Dry Eye Prevalence and Key Risk Factors

By Dr. Abdalrahman Alabsi – Ophthalmologist | Last reviewed: October 2026

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Dry eye disease (DED) is one of the most common conditions in ophthalmology.

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Prevalence of dry eye by diagnostic criteria

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Based on dry eye symptoms only (patient complaints):

Prevalence ranges from about 7.3% in children aged 6–9 years to 31.6% in women aged 20–29 years. Among adults (40–80 years), rates are about 20% in men and 30% in women.

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Based on dry eye symptoms (patient complaints) together with clinical signs of dry eye (examination and diagnosis):

Prevalence rises to 62.9% in women aged 20–29 years.

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Based on clinical diagnosis without patient complaints:

Prevalence ranges from 1.0% in men over 80 to 15.3% in women aged 50–59 years.

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Note: Women show a higher prevalence than men from the age of 10 onward.

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Prevalence of meibomian gland dysfunction (MGD) – dysfunction of the tear-secreting oil glands

Meibomian gland dysfunction (MGD) is the main cause of evaporative dry eye (tear evaporation due to a deficient lipid layer).

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Current statistics indicate that meibomian gland dysfunction may be present in 50% to 70% of dry eye cases, and up to 86% in some studies depending on diagnostic criteria and geographic region. It is about 71% in the Arab world and 76.1% in Saudi Arabia, making it the most common underlying cause of dry eye disease.

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Risk factors for dry eye:

Risk factors are divided into modifiable and non-modifiable:

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1. Non-modifiable risk factors:

Female sex and older age.

Autoimmune diseases: up to 90% of patients with Sjögren's disease have dry eye, and other autoimmune diseases such as rheumatoid arthritis, lupus, and scleroderma carry a twofold risk of dry eye.

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2. Modifiable risk factors:

Contact lens wear.

Digital screen use.

Dry and air-conditioned environments.

Certain medications, especially those with anticholinergic effects, antihistamines (for allergies), some antidepressants, and isotretinoin (Roaccutane) for acne.

Skin and atopic conditions: such as rosacea, acne vulgaris, eczema, asthma, allergic diseases, and vernal keratoconjunctivitis.

Previous eye surgery: including all types of refractive surgery (surface laser/PRK, LASIK, FemtoLASIK, and SMILE) and cataract surgery.