What is the most likely cause of dry eyes in a long-term hydrogel contact lens wearer?

The most likely cause of dry eyes in a long-term hydrogel contact lens wearer is the use of anti-histamines. Anti-histamines are known to have a systemic drying effect, as they reduce secretions in the body, including those in the tear film. This can lead to a decreased tear production, resulting in dryness and discomfort, particularly for contact lens wearers who rely on a stable tear film to maintain lens hydration and comfort.

In the context of contact lens wear, maintaining adequate moisture is essential as hydrogel lenses are designed to retain water and create a healthy ocular surface environment. When tear production is compromised due to the use of anti-histamines, this can exacerbate dryness, leading to discomfort and potentially impacting lens wear time.

Other options do not directly correlate as strongly with causing dry eyes. For instance, while the use of oxidative solutions and rewetting drops may have an impact on lens comfort, they are typically not direct causes of dry eye symptoms in the same way that anti-histamines are. Additionally, the wearing of lenses in the wrong eyes is more likely to cause discomfort due to improper fit rather than directly causing dry eyes.