Aging and Dry Eyes

By

Jennifer Larson

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senior woman with one hand over eye

As you get older, you’re more likely to experience the condition known as keraconjunctivitis sicca. But you probably know the condition much better by the more common (and easier to pronounce) name “dry eye syndrome.”

In short, you don’t have enough tears on the surface of your eye to keep it properly lubricated. Dry eye can affect anyone, but it becomes more common as we age. A number of factors can contribute to it, but one of the biggest factors is age.

Signs and Symptoms of Dry Eye

First, it’s important to determine if you actually have dry eye syndrome. Only a doctor can diagnose the condition, but you can figure out if you need to see your provider for an exam and possible diagnosis. Are you blinking or rubbing your eyes as you’re reading this because they’re irritated or perhaps dry from staring at a computer screen for extended amounts of time? Imagine experiencing that kind of discomfort on an increasingly regular basis. Because dry eye is a progressive condition, it tends to get worse over time. Your eyes may be increasingly dry and irritated, causing discomfort and even pain. It can even lead to vision loss.

Consult this list of the most common signs that you have dry eye:

  • Your eyes don’t produce enough tears

  • The tears that your eyes do produce aren’t the appropriate consistency to keep your eyes properly lubricated

  • Your tears evaporate too quickly.

Why Aging is Linked to Dry Eye

Aging is hard on your eyes in general. As you age, you tend to lose some of your ability to read small print, a condition called presbyopia. You’re also more likely to develop cataracts, which are cloudy areas in the lens of your eye.

Unfortunately, as you age, you’re more likely to develop dry eye. Your eyes just don’t produce as many tears as they once did. Many of the microscopic glands that contribute to the tear film stop production. You’re also more likely to develop certain health conditions that can lead to dry eye—and sometimes the medications used to treat them—can cause or worsen dry eye. For example, the older you get, the more predisposed you are to developing certain neurogenerative diseases like Parkinson’s disease that also are linked to a higher incidence of dry eye. Dry eye is also linked to certain blood pressure medications, which many people begin needing as they age.

Also, as we age, we tend to experience more inflammation and something called oxidative stress. When your body doesn’t have enough antioxidants to fight off potentially harmful free radical cells, it creates an imbalance, and that imbalance causes stress and tissue damage to your eyes. The result: dry eye.

The Association Between Dry Eye and Menopause

Women are more likely to suffer from dry eye than men. And as they age, women are even more liklely to develop dry eye. One major contributing factor is the link between menopause and dry eye. While researchers haven’t identified the exact cause, they do know that dry eye becomes more common once a woman enters menopause. Also, women who enter menopause early are more likely to develop eye surface damage as a result of dry eye. If you have a family history of early menopause, talk to your healthcare provider.

But the jury is still out on the benefits of hormone replacement therapy on dry eye symptoms. Some postmenopausal women discover that hormone replacement therapy is helpful. Research has shown that phytoestrogen supplementation can actually increase tear production and have a positive effect on the concentration levels of electrolytes of the tears that are produced. Some research suggests androgen therapy may help other older women by stimuatling the lacrimal gland. That’s the gland in the eye area that secretes proteins, electrolytes and water that help make up the liquid substance that we call “tears.”

However, other research suggests that women on hormone replacement therapy report a higher incidence of dry eye syndrome. You may need to discuss your specific situation with your doctor to determine if hormone replacement therapy is worth considering for you.

Get Treated

If you’ve noticed your eyes seem drier than usual or if you’re experiencing other symptoms like grittiness, discharge, increased fatigue and pain in your eyes, consult your healthcare provider. You may be able to try some eyedrops and lifestyle management strategies to address your dry eye symptoms. You might be able to start with something as simple as non-prescription artificial tears during the day and thick lubricating gels at night. In more serious cases, your doctor might recommend treatment with the anti-inflammatory medicine called cyclosporine, which you would have to take twice a day for several weeks or months before seeing results. 

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: May 24, 2017

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Medical References

  1. Abelson MD, et al. Oxidative Stress Reduction for Dry Eye. Review of Opthalmology. March 4, 2016. https://www.reviewofophthalmology.com/article/oxidative-stress-reduction-for-dry-eye
  2. Aging and Your Eyes. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/aging-and-your-eyes
  3. Dry Eye. American Optometric Association. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-condition...
  4. Facts About Dry Eye. National Eye Institute. https://nei.nih.gov/health/dryeye/dryeye
  5. Goldman H. The Fix for Dry Eyes. Harvard Health Letter. Harvard Medical School. http://www.health.harvard.edu/blog/the-fix-for-dry-eyes-2017021011090
  6. Sharma A and Hindman HB. Aging: A Predisposition to Dry Eyes. Journal of Ophthalmology. 2014 (2014). https://www.hindawi.com/journals/joph/2014/781683/

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