Elderly people frequently experience dryness of the eyes, but dry eye can occur at any age. Dry eye syndrome occurs in approximately 5–30% of the general elderly population, and affects women more often than men. It’s estimated that nearly five million Americans 50 years of age and older have dry eye. Of these, more than three million are women and more than one and a half million are men. Tens of millions more have less severe symptoms. For women, menopause may be a turning point, as dry eye is more common in women after menopause.
Dry Eye Syndrome
Dry eye syndrome is a disease of the surface of the eye and the tear film that is common in older adults. Even though the degree of vision loss in dry eye patients is usually mild, for older people this minimal change in vision can lead to a significant decrease in sight and quality of life. A healthy eye needs good tear production and drainage, and deficiencies in this delicate balance in the eye can lead to dryness.
The tear film in the eye consists of 3 main layers: the lipid layer, the aqueous layer, and the mucin layer. The eye requires a fine balance of tear production and appropriate tear drainage to function well. Tear production is orchestrated by multiple components of the eye, and each component can be compromised by age.
Risks of Dry Eye for the Elderly
In the aging eye, risk factors such as systemic and topical medication use (which generally increase as people age), hormonal changes, decreased blink rates, and stress can predispose the patient to develop dry eye. In older people dry eye is frequently more severe than in younger people, has higher economic costs, and leads to worse consequences to the quality of life. Quality of life is affected since even with mild vision loss, such as that which most commonly occurs with dry eye, the risk of falling, depression and hip fracture increases in an elderly population. Even small impairments from dry eyes, such as impaired reading, can lead to errors in medication administration which can be life-threatening. Quality of life can be severely affected and lead to greater problems in daily activities.With greater life expectancy, many more people will be joining the over-60 age group, and the prevalence of dry eye disease will increase even more.
Dry Eye Treatment
Standard treatments with artificial tears, cyclosporine, punctal plugs, steroids, or antibiotics can be effective for an older population. For mild dry eye, the first step is lubrication with artificial tear drops and gels. Due to increased eye sensitivity, preservative-free artificial tears may be better for older adults but are more expensive than other types of artificial tears. It’s important for patients to minimize environmental factors contributing to dry eyes. Some factors that need to be considered and minimized are cigarette smoking, medications such as antihistamines or diuretics, conditioners or ceiling fans, and low-humidity environments. For mild-to-moderate dry eye, treating the underlying diseases—blepharitis, rosacea, autoimmune disease, and others—with topical or oral antibiotics, low-dose steroids, warm compresses, or lid hygiene is necessary. Other medications may be indicated in dry eye that is associated with inflammation, including steroids.
If you think you may be suffering from Dry eye syndrome or you need more information on behalf of a family member, please contact out Practice today.