The Link Between Aging and Chronic Dry Eye

As people age, it is fairly common for their eyes to dry out. In fact, research shows that the chance of chronic dry eye occurring increases every 5 years after the age of 50. There are several reasons why this occurs.¹

How healthy eyes work

When eyes are functioning well, each blink coats the surface of the eye with a film of tears. These tears lubricate the eye and help remove any small particles that may have entered the eye. Any overflow tears drain into small ducts in the corners of the eye closest to the nose.²

When tear production or drainage is interrupted, dry eye can be the result.

Causes of dry eye

Dry eye can be caused by a lack of adequate tear production or tears that are poor quality and evaporate too quickly.³

Tears have 3 layers: water, oil, and mucus. The oil prevents the water from evaporating, while mucus helps the tears spread across the eye. When any of these ingredients is out of balance, the quality of the tears is compromised. This can lead to chronic dry eye.²

Other age-related factors can contribute to chronic dry eye, such as:⁴

• Increased use of prescription drugs, vitamins, and other medicines
• Changes in the shape of the skin of the eyelid
• Hormonal changes
• Inflammatory conditions

Age-related immune changes

As we age, our immune system function decreases. The process is called immunosenescence. It results in inflammation throughout the body and leaves us more open to infection.¹

Researchers have found a link between inflammation, decreased immune function, and chronic dry eye. They have noted increased levels of cells related to these conditions in tears of people with dry eye.¹

Medicines and dry eye

Research shows that more than 75 percent of people over age 60 take 2 or more prescription drugs, and 37 percent take 5 or more. Many medicines used to treat conditions related to aging can cause dry eye. Examples include:⁴

• Diuretics (water pills)
• Dopamine agonist drugs used to treat Parkinson’s disease
• Antimetabolite drugs used to treat rheumatoid arthritis
• Antidepressants

One study also showed that people taking antihistamines, decongestants, and vitamins had higher rates of dry eyes compared to others in their age group. People tend to take these drugs and supplements more as they age, possibly leading to an increased risk of dry eye.⁴

Physical changes to the eye

The shape of our eyelids changes as we age, and skin grows softer and more stretchy. This change, along with the slowing of our blink reflex, can change the way tears are spread across the surface of the eye. This can cause eyes to dry out.⁴

The impact of dry eye on everyday life

Researchers used a time trade-off system to determine the impact that chronic dry eye might have on a person’s life. Their results showed that chronic dry eye had the same impact on quality of life as moderate to severe angina. Dry eye can prevent a person from being able to properly read, use a computer, drive, and manage other normal life activities.¹

With increasing life expectancy and a large portion of the population aging, it is expected that dry eye will remain 1 of the top reasons people visit an eye doctor.¹

Diagnosing dry eye

If you think you have chronic dry eye, the first step is to see an eye doctor for a thorough exam. They will examine the inside and outside of the eye. They will also test the quality and quantity of tears produced to see if they are sufficient.²

It is also important to provide a detailed medical history. This can help your doctor understand if there are any factors that may be contributing to your symptoms, such as your environment, health issues, or medicines you are taking.²

A correct diagnosis is key to ensuring you get the treatment you need.

Treatments for dry eye

There are several effective treatments for dry eye. Using over-the-counter artificial tears several times a day may be the first thing your doctor suggests. Your doctor may also write you a prescription for cyclosporine eye drops.^1,3

If those treatments are not effective, there are other options like punctal plugs. These are plugs that block tears from draining into the tear ducts to help tears stay on the surface of the eye longer.¹

Talk to your doctor about your dry eye symptoms and history. This will ensure you get the best treatment for your condition.