Skip to main content

Dry Eye Syndrome in the Elderly: Challenges and Treatment Options

  • Chapter
  • First Online:
Ophthalmology and the Ageing Society

Abstract

The term dry eye was initially introduced by Roetth in 1953, who described dry eye as low flow of tears measured with the Schirmer test (de Roetth 1953). Now in the twenty-first century, our understanding of the underlying mechanisms and multiple possible etiologies underlying this form of ocular surface disease is more complex and nuanced, but the term “dry eye” is still prevalently used worldwide (Morube 2004).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Albietz JM, Lenton LM, McLennan SG (2004) Chronic dry eye and regression after laser in situ ­keratomileusis for myopia. J Cataract Refract Surg 30:675–684

    Article  PubMed  Google Scholar 

  • Aragona P, Papa V, Micali A et al (2002) Long term treatment with sodium hyaluronate containing artificial tears reduces ocular surface damage in patients with dry eye. Br J Ophthalmol 86:181–184

    Article  Google Scholar 

  • Aragona P, Bucolo C, Spinella R et al (2005) Systemic oomega-6 essential fatty acid treatment and PGE1 tear content in Sjögren’s syndrome patients. Invest Ophthalmol Vis Sci 46:4474–4479

    Article  PubMed  Google Scholar 

  • Avni I, Garzozi HJ, Barequet IS et al (2010) Treatment of dry eye syndrome with orally administered CF101- data from a phase 2 clinical trial. Ophthalmology 117:1287–1293

    Article  PubMed  Google Scholar 

  • Barabino S, Rolando M, Camicione P et al (2003) Systemic linoleic and γ-linolenic acid therapy in dry eye syndrome with an inflammatory component. Cornea 22:97–101

    Article  PubMed  Google Scholar 

  • Bashour M, Harvey J (2000) Causes of involutional ectropion and entropion- age related tarsal changes are the key. Ophthal Plast Reconstr Surg 16:131–141

    Article  PubMed  CAS  Google Scholar 

  • Baudouin C (2001) The pathology of dry eye. Surv Ophthalmol 45:S211–S220

    Article  PubMed  Google Scholar 

  • Behrens A, Doyle JJ, Stern L et al (2006) Dysfunctional tear syndrome- a Delphi approach to treatment recommendations. Cornea 25:900–907

    Article  PubMed  Google Scholar 

  • Bron AJ, Tiffany JM (2004) The contribution of meibomian disease to dry eye. Ocul Surf 2:149–164

    Article  PubMed  CAS  Google Scholar 

  • Burns E, Mulley GP (1992) Practical problems with eye-drops among elderly ophthalmology outpatients. Age Ageing 21:168–170

    Article  PubMed  CAS  Google Scholar 

  • Chen SX, Lee GA (2007) SmartPlug in the management of severe dry eye syndrome. Cornea 26:534–538

    PubMed  Google Scholar 

  • Cho YK, Kim MS (2009) Dry eye after cataract surgery and associated intraoperative risk factors. Korean J Ophthalmol 23:65–73

    Article  PubMed  Google Scholar 

  • Damasceno RW, Osaki MH, Dantas PEC et al (2011) Involutional entropion and ectropion of the lower eyelid: prevalence and associated risk factors in the elderly population. Ophthal Plast Reconstr Surg 27:317–320

    Article  PubMed  Google Scholar 

  • de Paiva CS, Pflugfelder SC (2008) Rationale for anti-inflammatory therapy in dry eye syndrome. Arq Bras Oftalmol 71:S89–S95

    Article  Google Scholar 

  • de Paiva CS, Corrales RM, Villarreal AL (2006) Corticosteroid and doxycycline suppress MMP-9 and inflammatory cytokine expression, MAPK activation in the corneal epithelium in experimental dry eye. Exp Eye Res 83:526s–535s

    Article  Google Scholar 

  • de Roetth AFM (1953) Low flow of tears- the dry eye. Am J Ophthalmol 35:782–787

    Google Scholar 

  • Department of Health and Human Services (2010) Distribution of age at diagnosis of diabetes among adult incident cases aged 18–79 years, United States, 2008. http://www.cdc.gov.proxy3.library.jhu.edu/diabetes/statistics/age/fig1.htm. Accessed 6 Dec 2011

  • Di Pascuale MA, Espana EM, Kawakita T et al (2004) Clinical characteristics of conjunctivochalasis with or without aqueous tear deficiency. Br J Ophthalmol 88:388–392

    Article  PubMed  Google Scholar 

  • Dogru M, Katakami C, Inoue M (2001) Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology 108:586–592

    Article  PubMed  CAS  Google Scholar 

  • Foulks GN (2006) Topical cyclosporine for treatment of ocular surface Disease. Int Ophthalmol Clin 46:105–122

    Article  PubMed  Google Scholar 

  • Fox RI (2005) Sjögren’s syndrome. Lancet 366:321–331

    Article  PubMed  CAS  Google Scholar 

  • Friedman NJ (2010) Impact of dry eye disease and treatment on quality of life. Curr Opin Ophthalmol 21:310–316

    PubMed  Google Scholar 

  • Galor A, Feuer W, Lee DJ et al (2011) Prevalence and risk factors of dry eye syndrome in a United States veterans affairs population. Am J Ophthalmol 152:377–384

    Article  PubMed  Google Scholar 

  • Gilbard JP (2009) Dry eye blepharitis: approaching the patient with chronic eye irritation. Geriatrics 6:22–26

    Google Scholar 

  • Guillon M, Maissa C (2008) Contact lens wear affects tear film evaporation. Eye Contact Lens 34:326–330

    Article  PubMed  Google Scholar 

  • Henstrom DK, Lindsay RW, Cheney ML et al (2011) Surgical treatment of the periocular complex and improvement of quality of life in patients with facial paralysis. Arch Facial Plast Surg 13:125–128

    Article  PubMed  Google Scholar 

  • Jaworowski S, Drabkin E, Rozenman Y (2002) Xerophthalmia and undiagnosed eating disorder. Psychosomatics 43:506–507

    Article  PubMed  Google Scholar 

  • Kojima T, Dogru M, Ishida R et al (2006) Clinical evaluation of the SmartPlug TM in the treatment of dry eyes. Am J Ophthalmol 141:386–387

    Article  PubMed  Google Scholar 

  • Lemp MA (1994) Management of the dry-eye patient. Int Ophthalmol Clin 34:101–113

    Article  PubMed  CAS  Google Scholar 

  • Lemp MA (1995) Report of the National Eye Institute/Industry workshop on Clinical Trials in Dry eyes. CLAO J 21:221–232

    PubMed  CAS  Google Scholar 

  • Lemp MA (2008a) Advances in understanding and managing dry eye disease. Am J Ophthalmol 146:350–356

    Article  PubMed  Google Scholar 

  • Lemp MA (2008b) Management of dry eye disease. Am J Manag Care 14:S88–S101

    PubMed  Google Scholar 

  • Lemp MA, Baudouin C, Baum J et al (2007) The definition and classification of dry eye disease: report of Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 5:75–92

    Article  Google Scholar 

  • Lépine JP, Bouchez S (1998) Epidemiology of depression in the elderly. Int Clin Psychopharmacol 13:S7–S12

    Article  PubMed  Google Scholar 

  • Li M, Gong L, Sun X et al (2011) Anxiety and depression in patients with dry eye syndrome. Curr Eye Res 36:1–7

    Article  PubMed  Google Scholar 

  • Lin PY, Tsai SY, Cheng CY et al (2003) Prevalence of dry eye among an elderly Chinese population in Taiwan- the Shihpai Eye Study. Ophthalmology 110:1096–1101

    Article  PubMed  Google Scholar 

  • Liu H, Begley C, Chen M et al (2009) A link between tear instability and hyperosmolarity in dry eye. Arch Ophthalmol 127:763–768

    Article  Google Scholar 

  • Luo L, Li D, Pflugfelder SC (2007) Hyperosmolarity- induced apoptosis in human corneal epithelial cells is mediated by cytochrome c and MAPK pathways. Cornea 26:452–460

    Article  PubMed  Google Scholar 

  • Manaviat MR, Rashidi M, Afkahami-Ardekani M et al (2008) Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC Ophthalmol 8(10)

    Google Scholar 

  • Mantelli F, Tranchina L, Lambiase A et al (2011) Ocular surface damage by ophthalmic compounds. Curr Opin Allergy Clin Immunol 11:464–470

    Article  PubMed  Google Scholar 

  • Marsh P, Pflugfelder SC (1999) Topical nonpreserved methylprednisolone therapy for keratoconjunctivitis sicca in Sjögren syndrome. Ophthalmology 106:811–816

    Article  PubMed  CAS  Google Scholar 

  • Mathers WA, Lane JA (1998) Meibomian gland lipids, evaporation and tear film stability. Adv Exp Med Biol 438:349–360

    Article  PubMed  CAS  Google Scholar 

  • Miljanovic B, Trivedi KA, Dana MR et al (2005) Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr 82:887–893

    PubMed  CAS  Google Scholar 

  • Miljanovic B, Dana R, Sullivan DA et al (2007) Impact of dry eye syndrome on vision-related quality of life. Am J Ophthalmol 143:409–415

    Article  PubMed  Google Scholar 

  • Morube J (2004) Andrew de Roetth (1893–1981): dacryologist who introduced the term dry eye. Ocul Surf 2:225–227

    Article  Google Scholar 

  • Moss SE, Klein R, Klein BEK (2000) Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol 118:1264–1268

    Article  PubMed  CAS  Google Scholar 

  • Murray MD, Morrow DG, Weiner M et al (2004) A conceptual framework to study medication adherence in older adults. Am J Geriatr Pharmacother 2:36–43

    Article  PubMed  Google Scholar 

  • Nichols KK, Nichols JJ, Mitchell GL (2004) The lack of association between signs and symptoms patients with dry eye disease. Cornea 23:762–770

    Article  PubMed  Google Scholar 

  • Niti M, Ng TP, Kua EH et al (2007) Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. Int J Geriatr Psychiatry 22:1087–1094

    Article  PubMed  Google Scholar 

  • Ono M, Takamura E, Shinozaki K et al (2004) Therapeutic effect of cevimeline on dry eye in patients with Sjögren’s syndrome: a randomized, double-blind clinical study. Am J Ophthalmol 138:6–17

    Article  PubMed  CAS  Google Scholar 

  • Patane MA, Cohen A, From S et al (2011) Ocular iontophoresis of EGP-437 (dexamethasone phosphate) in dry eye patients: results of a randomized clinical trial. Clin Ophthalmol 5:633–643

    PubMed  CAS  Google Scholar 

  • Pflugfelder SC, Maskin SL, Anderson B et al (2007) A randomized, double-masked, placebo-controlled, multicenter comparison of loteprednol etabonate ophthalmic suspension, 0.5 %, and placebo for treatment of keratoconjunctivitis sicca in patients with delayed tear clearance. Am J Ophthalmol 138:444–457

    Article  Google Scholar 

  • Pflugfelder SC, Geerling G, Kinoshita S et al (2007) Management and therapy of dry eye disease: Report of the management and therapy subcommittee of the international dry eye workshop. Ocular surface 5:163–178

    Article  Google Scholar 

  • Roberts CW, Carniglia PE, Brazzo BG (2007) Comparison of topical cyclosporine, punctual occlusion, and a combination for the treatment of dry eye. Cornea 26:805–809

    Article  PubMed  Google Scholar 

  • Rosenthal P, Corteau A (2005) Fluid-ventilated, gas-­permeable sclera contact lens is an effective option for managing severe ocular surface disease and many corneal disorders that would otherwise require penetrating keratoplasty. Eye Contact Lens 31:130–134

    Article  PubMed  Google Scholar 

  • Rossi GCM, Tinelli C, Pasinetti GM et al (2009) Dry eye syndrome-related quality of life in glaucoma patients. Eur J Ophthalmol 19:572–579

    PubMed  Google Scholar 

  • Schaumberg DA, Buring JE, Sullivan DA et al (2001) Hormone replacement therapy and dry eye syndrome. JAMA 286:2114–2119

    Article  PubMed  CAS  Google Scholar 

  • Schaumberg DA, Sullivan DA, Buring JE et al (2003) Prevalence of dry eye syndrome among US women. Am J Ophthalmol 136:318–326

    Article  PubMed  Google Scholar 

  • Schaumberg DA, Dana R, Buring JE et al (2009) Prevalence of dry eye disease among US men. Arch Ophthalmol 127:763–768

    Article  PubMed  Google Scholar 

  • Schein OD, Tielsch JM, Munoz B et al (1997) Relation between signs and symptoms of dry eye in the elderly- a population-based perspective. Ophthalmology 104:1395–1401

    Article  PubMed  CAS  Google Scholar 

  • Semba CP, Torkildsen GL, Lonsdale JD et al (2012) A phase 2 randomized, double-masked, placebo-­controlled study of a novel integrin antagonist SAR 1118 for the treatment of dry eye. Am J Ophthalmol 153:1050–1060

    Article  PubMed  CAS  Google Scholar 

  • Shimmura S, Ono M, Shinozaki K et al (1995) Sodium hyaluronate eyedrops in the treatment of dry eyes. Br J Ophthalmol 79:1007–1011

    Article  PubMed  CAS  Google Scholar 

  • Shine WE, McCulley JP, Pandya AG (2003) Minocycline effect on meibomian gland lipids in meibomianitis patients. Exp Eye Res 76:417–420

    Article  PubMed  CAS  Google Scholar 

  • Smith VA, Cook SD (2004) Doxycycline- a role in ocular surface repair. Br J Ophthalmol 88:619–625

    Article  PubMed  CAS  Google Scholar 

  • Smith JA, Albeitz J, Begley C et al (2007) The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop. Ocul Surf 5:93–107

    Article  Google Scholar 

  • Snibson GR, Greaves JL, Soper NDW et al (1990) Precorneal residence times of sodium hyaluronate solutions studied by quantitative gamma scintigraphy. Eye 4:594–602

    Article  PubMed  Google Scholar 

  • Sullivan DA, Sullivan BD, Ullman MD et al (2000) Androgen influence on the meibomian gland. Invest Ophthalmol Vis Sci 41:3732–3741

    PubMed  CAS  Google Scholar 

  • Terry MA (2001) Dry eye in the elderly. Drugs Aging 18:101–107

    Article  PubMed  CAS  Google Scholar 

  • Tsubota K (1998) Tear dynamics and dry eye. Prog Retin Eye Res 17:565–596

    Article  PubMed  CAS  Google Scholar 

  • Tsubota K, Yamada M, Urayama K (1994) Spectacle side panels and moist inserts for the treatment of dry-eye patients. Cornea 13:197–201

    Article  PubMed  CAS  Google Scholar 

  • Tsubota K, Goto E, Fujita H et al (1999) Treatment of dry eye by autologous serum application in Sjögren’s ­syndrome. Br J Ophthalmol 83:390–395

    Article  PubMed  CAS  Google Scholar 

  • Tsubota K, Kawashima M, Inaba T et al (2010) The era of antiaging ophthalmology comes of age: antiaging approach for dry eye treatment. Ophthalmic Res 44:146–154

    Article  PubMed  Google Scholar 

  • Uchino M, Nishiwaki Y, Michikawa T et al (2011) Prevalence and risk factors of dry eye disease in Japan: Koumi study. Ophthalmology. doi:10.1016/j.ophtha.2011.05.029

  • Utine CA, Stern M, Akpek EK (2010) Clinical review: topical ophthalmic use of cyclosporine A. Ocul Immunol Inflamm 18:352–361

    Article  PubMed  CAS  Google Scholar 

  • Vivino FB, Al-Hashimi I, Khan Z et al (1999) Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome. Arch Intern Med 159:174–181

    Article  PubMed  CAS  Google Scholar 

  • Wilson SE, Stulting RD (2007) Agreement of physician treatment practices with the international task force guidelines for diagnosis and treatment of dry eye disease. Cornea 26:284–289

    Article  PubMed  Google Scholar 

  • Winfield AJ, Jessiman D, Williams A et al (1990) A study of the causes of non-compliance by patients prescribed eyedrops. Br J Ophthalmol 74:477–480

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization (WHO) (2011) 10 facts on ageing and the life course. http://www.who.int/features/factfiles/ageing/en/index.html. Accessed 3 Nov 2011

  • Yokoi N, Komuro A, Nishii M et al (2005) Clinical impact of conjunctivochalasis on the ocular surface. Cornea 24:S24–S31

    Article  PubMed  Google Scholar 

  • Yoo SE, Lee DC, Chang MH (2005) The effect of low dose doxycycline therapy in chronic meibomian gland dysfunction. Korean J Ophthalmol 19:258–263

    Article  PubMed  Google Scholar 

  • Yoon KC, Jeong IY, Park YG et al (2007) Interleukin-6 and tumor necrosis factor-α levels in tears of patients with dry eye syndrome. Cornea 26:431–437

    Article  PubMed  Google Scholar 

  • Yüksel B, Bozdag B, Acar M et al (2010) Evaluation of the effect of topical cyclosporine A with impression cytology in dry eye patients. Eur J Ophthalmol 20:675–679

    PubMed  Google Scholar 

  • Zoukhri D (2006) Effect of inflammation on lacrimal gland function. Exp Eye Res 82:885–898

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Conflict of Interest: none; Ethical standards: Informed consent – not applicable; Animal rights – not applicable.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fabiana Kimie Kashiwabuchi MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kashiwabuchi, F.K., Rodrigues, M.W., McDonnell, P.J. (2013). Dry Eye Syndrome in the Elderly: Challenges and Treatment Options. In: Scholl, H., Massof, R., West, S. (eds) Ophthalmology and the Ageing Society. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36324-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-36324-5_9

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-36323-8

  • Online ISBN: 978-3-642-36324-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics