VIDEO: Risk factors for developing dry eye

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There's intrinsic risk factors, meaning in our body, and there's extrinsic, means our daily functionality, right? So with women specifically, as we get through that kind of perimenopausal, menopausal age ranges, what could happen is we have a change in the actual composition of some of the hormones that are sex hormones like progesterone and estrogen, et cetera. And that change in the actual relative contributions of those two hormones can change the actual lipid composition of our body, right? So what happens [is] we have decrease in some of the gland production and the oils that our body makes, the length, the fatty acids, the chain of our fats that are produced change, and they come thicker. And so for some patients, meibomian gland dysfunction can be higher risk. We lose, in a more rapid rate, the goblet cells as well, and they can all both contribute to ocular surface disease. And also we find, whether it's women or men, a lot of the extrinsic factors are really a big issue. So we have issues like our telephones that we're using, iPads, like what I'm doing right now, computer screens, right? We're sitting there like spaced out for, you know, five minutes at a time and we're not blinking, right? And studies have shown our blink reflex goes down the more we're focusing, whether reading, watching TV or our computer screen. And because of our computers and our iPads, we are using our phones so much more. We are seeing even meibomian gland drop. If you look at some of the new diagnostics, looking at meibography, we see even in children we see a loss of goblet cells early on because of the activities we do as well.

And then there's other systemic issues that are not related to internal natural intrinsic issues, but also other comorbidities such as rheumatoid arthritis, lupus, autoimmune conditions, and drugs that we take. Antipsychotics, antidepressants, anti-allergy medications, anti-blood pressure pills, right? A lot of these medications can also induce an ocular surface disease or exacerbate ocular surface disease. So whether men or women, you know, I think the women, no doubt, there's a potential with the hormone changes. And men too have been shown as time goes on, because of the hormone composition changing, to have those intrinsic issues. But with the medications that we use, the systemic comorbidities and the extrinsic activities that we do, we're seeing a significant increase in the actual prevalence of ocular surface disease.