Risk only increases with age
It may feel like just a little irritation, but untreated dry eye syndrome can cause lasting damage. Millions worldwide suffer from it without realising, and Rambam experts warn the risk only increases with age.
Dry eye syndrome isn’t just “having dry eyes.” It’s a chronic condition in which the eyes do not produce enough tears, or the tears evaporate too quickly. Beyond discomfort, it can blur vision, damage the cornea, and in severe cases, threaten sight. Rambam ophthalmology experts emphasise that understanding who is at risk and recognising symptoms early is essential for effective treatment.
With every passing decade, the prevalence of dry eye increases by roughly ten percent. Professor Michael Mimouni, director of the Cornea Unit in the Department of Ophthalmology at Rambam Health Care Campus and clinical associate professor at the Technion – Israel Institute of Technology, explains: “In younger people, as many as 20–40% may already experience symptoms. As we age, the condition becomes increasingly common, and by age 60 or 70, some two thirds of the population are affected.”
Mimouni explains the physiology behind dry eye. “There are around 20 to 30 Meibomian glands in the eye, which produce a lipid layer that protects the tearing mechanism. As people age, these glands are less effective, leading to tear evaporation and dry eyes.”
Who is at risk?
Mimouni explains that people with diabetes are especially vulnerable because they may not feel the dryness. “Just like they don’t feel a leg wound, they don’t feel one on the cornea,” says Mimouni. This can cause serious complications, corneal damage, and in rare cases, necessitate a corneal transplant. Autoimmune diseases such as Sjogren’s, arthritis, psoriasis, thyroid disorders, and Crohn’s, also raise risk. Other factors that can make symptoms worse include mental distress, anxiety, long hours at screens, and even air conditioning, which reduces humidity, with a negative effect on already dry eyes.
Other experts also warn that psychiatric medications and glaucoma drops may worsen the condition. Mimouni concurs, pointing out that even essential medications can trigger dry eye symptoms: “There is a wide range of biological drugs used to treat autoimmune diseases and cancer, which often cause dryness.” These drugs may interfere with tear production or damage the ocular surface, making patients more susceptible to discomfort and irritation.
Causes and Treatment
In older adults, malfunctioning Meibomian glands are one of the primary causes of dry eye. In younger people, contact lens use, workplace stress, laser eye surgery, and allergies are more common factors. Treatment may include warm compresses, eyelid hygiene, and preservative-free artificial tears. For insufficient tear production, artificial tear substitutes or autologous serum eye drops (from the patient’s own blood) can restore moisture. Adjusting the environment by using humidifiers, taking screen breaks, or reducing makeup around the eyes can also help.
Glaucoma patients face a unique challenge because many medicated eye drops contain preservatives that worsen dryness. Switching to preservative-free alternatives can make a big difference.
Practical Advice
Professor Mimouni recommends the 20-20-20 rule: every 20 minutes, look at something 20 feet (seven meters) away for 20 seconds. Positioning screens slightly below eye level and consciously blinking more often can also reduce evaporation.
“There is no magic solution.” Mimouni emphasises. “Dry eye requires ongoing, personalised care. With proper treatment and follow-up, symptoms can be reduced and complications prevented.”
