients in this study belonged to rural background (60.5%). Air pollution (33.3%) was found to be the most common attributable risk factor affecting most of the farmers/laborers (33.4%). In this study 43.8% patients had moderate and 39.6% patients had mild grade of dry eye. Conclusion: Diagnosis of dry eye is often overlooked as a possible cause of patient's complaint. Therefore, detection of disease at the earliest stage and prevention of attributable risk factors for dry eye alluded to in literature include air pollution, cigarette smoking, low humidity, high temperature, sunlight exposure, drugs, and uncorrected refractive error should be the goal so that disease progression to severe stage and serious sight-threatening complications caused by severe dry eye could be prevented. Thus prevention of attributable risk factors and early diagnosis could be the key for dry eye and offers good hope for better outcome.

Prevalence of and Risk Factors Associated With Dry Eye: The Korea National Health and Nutrition Examination Survey 2010–2011

To investigate the prevalence of and risk factors associated with dry eye syndrome (DES) in South Korea. Cross-sectional study. In 2010 and 2011, 11,666 subjects, ranging in age from 19 to 95, were randomly selected as nationally representative participants in the Korea National Health and Nutrition Examination Survey (KNHANES). Subjects were divided into 2 groups: 1 with clinically diagnosed DES and 1 with symptoms of dry eye. We determined the prevalence of and risk factors for dry eyes in a Korean population. Health-related quality of life (HRQoL), measured by the EuroQoL-5 dimension (EQ-5D), was evaluated in patients with dry eyes. The mean age was 49.9 years. The overall prevalence of diagnosed DES was 8.0% (95% confidence interval [CI], 7.3% to 8.7%), and of dry eye symptoms the prevalence was 14.4% (95% CI, 13.1 to 15.7). Age (adjusted odds ratio [aOR] = 1.8, 1.6), female (aOR = 2.8, 1.9); history of eye surgery (aOR = 2.6, 2.2); stress (aOR = 1.7, 1.6); thyroid disease (aOR = 1.7, 1.5); and high education level (aOR = 1.6, 1.5) were common risk factors in the groups. Subjects who had undergone ptosis, cataract or refractive surgery were more likely to have dry eye than subjects with no history of eye surgery. Means of pain and anxiety dimensions in the EQ-5D and the Euro Quality of Life Visual Analog Scale (EQ-VAS) were significantly higher in the group with diagnosed DES than in the normal group. The risk factors were mostly similar in both groups. It is thought there are more patients with DES who have not been diagnosed by doctors. Doctors should identify whether a patient has any risk factors for dry eye. Patients need to be educated about the modifiable factors of DES.

Ocular surface diseases and corneal refractive surgery.

The purpose of this article is to provide an overview and update on recent literature regarding ocular surface disease and corneal refractive surgery. Studies involving ocular surface disease and/or keratorefractive (corneal) surgery published found on the Medline database were included in the report. Studies focused on mechanisms of refractive surgery induced dry eye disease, surgical options, including modification of technique, to prevent dry eye, and postoperative dry eye prevention and management by way of both established and novel therapies. By understanding the mechanisms of postoperative dry eye as well as patient risk factors for dry eye, patient satisfaction and surgical outcomes can be maximized. Patients identified as having an increased risk for postoperative dry eye may benefit from surgical techniques such as small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (LASIK). Employing well known therapies such as preserved and nonpreserved artificial tears, nutritional supplements, topical cyclosporins, punctal plugs and autologus serum as well as novel therapies such as insulin-like growth factor 1, neuropeptides and acupuncture could provide improve outcomes and, if started early, could allow more patients to be candidates for corneal refractive surgery.

Presence of Dry Eye in Patients with Hashimoto's Thyroiditis.

Purpose. To evaluate the tear function tests in patients with Hashimoto's thyroiditis and to compare the results with healthy subjects. Methods. A hundred and ten patients with Hashimoto's thyroiditis and 100 healthy subjects were included in this study. The presence of thyroid-associated ophthalmopathy and tear function tests were evaluated clinically. The results were first compared between the patients and the control groups and then compared between patients with NOSPECS and patients without NOSPECS. Logistic regression analyses of the risk factors for dry eye including sex, gender, free plasma thyroxine, proptosis, upper eyelid margin-reflex distance, and duration of the disease were also evaluated. Results. The mean ocular surface disease index score was significantly higher and mean Schirmer and mean tear break-up time scores were significantly lower in patients compared to control subjects. Mean Schirmer and tear break-up time scores were found to be significantly lower in patients with NOSPECS when compared to the patients without NOSPECS. Both proptosis and free plasma thyroxine levels were significantly associated with dry eye. Conclusions. Patients with Hashimoto's thyroiditis tend to develop dry eye more common than healthy subjects. Proptosis and lower free plasma thyroxine levels were found to be risk factors for the presence of dry eye.

Dry eye disease in French elderly subjects: the Alienor Study

To describe dry eye disease in French elderly subjects. The Alienor Study is a population-based study on age-related eye disease in 963 residents of Bordeaux (France), aged 73 years or more. Self-reported dry eye disease and use of artificial tears were documented through face-to-face interview. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire and tear film stability by tear break-up time measurements (TBUT). Definite dry eye disease was defined as self-reported dry eye, confirmed by use of artificial tears and/or OSDI greater or equal to 22. Nine hundred and fifteen subjects, with mean age of 80 ± 4 years, returned the OSDI questionnaire. Of these, 271 (29.6%) subjects reported a dry eye disease and 135 (14.7%) were using artificial tears. An OSDI score > 22 was found in 359 (39.2%) subjects and a TBUT < 5 seconds in 335/746 (44.9%) subjects. Overall, definite dry eye affected 21.9% of subjects and was more frequent in women (27.1%) than in men (13.6%). After multivariate adjustment, dry eye disease was also significantly less frequent in subjects with high educational level (odds ratio (OR) = 0.49, 95% confidence interval (CI): 0.31-0.78 for long secondary school) and more frequent in subjects with ocular hypertension (OR = 1.61, 95% CI: 1.02-2.57) and those using anxiolytics (OR = 1.53, 95% CI: 1.02-2.29). This large observational study confirmed the high prevalence of dry eye symptoms among elderly subjects and confirmed some of the previously identified risk factors (in particular female gender and use of anxiolytics).

Risk Factors for Dry Eye After Hematopoietic Stem Cell Transplantation

s / Biol Blood Marrow Transplant 19 (2013) S211eS232 S222 pain (11%) and the most common was fatigue (41%) with the other four symptoms in the 24-26% range. Multivariate logistic regression was used to analyze predictors with a cutoff of >3 symptoms. Participants currently on medication for cGVHD (OR1⁄42.32, P 1⁄4 .003) and females (OR1⁄41.72, P 1⁄4 .04) were more likely to report 3 or more symptoms. There was a reduced likelihood of reporting 3 or more symptoms for every 5 years post-treatment (OR1⁄4.72, P 1⁄4 .008) and for participants with incomes more than $60,000 per year (OR1⁄4.59, P 1⁄4 .04). Discussion: Risk for long-term symptoms after HCT was associated with ongoing cGVHD treatment, being female, as well as shorter time since transplant and lower income. Future research needs to examine how treatment and demographic factors interact as either risk or protective factors for symptom burden and identify strategies to reduce symptoms.

Pharmaceutical and Herbal Products That May Contribute to Dry Eyes

Symptomatic dryness of the eyes is a most common blepharoplasty complication. The authors reviewed the medications and herbal products that may potentiate this complication. The MEDLINE and PubMed databases were searched for the years 1991 to 2011. Search terms included "dry eye syndrome," "keratitis sicca," "keratoconjunctivitis sicca," "ocular side effects," "herbal supplements," "herbals and dry eye," "dry eye risk factors," "etiology of dry eye," "drugs side effects," "drugs and dry eye," "dietary supplements," "ocular toxicity," and "tear film." References from herbal product reviews and eligible medication reports were searched for additional articles. A manual search was also conducted based on citations in the published literature. Of 232 articles found to be related to dry eye syndrome and possible risk factors, 196 were excluded because they did not discuss medications or herbal products as risk factors in dry eye syndrome. Thirty-six articles that examined the pathophysiology and risk factors of dry eye were included. Nine books were reviewed that contained some information regarding the association of medications and herbal products with dry eye. These agents were then categorized based on mechanism of action and usage. Medications listed include antihistamines, decongestants, antidepressants, anticonvulsants, antipsychotics, antiparkinson drugs, beta-blockers, and hormone replacement therapy. The three main herbal products that contribute to dry eye are niacin, echinacea, and kava. There was a strong association between anticholinergic alkaloids and dry eye. This study identifies the medications and herbal products that should be considered when a patient undergoes blepharoplasty and complains of symptoms associated with dryness of the eyes.