It may seem like a minor annoyance to someone who doesn’t experience this symptom. But just ask anyone who suffers from dry eyes what it feels like and you will hear some serious woe and misery.

Imagine sandpaper under your eyelids. If you have ever gotten a foreign object in your eye you know how distressing that can feel until you get it out. Now consider what it would be like if you could not remove it and instead had a constant gritty, burning, scratching or stinging sensation that never goes away.

This incredibly unpleasant condition can be caused by a number of things. Dry eyes can be triggered by reduced tear production or increased evaporation from the surface of the eye. In some people the immune system attacks the tear glands just as it destroys other body tissue. This can lead to dry eyes in rheumatoid arthritis, lupus and Sjogren’s syndrome. Conditions that reduce the cornea’s sensitivity reduce blinking and tear production, too. That is why diabetes, herpes eye infection and laser eye surgery (LASIK) may sometimes result in dry eyes. In certain cases, this reaction may be severe and can last for months or even years. This has a serious impact on quality of life and explains why some people may be dissatisfied with the outcome of their LASIK surgery.

Drugs can also contribute to dry eyes

Physicians and pharmacists rarely mention dry eyes as a drug side effect. That may be because it doesn’t seem like such a big deal, especially compared to serious side effects like liver or kidney damage, heart attack or stroke. But just ask someone with dry eyes how it affects their quality of life and you will quickly learn that this is not a minor complication. And treating drug-induced dry eyes with eye drops might be a little like trying to slake your thirst in the middle of the desert with an eye dropper of water. Such a drip-by-drip solution is unlikely to alleviate the problem.

There are various ways that medications contribute to dry eye syndrome. A surprising number of drugs have what is referred to as anticholinergic activity. That means they affect the way the neurochemical acetylcholine interacts with receptors in the body. Such drugs can cause both a dry mouth and dry eyes by interfering with glands in these organs. A surprisingly large number of drugs have the potential to trigger this complication. A review article in the Journal of Ophthalmology (online, Aug. 27, 2012) lists many such drugs and discusses this topic in detail. They point out that the more medications a person is taking, the greater the likelihood that a combination could contribute to dry eyes.


  • Atenolol
  • Atropine
  • Brompheniramine
  • Carvedilol
  • Cetirizine
  • Cetuximab
  • Chlorothiazide
  • Chlorpheniramine
  • Chlorpromazine
  • Citalopram
  • Clemastine
  • Clonidine
  • Cyclophosphamide
  • Cyproheptadine
  • Desloratadine
  • Diphenhydramine
  • Doxazosin
  • Doxylamine
  • Eye drop preservative (benzalkonium chloride)
  • Fesoterodine
  • Fexofenadine
  • Fluoxetine
  • Fluphenazine
  • Fluvoxamine
  • Furosemide
  • Homatropine
  • Hydrochlorothiazide
  • Hyoscine
  • Ibuprofen
  • Indapamide
  • Interferon
  • Ipratropium
  • Isotretinoin
  • Labetalol
  • Lithium
  • Loratadine
  • Metoprolol
  • Nadolol
  • Naphazoline
  • Oxprenolol
  • Oxybutynin
  • Paroxetine
  • Pindolol
  • Prazosin
  • Primidone
  • Prochlorperazine
  • Propranolol
  • Quetiapine
  • Sertraline
  • Tamsulosin
  • Terazosin
  • Thioridazine
  • Timolol (topical)
  • Tolterodine
  • Tripelennamine
  • Tropicamide
  • Vinblastine

We NEVER suggest that a patient stop taking a medication without first checking with the prescriber. Some of these medications are essential for good health. But if someone is suffering from drug-induced dry eyes (or dry mouth), it is absolutely essential that this information be communicated to a physician to see if an alternative medication might not be appropriate that would not cause this adverse reaction.

Share your own story about dry eyes below. If you have found a solution, please share your success story with others. If a medication contributed to your symptoms, we would like to learn about that as well.



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  1. Keza

    Hi all,
    I thought I would share my success story, a very simple dry eye cure that worked for me :))
    I used to have mild dry eyes for close to 10 years. A little annoying at times and drops did help soothe of which I only used a couple of times a week.
    4/5 months ago (mostly in one eye, my weakest) my eye was so red and sore from dry eye that drops did not work. My eye was classed with severe dry eye by my doctor.
    He gave me a script of drops that would help with the redness but this only made them worse and stung like mad.
    He referred me to an eye specialist however I did not end up going.
    I searched high and low for natural ways on the internet but didn’t really get anywhere as they all recommended different things and they were very confusing.
    Seeing I needed new glasses and time for another eye test I thought I would visit the optometrist and see if he can help me.
    Before I said anything to him he took one look at my eye and asked me how much fluid was I drinking?…. the answer was 1 maybe two glasses a day along with umpteen cups of coffee.
    His advice – Hydrate your body, WATER, milk, organic teas as your organs take at least 6-8 weeks to get fully hydrated.
    He also said to me that the over the counter dry eye drops sometimes make your eyes worse and that there is really only one cure.
    The first couple of weeks were the hardest, not being used to drinking so much water. I gave up coffee of which I feel more enegised anyway and drank loads of water and organic teas.
    Start off with drinking at least a litre of water a day and by week 2/3 you should be drinking 3.3 divided by your weight.
    I noticed a big difference by the 6th week and by week 10 which is now “I NO LONGER HAVE DRY EYE”… It took a little longer for me being so dehydrated however i persevered with it..
    Who would think that such a simple thing like keeping your body hydrated would cure dry eye… makes very good sense now of course.
    If anyone does try this I would be grateful to know how you went…Please be patient with this process and keep me posted :)

    kEz KeZ kEz KeZ kEz KeZ

  2. Cindy M. B.

    I never had any problem with dry eyes until this past year when, after being Dx’ed with atrial fibrillation, I had to take Warfarin (Coumadin) and Sotalol, a beta-blocker. Within a short time my eyes were so dry on awakening that some days I literally had to massage the eyelid off the eyeball with my fingers!
    During this time my visual acuity just fell off a cliff. I’d had a refraction just a year earlier and had had perfect (corrected) vision. Went to the ophthalmologist, who said I now had cataracts in both eyes!
    I absolutely blame the dry eyes and the medication. Now I’m off those meds, and no more dry eyes! The cataracts are getting repaired. But have you ever heard of dry eyes causing cataracts?

  3. JRC

    I had “after cataract surgery” recently and have had dry eyes (sandpaper) every since. It is not terrible–I do not feel it all the time–but it is annoying. My Opthamologist prescribed an antibiotic, but I did not take it because I have debilitating SIBO and need to take as few antibiotics as possible. Also, I didn’t believe a temporary antibiotic would relieve a chronic condition permanently.

  4. Sha

    Do you put the castor oil in eye or on eyelid?

  5. CEL

    I’m so happy that you have addressed this problem with dry eyes. I have dealt with this problem for ten years. Nothing I have used topically or orally has helped the problem. I also have the tear duct plugs which haven’t worked that great. I have glaucoma and use drops for that three times daily which makes the problem worse.
    I have never found an eye drop, even the preservative free ones that worked more than five minutes. I take Fish oil capsules three times daily which hasn’t helped that much, and metformin for diabetes. I also use Armour thyroid for hypothyroidism.
    Some have wrote about using Castor oil in the eyes for this problem. Would this be safe to try?If anyone has any suggestions of what to use, it would be greatly appreciated. This problem has made my life miserable.
    People’s Pharmacy response: We would caution against putting castor oil in your eyes unless your doctor suggested it. It sounds as though you have a fairly complicated eye situation, and we would hate to have you make it worse with an over-the-counter drug not intended for this purpose.

  6. Norma

    Starting after my Lasik surgery, I too had such extremely dry eyes, and eye duct plugs kept working out and scratching my eyeball, so they were removed. I could not open my eyes after sleeping without tearing them from the eyelids.
    My solution was to think of something very sad, like the loss of one of our beloved pets, which flooded my eyes with that type of tears. It could be the plight of any persons near or far that you empathize with, & shed some tears about.
    Love for humanity always being good.

  7. bill

    I would add ambien to the list. As would my eye doc.

  8. JBG

    Some 20 years ago I began to experience mild, but annoying, dry eye. An ophthalmologist suggested drugstore artificial tears. I bought some, but before trying them even once, I reflected that this solution was going to become very tiresome if, as he indicated, I would need to use them for the rest of my life.
    Somewhere, I no longer remember just how, I learned that evening primrose oil could help dry eye. I tried borage oil, which contains the same essential ingredient (gamma linolenic acid) but is much cheaper. The dry eye essentially went away. A time or two since then, I have tried cutting back on the borage oil (I take three grams a day orally), but each time the dry eye returned.
    In the last year or two, a bit of the dry eye seems to be coming back. Even if it does, twenty years of success seems pretty good. Three grams of the borage oil is a hefty dose, and I don’t intend to try increasing it.

  9. mkp

    Apx. March of last year, I started having a major problem with dry eyes. I used a variety of artificial tears as well as regular eye drops but got only brief relief with any of them and I was using them frequently during the day. I remembered something from People’s Pharmacy re. castor oil. After a bit of research I went to a health food store and bought cold pressed, hexane free castor oil. I have been using it for several months and have never needed it more than twice in one day. All it takes is a drop or two. Oh what sweet relief.

  10. VFC

    My dry eyes drove me crazy- tried all the things the opthalmologist suggested none of which worked. The itch was unbearable, I felt like clawing my eyes out at times, especially the tear ducts.
    Finally I decided to try an anti-fungal ointment on my eyelids, and voila, relief. It took awhile of daily application but it worked.
    I checked with my pharmacist & she said as long as I didn’t put it into the eye it should be no problem. I use plain saline eye drops without all the extra ingredients in today’s drops because they are very irritating in themselves. I keep a bottle in my purse & at the bedside so I never have to put up with the dryness that I still have.
    This regimen has maintained the integrity of my corneas too.The expensive eyelid cleaning wipes can be replaced by using a cotton ball & contact lens wetting solution.

  11. MNS

    I am a Sjogren’s patient and have found that the eye drops and tears that are individually packaged by dose work much better than the ones with preservatives in them. The ones with preservatives actually worsen my symptoms.
    I know I am allergic to benzalkonium chloride and thimerosal and many other people are without being aware of it. Watch out as the thimerosal is also in some vaccines so I am always careful to ask after very uncomfortable reactions in the past. Fish oil also helps and don’t run a fan at night or allow AC or heater to blow directly at you in the car.

  12. CJL

    Fifteen years ago, I had several spells of “recurrent erosion” (I would awaken with my eyelid stuck to my cornea – very painful!) and it was finally suggested that I use Bausch & Lomb’s Muro 128 (5%) ointment. I’ve used that every night at bedtime ever since and have not had another episode. For occasional dryness in the daytime, I use Muro 128 drops (ointment in the daytime makes vision too blurry). I take several drugs that cause dryness, so the Muro is a godsend.

  13. JRH

    Sometimes I have the feeling that I get a dry patch behind my eye when I sleep. This can be painful in the morning and I put in eye drops and massage my eye to relieve the pain. Maybe I sleep with my eye open to cause this. Anyone else?

  14. Jay

    I use fish oil capsules for my dry eyes: 3 capsules per day, one at each meal.
    Also, in the past, I used Chinese herbs (traditional Chinese medicine) that included mulberry leaf and got relief that way.

  15. CSN

    I have had moderate to mild dry eye for years. One opthalmologist I used to go to strongly recommended lubricating eye ointment. I used it and soon after my eyes were red swollen and unbearably itchy.
    Beleive it or not it took me a long time to figure out it was the eye ointment causing the problem. Then it took a long time to get the reaction to quiet down.
    Pred-forte eye drops worked, but as soon as I tapered off enough the horrible itchyness returned.
    Fnally I went to a dermatologist who prescribed a doxycycline at low dose, and amazingly that is what worked. I have never used any eye medication since then, and hope I never have to as the symptoms were unbearable.
    I have been on fish oil capsules for years and the dry eye is improved and not usually bothersome. I find that driving, especially with the air conditioning blowing toward my face really dries my eyes out, as does a fan. I sometimes use a sleep mask at night if the celing fan is on.

  16. A.S.T.

    I have terrible chronic dry eyes. This is from a combination of having Hypohydrotic Ectodermal Dysplasia, menopause, a history of receiving chemotherapy, allergies, and who knows what else. Even with using preservative free eye lubricants many times a day and Restasis twice a day for years as well as taking Dry Eye Omega with D3 twice a day, my condition is not good. I also have plugs in my tear ducts. A few months ago my Ophthalmologist had to remove an area of one cornea that was “wrinkling” and separating from the next layer. I never even knew such a thing could happen. I really fear that my vision will be affected by this condition at some point.

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