Can Medications Cause Dry Eye?

Yes. Some prescription and over the counter medications can contribute to dry eye by reducing tear production, changing meibomian gland secretions, altering blinking or affecting the nerves and tissues that regulate the ocular surface.

Medication related dry eye is often only one part of the problem. Age, hormonal changes, eyelid disease, contact lens wear, systemic health and environmental exposure may contribute at the same time.

Which Medications May Contribute to Dry Eye?

Medication effects vary among patients, but potential contributors include certain:

• Antihistamines
• Decongestants
• Antidepressants
• Anti-anxiety and sedating medications
• Blood pressure medications
• Diuretics
• Medications with anticholinergic effects
• Acne medications containing retinoids
• Hormonal therapies
• Parkinson’s disease medications
• Medications that affect nerve function or blinking

This list is not exhaustive, and the presence of a medication on the list does not mean it is definitely causing a particular patient’s symptoms. Do not stop any currently prescribed medications without consulting with the prescribing doctor.

How Can a Medication Affect the Tear Film?

Medications can contribute through several mechanisms.

Reduced Tear Production

Some medications reduce secretion from the lacrimal glands or other moisture-producing tissues.

Changes in Meibomian Gland Function

Certain medications may affect the production, composition or flow of meibomian gland oils. This can increase tear evaporation.

Reduced Blinking

Sedating medications and medicines affecting muscle or nerve function may reduce blink frequency or completeness.

Changes in Corneal Sensation

Normal corneal sensation helps regulate tear production and blinking. Medications that affect sensory signaling may interfere with this feedback system.

Ocular Surface Irritation

Some medications can alter epithelial health or promote inflammation, making the ocular surface less able to retain a stable tear film.

Can Medicated Eye Drops Cause Dry Eye?

Yes. Topical medications can affect the ocular surface through their active ingredients, preservatives or dosing frequency.

Patients using long term glaucoma drops or several different eye medications may be particularly susceptible to preservative exposure. Symptoms may include burning immediately after application, chronic redness, irritation or increasing sensitivity to drops.

Preservative free alternatives may be appropriate in some situations, but changes should be made with the prescribing eye doctor.

How Soon Can Medication Related Dry Eye Begin?

The timing varies. Symptoms may begin soon after starting a medication, develop following a dosage change or appear gradually after prolonged use.

A medication may also reveal a previously compensated tear film problem. For example, someone with mild meibomian gland dysfunction may become symptomatic after beginning a medication that reduces tear production.

A clear timeline of medication changes and symptom onset can help identify possible relationships.

Should I Stop a Medication That May Be Causing Dry Eye?

Do not stop, reduce or replace a prescribed medication without consulting the clinician who prescribed it.

The medical benefit of a medication may be more important than its ocular side effects. In many cases, the dry eye can be treated while the medication continues. In other situations, the prescribing clinician may identify an appropriate alternative.

Bring a complete list of prescription medications, over the counter products, supplements and eye drops to your dry eye evaluation.

How Is Medication-Related Dry Eye Evaluated?

The evaluation may include:

• Review of medications and recent dosage changes
• Meibography
• Noninvasive tear breakup time
• Tear osmolarity
• Fluorescein staining
• Assessment of tear production and volume
• Examination of eyelid margins and gland secretions
• High resolution video for evaluation of blink frequency and completeness

The purpose is to determine whether the primary problem involves aqueous deficiency, evaporation, inflammation, exposure or a combination of mechanisms.

How Is It Treated?

Treatment depends on the findings and may include:

• Adjusting tear supplementation
• Reducing preservative exposure when medically appropriate
• Treating meibomian gland dysfunction
• Managing eyelid or ocular-surface inflammation
• Conserving or stimulating natural tears
• Protecting the ocular surface
• Coordinating possible medication changes with the prescribing clinician

​​​​​​​Medication review is an important part of the evaluation, but it should not replace objective testing of the tear film and ocular surface.

Schedule a Comprehensive Dry-Eye Evaluation

If your symptoms began after starting a medication, or remain uncontrolled while using several medications, a comprehensive evaluation can help identify the mechanisms involved.

At EnVision Dry Eye Center, Dr. Jason Besecker reviews medication history alongside advanced diagnostic testing to develop an individualized treatment plan.

EnVision Dry Eye Center
3752 E Amity Avenue, Suite 103
Nampa, Idaho 83687
(208) 490-8823

Request a Comprehensive Dry-Eye Evaluation

Medically reviewed by Jason Besecker, OD, MS
Last updated: October 2026

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​​​​​​​Clinical References

• TFOS DEWS III: Executive Summary (2025)
• TFOS DEWS II: Iatrogenic Report (2017)
• TFOS DEWS III: Management and Therapy (2025)