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Dry Eye and Menopause: What’s the Link?

During menopause, have you noticed that you’re struggling more with your vision or experiencing a lot of discomfort around your eyes? Don’t worry, you’re not the only one. In fact, there’s a link between menopause and Dry Eye disease.

Some studies suggest that around 61% of perimenopausal and menopausal women are affected by Dry Eye syndrome [1] , while a survey of 6,000 women revealed that one in four women said they experienced dry eyes, making it the second most common hidden menopause symptom. [2]

 

Woman with dry eye drinking water

What is Dry Eye?

Dry Eye syndrome is an extremely common eye condition affecting one in four people in the UK. [3] When your tears aren’t able to provide adequate lubrication for your eyes, you may notice inflammation in the eye which is related to a wide range of symptoms. You may experience red eyes, itching, a burning sensation, sensitivity to light, and even fatigue. Symptoms are wide-ranging, so if you’re experiencing discomfort and irritation in your eyes, it may be Dry Eye. [4]

 

Why Dry Eye?

There are several reasons you might start to show symptoms of Dry Eye disease. From smoking to aging, there are a lot of factors to consider but one you may not have thought about is your hormone levels.

During menopause your androgen hormones (which include testosterone) decrease. This hormone change affects the meibomian and lacrimal glands in the eyelids that provide the essential oils for tears. Tears moisten the eyes so you will see increased tear evaporation and drier eyes as a result.

Recent research shows that testosterone helps to manage the balance of tear production which you need to lubricate your eye. Without enough tear film, you may end up feeling an itchy, gritty, or stinging sensation – otherwise known as Dry Eye.

There is also some evidence that estrogen levels changing during this phase can also lead to Dry Eye disease. More research needs to be done to solidify this link but it would explain the increase in Dry Eye symptoms at different points of a woman’s monthly fertility cycle. [5]

One thing that’s clear, however, is that dry eyes can be a result of a sex hormone deficiency, meaning it’s a common side effect of menopause, when your hormone levels will drop.

 

couple laughing together

Is Dry Eye Disease a Common Menopause Symptom?

That gritty feeling in your eyes might make you feel like you’re all alone but don’t worry. Many people deal with Dry Eye disease every day and during menopause, it’s a very common symptom.

Menopausal symptoms vary depending on the person and their age, so you could end up facing very different symptoms and experiences from your friends. However, if you are noticing redder eyes, blurred vision, and excessive tearing then you might be dealing with hormonally-induced Dry Eye disease.

 

How do Hormones Play a Role?

During perimenopause and menopause, there’s a variety of changes in hormones that can be related to dry eye symptoms. We see a decrease in both estrogen and testosterone. Sex hormones are incredibly important to keep the ocular surface of the eye stable, which means they’ll affect producing tears, evaporating tears, draining tears, maintaining nerves behind the cornea, and maintaining the immune system of the eye. When it comes to Dry Eye the ability to keep the eyes moist (usually by tears) plays a large role. When the eyelid becomes dry and irritated , it causes pain, a burning sensation, and red eyes. [6]

During perimenopause, your sex hormone levels begin to drop and eventually, you’ll find you no longer have periods (the process we call the menopause).

After this your body entirely stops making progesterone and the production of estrogen and androgens decreases at a quicker rate, which is why we see the onset of these symptoms around this period of a woman’s life. [7]

 

Higher Risk Factors

One thing of note is that women who experience premature or early menopause (when the final menstrual period happens before the age of forty) are more at risk for androgen deficiency. [8]

Additionally, it may be worth considering the increased risk factor if you’ve been on estrogen tablets or the pill, have had surgical removal of the ovaries, or have suffered from an eating disorder that’s placed stress on the body. You can get tested for this deficiency, however, due to the levels naturally being so low in women, it’s difficult to do so.

If you’re looking into testing your levels to work out the cause of your Dry Eye disease then make sure you get your blood taken in the morning when testosterone levels are at their highest.

 

Hormone Replacement Therapy and Dry Eye Disease

Most doctors would recommend hormone replacement therapy (HRT) for alleviating particularly troublesome symptoms of menopause. Traditionally HRT replaces estrogen and progesterone which will fall during this period of a woman’s life. [9] However, HRT usually treats hot flashes, mood swings, and sleep issues rather than Dry Eye disease. You may be considering this treatment to soothe your dry eyes but unfortunately, research hasn’t yet proven the benefits of it.

While some studies show a small amount of improvement in the alleviation of symptoms, the largest cross-sectional study to date found that long-term use of HRT increases the risk of Dry Eye symptoms. Essentially the longer women stayed on hormone replacement therapy the worse and more frequent their Dry Eye symptoms became. [10]

So even if you were only experiencing mild Dry Eye symptoms during perimenopause, you may find that once you start treatment, you experience the onset of Dry Eye disease.

 

Woman rubbing her eyes

Treating Dry Eye During Menopause

With the effects of HRT in mind, it’s important to consider how your treatments of Dry Eye symptoms will impact your treatment of other menopausal symptoms, and visa versa. HRT can help alleviate some menopausal symptoms but research shows that the treatment can make Dry Eye Disease worse.

However, many usual recommendations for Dry Eye are lifestyle suggestions that may boost your overall health. Eating well, drinking enough water, and getting enough sleep can all help battle that dry, itchy feeling while decreasing screen time can boost your mood as well!

If you’re usually a fan of contact lenses, make sure you’re also grabbing those glasses every now and then to give your eyes a break. Hydrating eye drops in the mornings and evening can help soothe your eyes, and make sure you’re limiting stress where you can. [11]

If your dry eyes are chronic or causing large problems in your life the VISUshop site has a wide range of products for treatment and prevention you can check out here .

 

For more information on Dry Eye and Menopause, take a look at our other blogs on the subject, and what you can do to alleviate your dry, itchy eyes.

 

References

  1. ‘What’s the Link between Dry Eye and Menopause?’ Dryeyecare.net, 08/04/21, Last Accessed January 2024
  2. ‘Dry Eyes and Menopause Demystified’, Balance by Newson Health, 24/06/23, Last Accessed January 2024
  3. ‘Dry Eye Syndrome’, Association of Optometrists, Last Accessed January 2024
  4. ‘Dry Eye Symptoms’, Dry Eye and Me, Last Accessed January 2024
  5. Lazarus, Russel, ‘Dry Eye and Menopause’, Optometrists.org, 09/09/2020, Last Accessed January 2024
  6. Millar, Helen, ‘Dry Eyes and Menopause: What to Know’, Medical News Today, 18/09/23, Last Accessed January 2024
  7. ‘The Link Between Menopause and Dry Eye’, Slingsby & Huot Eye Associates, Last Accessed January 2024
  8. ‘Androgen Deficiency in Women’, Better Health Channel, Last Accessed January 2024
  9. ‘About Hormone Replacement Therapy (HRT)’, NHS, Accessed January 2024
  10. Osborn, Corrinne, ‘Menopause and Dry Eyes: What’s the Link?’, Healthline, Last Accessed January 2024
  11. ‘Dry Eyes: The Unexpected Symptom of Perimenopause and Menopause’, The Latte Lounge, 26/09/22, Last Accessed January 2024
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Menopause & Dry Eye: 5 Things You Need to Know

Women over the age of 50 are at a greater risk of experiencing Dry Eye Syndrome.[1] In fact, around 61% of perimenopausal and menopausal women are affected by Dry Eye Syndrome.[2] In this blog, we’ll be sharing everything you need to know about menopause and Dry Eye.

What are the symptoms of Dry Eye Syndrome?


Dry Eye Syndrome is a chronic condition that can have many different causes.[3] It can be moderate to severe, and can flare up due to environmental conditions and lifestyle.[4]

Dry Eye symptoms include:

  • Itchy eyes
  • Sore eyes
  • Gritty eyes
  • Red eyes
  • Blurry vision
  • Sensitive to light
  • Eyes more watery than normal
  • Tears drying up (tear evaporation)
  • Decreased tear production. [5]

 

Woman with dry eye relaxing

 

Can menopause affect your Dry Eye?

Yes! Research published in the National Library of Medicine shows that there is a link between menopause and dry eyes due to women’s decreasing hormones. This can cause itchy, sore and dry eyes.[6]

 

Why are women over 50 more likely to suffer from chronic Dry Eye?

Menopause is when your periods stop because of the decrease in hormone levels, which usually happens between the ages of 45 and 55. Perimenopause is when you have symptoms before your periods stop. 

Menopause can cause symptoms such as:

  • Mood swings
  • Brain fog
  • Hot flushes [7]

Perimenopausal, Menopausal and Postmenopausal women are particularly prone to dry eyes, because sex hormones such as androgens affect tear production. Androgens are present in all genders, but females present lower levels, which then decrease after menopause.[6] This affects the balance of tear production, causing dry eyes.

 

Two women with dry eye on a sofa smiling

 

What does menopause do to your eyes?

Menopause and eye problems can often go hand in hand. Menopause can alter your eyesight and even the shape of your eyes! 


Dry Eye Disease is also more common after menopause, as well as cataracts. There is also a risk of glaucoma, which can come with age. [8]

 

Woman with dry eye smiling

 

Are dry eyes part of perimenopause?

If you have dry eyes and perimenopause, you’re not alone! Dry eyes can be linked to perimenopause, due to changing hormonal balances. Often unspoken of, Laurie G. Barber, Doctor of Medicine, said that perimenopause and Dry Eye should have more awareness and attention. [9]

 

Does low oestrogen cause Dry Eye?

When women go through menopause, the body makes less oestrogen, progesterone and androgen. This can in turn cause Dry Eye Disease. [1]

Your doctor might recommend hormone therapy to restore your oestrogen levels. However, one large study found that long-term hormonal replacement therapy (HRT) can put you more at risk of Dry Eye and make symptoms worse. [10]

 

Woman with dry eye on laptop

 

What other things can make Dry Eye worse?

Dry Eye Syndrome can have many different causes. When they overlap with each other, patients can experience painful flare-ups. Here are some of the factors other than menopause that can trigger Dry Eye symptoms: 

 

Dry Eyes at night

Night time Dry Eye affects many people, as your body’s metabolism slows at night, so fewer tears are produced. [11]

For people that already suffer from chronic dry eyes, this can result in irritating symptoms during the night because they already deal with problems to do with the quality and quantity of tear production.

 

Computer Vision Syndrome 

Staring at screens reduces our blink rate, causing our eyes to dry out.[12] Chronically dry, itchy eyes are one of the key symptoms of Computer Vision Syndrome, which between 50-90% of people who work at a computer screen can suffer from. [13]

 

Does Dry Eye Disease improve after menopause?

Dry Eye symptoms can be improved through different changes and choices we make. Here are our top tips for dealing with dry eyes during menopause:

 

Woman with dry eye drinking water

 

1. Eat well and stay hydrated

Drink lots of fluids to properly hydrate your body and eat a diet rich in omega-3 fatty acids and Vitamin A to encourage healthy tear production and prevent Dry Eye.[14] Experts suggest that you should drink between 8 and 10 glasses of water a day, if you have Dry Eye Disease.[15] Discover more about what vitamins are best for Dry Eye here: 6 Vitamins to Boost Eye Health

 

Humidifier for dry eyes

 

2. Use a humidifier to prevent dry eyes.

Humidifiers add moisture to the air, which can help people who suffer from Dry Eyes.[16] These can often be bought at a low cost, making them an easy solution to bring into your home or office space. For more information on lifestyle changes that you can make, visit our blog: 6 Lifestyle Tips to Help Dry Eye

 

Woman with dry eye rejects drink

 

3. Cut down on smoking and drinking.

Do not smoke or drink too much alcohol as this can profoundly affect your Dry Eye symptoms. This is because smoking can change the composition of your tears over time and alcohol dehydrates your eyes.[17][18]

Our blog about alcohol and Dry Eye is a great resource: Is Drinking Alcohol Bad For Your Eyes?

You can also read more about the effects of smoking on Dry Eye here: Smoking and Dry Eye

 

Woman with dry eye on phone

 

4. Take regular breaks from staring at screens

Taking regular breaks to rest your eyes from digital screens can prevent Computer Vision Syndrome. One technique that can help is the 20/20/20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.[19] To find out more about Computer Vision Syndrome, read our blog: What is Computer Vision Syndrome?

 

Woman using eye drops for dry eyes

 

5. Follow a three-step treatment plan

A three-step treatment plan is a great way to effectively manage your Dry Eye.

 

Step 1: If you are suffering from Evaporative Dry Eye, or Meibomian Gland Disorder, use a heated compress, such as Meibopatch®, to unblock your meibomian glands and relieve your eyes.[20]

 

Step 2: Cleanse and wipe away the melted oil blocking your glands, as well as any built-up debris with a cleanser like Naviblef ®, which is specially designed to reduce discomfort.[21]

 

Step 3: Incorporate an effective lubricant such as any drop from the VISUFamily range. Depending on your condition, you can choose an eye drop that will help ease your symptoms.

 

Best eye drops for menopause and Dry Eye

Don’t let Dry Eye and menopause hold you back! Eye drops are a great solution for fast and effective Dry Eye relief. Drops, tears, gels and ointments should all be considered to help.

 

We offer a range of eye care solutions including our VisuEvo® eye drops. These drops include vitamins such as Vitamin A, which can help to reduce the effects of Dry Eye. You can browse these drops here: VisuEvo® Eye Drops

In most cases, the best way to treat dry eyes, Also known as dry eye syndrome, is to use eye gel or eye drops.

VisuXL Gel® is a preservative-free smart gel lubricant for dry eye syndrome. It provides comfort in a bottle with it’s long-lasting lubrication properties giving 12-hour dosing with just one drop and is suitable for both day and night use.

VisuXL® is a preservative-free eye drop lubricant for dry eye syndrome. Due to its unique ingredients, VisuXL® will help you recover from eye surgery, an injury or persistent damaging dry eye.

VisuEvo® is a preservative-free eye drop that prevents excessive evaporation of the tear film. Its unique formula contains omega-3 essential fatty acids, Vitamins A and D and ultra-filtered phospholipids that facilitate tear film presentation and control evaporation.

All three products are contact lens-friendly and can be used for 180 days after opening.

Shop now

References

  1. Wilson, Debra Rose, ‘Menopause and Dry Eyes: What’s the link?’, Healthline, 01/04/2020. Accessed April 2022.
  2. Dry Eye Center of NY & NJ, ‘What’s the Link Between Dry Eye and Menopause?’, 08/04/21. Accessed January 2023.
  3. Mayo Clinic, ‘Dry Eyes. Accessed April 2022.
  4. Monica Alves, Priscila Novaes, Monica de Andrade Morraye, Peter Sol Reinach, Eduardo Melani Rocha, ‘Is Dry Eye an Environmental Disease?’, Arq Bras Oftalmol, May-Jun 2014;77(3):193-200. Accessed April 2022.
  5. NHS, ‘Dry eyes’. Accessed April 2022.
  6. Peck, Travis, Olsakovsky, Leslie, Aggarwal Shruti, ‘Dry Eye Syndrome in Menopause and Perimenopausal Age Group’, J Midlife Health, 2017 Apr-Jun; 8(2): 51–54. Accessed April 2022.
  7. NHS, ‘Menopause’. Accessed January 2023.
  8. The North American Menopause Society, ‘Menopause and Eye Health’. Accessed January 2023.
  9. Altersitz, Katrina. ‘Premenopausal women need extra dry eye care’, Ocular Surgery News, Healio, 15/12/06. Accessed January 2023.
  10. AlAwlaqi, A. MBBS, MSc; Hammadeh, M. PhD. ‘Examining the relationship between hormone therapy and dry-eye syndrome in postmenopausal women: a cross-sectional comparison study’, Menopause, 23(5):550-555, 05/16. Accessed February 2022.
  11. Lazarus, Russell. ‘Burning Eyes at Night’, Optometrists Network, 06/02/21. Accessed April 2022.
  12. Wheeler, Regina Boyle. ‘Dry Eye and Screen Use’, WebMD, 21/06/21. Accessed April 2022.
  13. Watson, Stephanie, ‘What is Computer Vision Syndrome?’, WebMD, 29/11/21. Accessed April 2022.
  14. BergFeinfield Vision Correction, ‘6 Foods to Eat to Help Dry Eye’, 27/02/20. Accessed April 2022.
  15. Complete Eye Care, ‘How Does Hydration Affect My Eyes?’. Accessed January 2023.
  16. Wang, M. Chan, E. Ea, L. ‘Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users’, Optometry and Vision Science: November 2017 – Volume 94 – Issue 11 – p 1052-1057. Accessed April 2022.
  17. Griffin, Morgan. ‘Smoking and Dry Eye’, WebMD, 05/05/21. Accessed April 2022.
  18. You, Young-Sheng, Qu, Nai-Bin, Yu, Xiao-Ning, ‘Alcohol consumption and dry eye syndrome: a Meta-analysis’, International Journey of Opthamology, 2016; 9(10): 1487–1492. Accessed December 2021.
  19. Marcin, Ashley. ‘How Does the 20-20-20 Rule Prevent Eye Strain?’, Healthline, 03/02/17. Accessed April 2022.
  20. Meibopatch® Instructions for Use (IFU). Accessed April 2022.
  21. Naviblef ® Instructions for Use (IFU). Accessed April 2022.

 

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What causes Dry Eye?

Dry Eye Syndrome is a chronic condition, with varying degrees of severity. It can have multiple causes which can overlap with each other. (1) Many people get dry eyes. It’s not usually serious and there are some things you can do to help. Knowing the route because of your condition is key to understanding how to manage it. [1]

Dry Eye can also co-exist, or be caused by other related conditions such as Meibomian Gland Disorder (MGD) and Blepharitis.

What is the cause of dry eyes ?

There are many different factors that can cause dry eyes. However, ultimately dry eyes occur because you do not make enough tears in your eyes, or your tears dry up quickly. [2]

What are the symptoms of dry eyes?

When you have dry eyes, it might feel like you’ve got something in your eye that won’t come out. This can feel like a scratchy, gritty or sandy sensation. Your symptoms might also include:

  • Feeling sensitive to light
  • Blurred or changed vision
  • Mucus coming out of your eyes
  • Watery eyes [2]

Watery, red eye close-up

What else causes dry eyes?

There are some very common causes or triggers of Dry Eye that affect lots of people, and some less common causes, like pre-existing conditions and specific medication that can cause irritating symptoms for a minority of people.

1. Age/ Menopause

One of the most common causes of Dry Eye Syndrome is age, especially if you are a woman. Dry Eye affects approximately 5-30% of the elderly population, with menopause increasing the likelihood of developing symptoms.[3]

As we age, our cells experience more oxidative stress, and the lacrimal gland that produces our tears deteriorates the older we get.[3] In Menopause especially, decreased production of androgens (sex hormones) in women further affects tear production.[4] [5]

For more information about Dry Eye and Menopause read our blog: 5 Things You Need to Know About Menopause and Dry Eye.

2. Lifestyle

Lifestyle, diet, and environment can really trigger Dry Eye Disease. Dry eyes can be caused by things like heating and air conditioning systems, as well as the outdoor environment e.g. windy, cold, dry or dusty weather conditions.[6]
Smoking and drinking alcohol can also cause Dry Eye, or can make existing symptoms much worse.[7]

On the other hand, eating certain foods, living a generally healthy lifestyle, and reducing screen time can help reduce symptoms.[8]

To understand more about what foods you can eat to help relieve Dry Eye, read our blog: 8 Foods to Eat if you Have Dry Eye

3. Medication

Certain medications can cause Dry Eye, or make it worse. These include:

  • Acne medication
  • Antidepressants
  • Parkison’s medications
  • Sleeping Pills
  • Antihistamines
  • Birth Control and other hormone treatment
  • Blood pressure medication.[9]

4. Screen Use

When we stare at computers, mobiles, or any other digital screens, our blink rate slows, drying out our eyes. [10]

This is called Computer Vision Syndrome (CVS) and affects people of all ages.[11] It can, combined with other Dry Eye triggers, make existing conditions much worse. Top tips to prevent CVS include reducing screen time and following the 20:20:20 rule.[11] [12]

We’ve written a blog about Computer Vision Syndrome, read it here to learn more: What is Computer Vision Syndrome?

Woman rubbing her eyes

5. Pre-Existing Conditions

Dry Eye can also be a symptom of other, pre-existing conditions, like:

  • Sjogren’s Syndrome
  • Diabetes
  • Rheumatoid Arthritis
  • Hypothyroidism
  • Lagophthalmos.[13]

Understand more about how different conditions can affect dry eyes in our blog: 6 Conditions That Cause Dry Eye

6. Contact Lenses

Contact lenses can aggravate Dry Eye because the presence of the lens on the cornea limits oxygen flow into the eye, and oxygen is necessary to develop natural tears.[14]

However, there are some top tips to manage wearing contacts if your eyes feel itchy and dry. Read our blog to explore what they are: How to Manage Dry Eye if you Wear Contact Lenses.

7. The Environment

Many people may notice that the change in seasons, the weather or new surroundings can worsen Dry Eye symptoms. Changes to the air temperature, humidity and air quality happen with the changing seasons. Therefore, it’s natural that in certain seasons, your eyes might feel dryer.

Spring can bring about seasonal allergies such as hay fever, when allergens in the air are more prominent. Whereas cold weather can also irritate dry eyes due to the cold air outside and central heating indoors. [15]

We’ve written a blog on this that dives into dry eyes and the environment in more detail. Read it here: Can the Environment Cause Dry Eyes?

Woman blowing her nose in a field with yellow flowers

8. Surgeries

Some underlying eye conditions, such as cataracts may require surgery in some cases. While this is great for treating these conditions, some eye surgeries can increase your risk of dry eyes. [2] Fortunately, these symptoms are usually only temporary as Dry Eyes almost always improves within a few months, once the eye fully heals. [16]

To understand more about dry eyes after eye surgery, read our blog: Why do I Have Dry Eyes After Cataract Surgery?

Can dry eyes be cured?

Unfortunately, Dry Eye is a condition which does not have a cure, but many treatments can help to manage your symptoms. We’d always recommend trying several different treatments to find what works best for you. [2]

We’ll discuss some of these treatments below.

Treatment of dry eyes

Eye drops and gels are the most common form of medical treatment for Dry Eye. They work by lubricating the eyes to relieve symptoms to ease itchiness. You can also buy different types of eye drops which may suit different people and their conditions. Discover what these are in our blog: Find Out Which Dry Eye Treatment is Best For Your Condition.

There are also many lifestyle changes, supplements and vitamins that you could try to help prevent symptoms. For example, quitting smoking and increasing your vitamins can be a great place to start if you’re suffering with dry eyes. [7] [17]

Person putting eye drops in (close-up)

What’s the best eye gel for dry eyes?

Eye gel aims to lock in moisture and help to soothe the itching and redness associated with dry eyes. It comes in many forms such as tubes or drops, like our popular VisuXL Gel. Our VisuXL Gel can be used for day and night use, making it a good choice for people looking for a reliable eye gel treatment. It contains cross-linked sodium carboxymethylcellulose which is a safe, effective and long lasting lubricant. [18]

If you think you are suffering visit a GP, or explore this guide to which Dry Eye Treatment might be best for you: Find Out Which Dry Eye Treatment is Best For Your Condition.

 

In most cases, the best way to treat dry eyes, Also known as dry eye syndrome, is to use eye gel or eye drops.

VisuXL Gel® is a preservative-free smart gel lubricant for dry eye syndrome. It provides comfort in a bottle with it’s long-lasting lubrication properties giving 12-hour dosing with just one drop and is suitable for both day and night use.

VisuXL® is a preservative-free eye drop lubricant for dry eye syndrome. Due to its unique ingredients, VisuXL® will help you recover from eye surgery, an injury or persistent damaging dry eye.

VisuEvo® is a preservative-free eye drop that prevents excessive evaporation of the tear film. Its unique formula contains omega-3 essential fatty acids, Vitamins A and D and ultra-filtered phospholipids that facilitate tear film presentation and control evaporation.

All three products are contact lens-friendly and can be used for 180 days after opening.

Shop now

References

  1. NHS UK, ‘Dry Eyes’, NHS. Accessed June 2023.
  2. Cleveland Clinic, ‘DryEye’, Cleveland Clinic. Accessed June 2023.
  3. Anushree Sharma, Holly B. Hindman, ‘Aging: A Predisposition to Dry Eyes’. J Ophthalmol, 2014; 2014: 781683.
  4. Cintia S. de Paiva, ‘Effects of Aging in Dry Eye’, Int Ophthalmol Clin. 2017 Spring; 57(2): 47–64.
  5. Corinne O’Keefe Osborn, ‘Menopause and Dry Eyes: What’s the Link?’. Accessed February 2022.
  6. Monica Alves, Priscila Novaes, Monica de Andrade Morraye, Peter Sol Reinach, Eduardo Melani Rocha, ‘Is Dry Eye an Environmental Disease?’. Arq Bras Oftalmol, May-Jun 2014;77(3):193-200..
  7. Griffin, Morgan. ‘Smoking and Dry Eye’. Accessed February 2022.
  8. Dry Eye and Me, ‘6 Lifestyle Tips to Get Rid of Dry Eye’. Accessed February 2022.
  9. ‘Is Your Medication Causing Dry Eye?’, WedMD. Accessed June 2023.
  10. Wheeler, Regina Boyle. ‘Dry Eye and Screen Use’, WebMD, 21/06/21. Accessed October 2021.
  11. Stephanie Watson, ‘Computer Vision Syndrome’, WebMD. Accessed February 2022.
  12. Marcin, Ashley , ‘How Does the 20-20-20 Rule Prevent Eye Strain?’ Healthline. Accessed June 2023.
  13. ‘Causes’, Not a Dry Eye Foundation. Accessed February 2022.
  14. Specsavers, ‘Your Guide to Wearing Contact Lenses for Dry Eyes’. Accessed September 2021.
  15. Compete Eye Care of Medina, ‘Which Season Has The Greatest Impact on Dry Eyes?’. Accessed June 2023.
  16. Cathy Lovering, ‘Dry Eye Surgery: Are You a Candidate?’, Healthline. Accessed June 2023.
  17. Laurie Capogna, ‘The Best Supplements for Dry Eye’, My Eye Wellness. Accessed June 2023.
  18. VisuXL Instructions for Use (IFU). Accessed June 2023.
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