Because advancing age is a major risk factor for dry eye disease (DED), researchers have now investigated its impact on the ocular surface to determine the optimal prognostic cut-off ages for clinical markers of DED, aqueous tear deficiency and meibomian gland dysfunction.

The prospective registry-based cross-sectional study included 1,331 community residents (785 females and 546 males between the ages of 19 and 57). Each participant underwent evaluation for dry eye symptoms, ocular surface characteristics and tear film quality during a single clinical session.

There were significant positive associations between aging and clinical markers for DED. The researchers identified the optimal prognostic cut-off ages:

Clinical Markers

Optimal Prognostic Cut-off Age

Meibomian gland dysfunction Third decade of life (24 to 29 years)
Tear film instabilityFourth decade of life (31 to 38 years)
Aqueous tear deficiencyFifth and sixth decades of life (46 to 52 years)

The researchers found that signs of meibomian gland dysfunction appeared earlier in the natural history of disease progression. They added that “the brief delay prior to the development of other clinical dry eye signs might represent a window of opportunity for preventative interventions in the young adult age group.”

Wang M, Muntz A, Kim JS, et al. Ageing and the natural history of dry eye disease: A prospective registry-based cross-sectional study. The Ocular Surface. August 3, 2020. [Epub ahead of print].