Why dry eye worsens with age

Several age-related changes combine to make the tear film progressively more vulnerable:

Declining meibomian gland function Meibomian gland function declines with age — gland secretion becomes less efficient, oil quality deteriorates, and gland atrophy gradually reduces the total functional gland mass. This is the primary driver of the increased prevalence and severity of dry eye in older adults.

Reduced lacrimal gland output Aqueous tear production decreases with age. The lacrimal gland undergoes structural changes over time that reduce its secretory capacity — contributing to aqueous deficient dry eye alongside the evaporative component.

Reduced blink rate and completeness Blink rate and blink completeness tend to decline with age, reducing the frequency with which the tear film is replenished and the meibomian glands stimulated.

Increased medication burden Older adults are more likely to be taking multiple medications, many of which — antihistamines, antidepressants, beta-blockers, diuretics, and others — have negative effects on tear production. Polypharmacy is a significant driver of dry eye severity in this age group.

Increased Demodex burden Demodex mite populations increase with age. The majority of people over 60 carry Demodex on their eyelids, and a meaningful proportion have infestation levels sufficient to drive significant anterior lid disease and dry eye.

Systemic disease Age-related systemic conditions including autoimmune disease, diabetes, thyroid disease, and Parkinson's disease all have ocular surface implications. Sjögren's syndrome — an autoimmune condition causing significant dry eye — most commonly presents in middle-aged and older women.

Dry eye and quality of life in older adults

The impact of dry eye on quality of life in older adults is significant and often underestimated. Difficulty reading, reduced driving confidence — particularly at night — problems with screen use, and persistent physical discomfort all have consequences for independence, social engagement, and wellbeing.

It's also frequently undertreated. Many older adults — and some clinicians — accept worsening dry eye as an inevitable consequence of ageing rather than a condition warranting active management. This is the wrong approach. The treatments we offer are effective in older adults, well-tolerated, and can produce meaningful improvements in comfort and quality of life.

What we offer

Our full range of specialist treatments — IPL, LLLT, ZEST, and NuLids — are appropriate and effective in older adults. Treatment planning takes account of the full clinical picture including medication history, systemic conditions, and the degree of gland atrophy present.

We'll be honest about what treatment can and can't achieve — significant gland atrophy cannot be reversed, but function can be improved and symptoms very substantially reduced in most patients.

Find out more about our treatments →

📍 Openshaw Opticians, Unit 4, 16 Cheapside, Cleckheaton, BD19 5AF 

📞 01274 878214