Dry eyes are a common and uncomfortable condition affecting millions of people, especially those over 50. It can lead to symptoms like stinging, redness, and a gritty sensation in the eyes. Many factors contribute to dry eyes, including age, contact lens use, and prolonged screen time. However, an often-overlooked cause of dry eyes is medication. Some prescription and over-the-counter drugs can affect tear production, leading to dry eyes as a side effect.

If you experience symptoms of dry eyes and take any medication regularly, it’s a good idea to consult an eye specialist. They can help determine if your medication may be contributing to your symptoms and recommend appropriate treatment.

Let’s explore five common types of medications that are known to cause dry eyes.

1. Antihistamines
Antihistamines are widely used to treat allergy symptoms such as sneezing, a runny nose, and itchy eyes. They work by blocking histamines, which are chemicals released by the body during an allergic reaction. While these medications can be effective at relieving allergy symptoms, they can also reduce the moisture in your eyes.

Antihistamines often decrease tear production and disrupt the tear film that keeps the eyes lubricated. As a result, people taking antihistamines may notice that their eyes feel dry and irritated. If you have dry, itchy eyes, it may be difficult to tell whether it’s due to your allergies or the medication itself. In this case, visiting an eye doctor can help clarify the cause and determine the best course of action.

2. Acne medications
Medications used to treat acne, particularly those containing retinoic acid, can also contribute to dry eyes. Acne medications often work by reducing the production of oils in the skin. This reduction in oil production can affect the eyes as well, since the tear film is made up of three layers: water, oil, and mucus. The oil layer helps prevent the tears from evaporating too quickly. When the oil production is reduced, the tear film becomes unstable, leading to dry eye symptoms.

If you are taking acne medication and notice increased dryness in your eyes, let your dermatologist and eye doctor know. They might adjust your treatment plan or recommend eye drops to help maintain moisture.

3. Beta-blockers
Beta-blockers are a class of medications commonly prescribed for heart conditions such as high blood pressure, heart failure, and abnormal heart rhythms . They work by blocking the effects of adrenaline, which helps reduce heart rate and lower blood pressure. While beta-blockers are effective in managing these health issues, they can also interfere with the body's fluid balance, including tear production.

These medications can reduce the production of certain components in tears, making them less effective at keeping the eyes lubricated. If you are on beta-blockers and notice dry eye symptoms, do not stop taking the medication without consulting your doctor. Instead, discuss your symptoms with both your primary care provider and an eye specialist. They may be able to adjust your medication or suggest additional treatment for dry eyes.

4. Diuretics
Diuretics, also known as water pills, are another common medication used to manage high blood pressure. They work by helping the body eliminate excess salt and water through increased urine production. While diuretics are effective at reducing fluid buildup in the body and lowering blood pressure, they can also reduce the amount of fluid available for tear production.

The decrease in body fluids caused by diuretics can lead to dehydration, which in turn can cause dry eyes. If you are taking diuretics and experiencing symptoms like dryness, irritation, or a gritty feeling in your eyes, it may be a sign that the medication is affecting your tear production. Talk to your doctor about your symptoms. They may recommend increasing your fluid intake or using artificial tears to help relieve the dryness.

5. Medications for gastrointestinal issues
Certain medications used to treat gastrointestinal conditions, such as proton pump inhibitors (PPIs) and H2 blockers, can also contribute to dry eyes. PPIs work by reducing the production of stomach acid, while H2 blockers inhibit histamine, which plays a role in acid production. Both of these types of medications can interfere with tear production, although the exact mechanism is not fully understood.

H2 blockers, for example, can affect the production of mucus, which is an important component of the tear film. When mucus production decreases, the tear film becomes less stable, leading to dry eyes. PPIs may also influence tear production by altering the body’s natural fluid balance.

If you are taking medications for acid reflux or other gastrointestinal issues and notice dry eye symptoms, discuss this with your healthcare provider. They may adjust your dosage or recommend using lubricating eye drops to alleviate the dryness.