Tear deficiency affects 10-15% of adults. The condition most commonly occurs in milder forms in postmenopausal women. Hormone replacement does not help. More severe forms of tear deficiency occur in collagen-vascular problems such as Sjögren’s syndrome and rheumatoid arthritis. Symptoms include burning, dry sensation, irritation, and mild redness. Certain medications can aggravate dry eyes. These include some blood pressure medications, anti-depressants, muscle relaxants, and decongestants/antihistamines. The mainstay of treatment is artificial tears. Non-preserved artificial tears are best for long-term use. Bland ointments may be beneficial. Preservation of moisture in the eyes can be achieved by closing the tear drain system with plugs or cautery. One drop form of medication can help the eyes produce more tears in some patients. Oral medication that produces tears may help some patients.

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