Genetic Factors in Dry Eye: Tear Film, Inflammation, and DNA

Last reviewed: May 12, 2026 Last updated: May 12, 2026

Written by: Jay Hastings , CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance. His work has included scaling healthcare startups, leading CLIA lab integrations, and helping expand consumer access to precision health tools.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

This article is part of the PlexusDx Education Hub — your resource for evidence-based guidance on the genes behind tear-film biology, inflammation, and ocular surface health. Browse all genetic health education

Dry eye is one of the most common reasons people see an eye doctor, and while environment, screen time, age, and hormones drive much of the risk, genetics plays a real supporting role. Family clustering of dry eye and related conditions has prompted researchers to look for the genes involved in tear production, tear-film stability, and ocular surface inflammation.

This article reviews what the current science says about the genetic factors in dry eye and reframes "management" the way the evidence supports it: understanding your biology and working with an eye care provider, not self-treating from a DNA result.

Is dry eye influenced by genetics?

Partly. Dry eye disease is multifactorial, meaning many small influences add up. Twin and family studies suggest a genetic contribution to tear-film characteristics and to autoimmune conditions that cause dry eye. No single "dry eye gene" explains most cases; instead, several genes that govern tear secretion, mucin production, and inflammation each contribute modestly.

Tear film biology: AQP5 and mucin genes

A healthy tear film has watery, mucin, and lipid layers. AQP5 encodes aquaporin 5, a water channel that helps the lacrimal and salivary glands move fluid — central to the watery component of tears. Altered AQP5 expression has been studied in the context of reduced tear secretion.

Mucins keep the tear film adhering evenly to the eye's surface. Genes such as MUC5AC (a secreted mucin) and MUC16 (a membrane-bound mucin) shape tear-film stability, and changes in mucin biology are a recognized feature of dry eye. Variants and expression differences in these genes are active areas of research into why some ocular surfaces stay hydrated and others do not.

Inflammation and autoimmune links

A large share of severe dry eye traces to Sjogren's syndrome, an autoimmune condition with strong, well-established genetic associations in the HLA class II region (HLA-DR and HLA-DQ genes) as well as immune-regulatory genes like IRF5 and STAT4. Chronic ocular surface inflammation also involves cytokine pathways — genes such as TNF and IL6 — that can perpetuate the dryness-inflammation cycle. This is why inflammation is a central target in clinical dry eye care.

Sex hormones and dry eye risk

Dry eye is more common in women, especially after menopause, pointing to sex-hormone influences on the tear-producing glands. Genes involved in androgen and estrogen signaling affect meibomian (oil) gland and lacrimal gland function, which helps explain sex differences in prevalence. Hormonal biology interacts with the tear-film and inflammatory genes above rather than acting alone.

Understanding genetic context versus managing dry eye

Knowing your genetic tendencies is useful context, but it is not a treatment plan. Evidence-based dry eye care — from artificial tears and lid hygiene to prescription anti-inflammatory therapy — is directed by an optometrist or ophthalmologist based on a clinical exam, not a genotype. A genetic test does not diagnose, treat, or manage dry eye. Its value is helping you understand the biological pathways involved so you can have a more informed conversation with your eye care provider.

What your genetic results reveal

A pathway-level genetic test can place tear-film and inflammation-related genes within your broader biology. The Precision Peptide Genetic Test analyzes 14 pathways, 49 peptides, 150+ genetic insights, framing named genes as part of a connected profile rather than a stand-alone answer to a symptom.

Genetics is a guide, not a guarantee: the test tells you about your biology, not what to put in your body. For dry eye specifically, diagnosis and management belong with a qualified eye care professional.

Frequently Asked Questions

Is dry eye hereditary?

Dry eye has a partial genetic component but is not simply inherited. It is multifactorial, combining genes that influence tear secretion, mucin production, and inflammation with age, hormones, screen use, and environment. Autoimmune causes like Sjogren's syndrome carry stronger genetic links, but most everyday dry eye reflects many small influences together.

Which genes are linked to dry eye?

Research points to several. AQP5 affects the watery tear layer, MUC5AC and MUC16 govern tear-film mucins, and HLA class II genes plus IRF5 and STAT4 drive autoimmune dry eye through Sjogren's syndrome. Inflammatory genes such as TNF and IL6 help sustain the dryness-inflammation cycle. No single gene explains most cases.

Can a genetic test diagnose or treat dry eye?

No. A pathway-level genetic test does not diagnose, treat, cure, or manage dry eye. It offers context about tear-film and inflammation-related pathways. Diagnosis and treatment require an eye exam and a plan from an optometrist or ophthalmologist, who can assess tear quality and recommend appropriate care.

Why is dry eye more common in women?

Sex hormones strongly influence the tear-producing lacrimal and meibomian glands, and dry eye becomes more common in women, particularly after menopause. Genes in androgen and estrogen signaling pathways affect gland function, interacting with tear-film and inflammatory biology. This hormonal contribution is one reason prevalence differs between women and men.

Want to understand the biological pathways behind your ocular and inflammatory health? Take the Precision Peptide Genetic Test to see named genes mapped across your 14 biological pathways — educational insight to bring to your eye care provider.

This article is part of the PlexusDx Education Hub. Browse all genetic health education

Peptide testing disclaimer: The Precision Peptide Genetic Test analyzes how your genes influence peptide-related biological pathways. It does not recommend, prescribe, or determine which peptides you should use. Consult a qualified healthcare provider before beginning any peptide protocol.

Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance. References are included at the end of the article when scientific, medical, or health-related claims are discussed.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.