Characterised by a lack of sufficient lubrication and moisture on the surface of the eye, dry eye is a prevalent condition that significantly affects quality of life¹

Dry eye disease can lead to various symptoms including irritation, redness, discharge, and visual disturbances.^1,2,3 Prevalence varies across different genders and age groups and is more commonly observed in older adults and women, especially post-menopausal women.³

PREVALENCE AMONG DIFFERENT DEMOGRAPHICS

• Gender differences: Research indicates that dry eye disease is more prevalent in women than in men.⁴ Hormonal fluctuations, particularly oestrogen and androgen, play a significant role in this disparity.³ Oestrogen can influence the lacrimal gland, which is responsible for producing tears,⁵ and androgen deficiency has been linked to the dysfunction of the meibomian glands in the eyelids, crucial for tear stability.⁶
• Age differences: Age is a significant risk factor for dry eye disease.^3,4 As people age, the production of tears decreases, and the tear film's stability is compromised. The prevalence of dry eye disease increases notably after the age of 50. This is partly due to general health decline and the increased incidence of comorbidities such as diabetes and rheumatoid arthritis, which are linked to higher rates of dry eye.⁷

OLDER ADULTS AND POST-MENOPAUSAL WOMEN

• Older adults: The tear film is composed of three layers: lipid, aqueous, and mucous. Each component plays a vital role in maintaining eye health.⁸ In older adults, there are changes in the composition of these layers, often exacerbated by systemic medications that affect tear production, such as antihistamines and antidepressants.¹ Additionally, age-related eyelid changes can lead to increased tear evaporation, further aggravating dry eye symptoms.⁹
• Post-menopausal women: For women, menopause marks a significant risk period for developing dry eye disease. The decrease in androgen and oestrogen levels during menopause directly affects the ocular tissues involved in tear production and regulation. Studies have shown that post-menopausal women report higher rates of dry eye symptoms compared to pre-menopausal women and men of the same age group.^4,10

Understanding the demographic differences in dry eye prevalence helps in tailoring more effective treatment and management strategies. Recognising these variations is crucial in advising and managing care for patients with dry eye disease, especially in older adults and post-menopausal women. Pharmacists can guide patients in selecting suitable OTC products and advise on the potential benefits of systemic treatments like hormone replacement therapy.