Dry Eye in Seniors: Why Your Eyes Burn, Feel Gritty, and Water, and What Actually Helps
Do your eyes ever feel like there is sand in them? Burning, stinging, scratchy, “gritty” eyes are one of the most common reasons seniors book an eye exam. Dry eye can make reading uncomfortable, worsen vision quality, and turn simple daily tasks like watching TV or driving into a frustrating experience.
Many people assume dry eye means you do not make enough tears. The truth is more nuanced, and that is good news, because once you know the cause, you can treat it more effectively.
This guide explains what dry eye is, why it is so common in older adults, what symptoms to watch for, and the practical steps that bring real relief.
What is dry eye?
Dry eye disease happens when your tear film does not protect your eyes properly. Healthy tears are not just “water.” They are a balanced blend of:
An oily layer (slows evaporation)
A watery layer (provides moisture)
A mucus layer (helps tears spread evenly)
If any part of that system is off, your eyes can feel dry, irritated, or blurry even if you have tears.
Common dry eye symptoms in seniors
Dry eye symptoms can look different from person to person. In older adults, the most common complaints include:
Burning or stinging eyes
A gritty or sandy sensation
Feeling like something is in your eye
Redness that comes and goes
Watery eyes (yes, this can still be dry eye)
Light sensitivity
Blurry vision that improves after blinking
Discomfort with reading or screens
Contact lens intolerance (for those who still wear them)
If you notice symptoms that are getting worse, or that are affecting reading, driving, or comfort, it is worth getting assessed. Dry eye is treatable, but it often needs more than “just use drops.”
Why dry eye is more common as we age
Dry eye becomes more common in seniors for several reasons.
1) Tear production can decrease with age
Your eyes may simply produce less of the watery portion of tears over time.
2) Eyelid oil glands can get blocked
Many seniors have meibomian gland dysfunction, which means the tiny oil glands along the eyelid margins do not release enough oil. Without that oil, tears evaporate quickly, leading to burning and grittiness.
3) Eyelid position and blinking changes
As eyelids age, they may not close or blink as efficiently. Incomplete blinking leaves part of the eye exposed, which increases dryness.
4) Medications can contribute
Several common medications can worsen dryness, including certain blood pressure medications, antidepressants, antihistamines, and others. Do not stop any medication on your own, but do mention your medications to your eye care provider, because it helps guide treatment choices.
5) Indoor environments are tough on the eyes
Forced air heating, air conditioning, fans, and low humidity can all increase tear evaporation, especially in winter.
The watery eye surprise: why dry eyes can cause tearing
One of the most confusing dry eye symptoms is excessive tearing. When the surface of the eye gets irritated and dry, the body sometimes triggers a reflex response and produces a rush of watery tears. These tears are often poor quality and do not stay on the eye long enough to help. People describe it as, “My eyes are watering all the time, so how can they be dry?”
This is common, especially in seniors, and it is a clue that the tear film is unstable.
What makes dry eye worse for seniors
If your symptoms flare up in predictable situations, these are common triggers:
Reading for long periods without breaks
Watching TV without blinking regularly
Spending time in heated or air conditioned rooms
Driving with vents blowing toward the face
Windy outdoor conditions
Dusty environments
Certain seasonal allergies
How an optometry dry eye assessment helps
Dry eye is not one single condition, so the best results come from identifying the main driver for you. A dry eye evaluation commonly looks at:
Eyelid margins and oil glands
Tear film stability and quality
Ocular surface irritation
Signs of inflammation
Eyelid closure and blink quality
For seniors, this matters because treatment is often more effective when it targets the correct cause. Someone with oil gland blockage will benefit from different strategies than someone with low tear production.
Dry eye treatment options that actually work
Dry eye relief is usually a combination plan, not a single product. Here are the most effective steps, starting with the simplest.
1) Use the right artificial tears
Not all eye drops are the same. Many seniors do best with preservative free lubricating drops, especially if you use them more than 4 times per day. Preservatives can irritate the surface when used frequently.
Tips:
Keep drops where you will use them, like beside your chair or on your bedside table
Use them before symptoms get severe, not only when eyes are already burning
2) Warm compresses and eyelid hygiene
If your oil glands are blocked, heat can help soften the oils so they flow better. A warm compress over closed lids for 5 to 10 minutes, followed by gentle lid massage, can make a big difference.
Consistency matters. For many seniors, this becomes part of a daily routine, like brushing teeth.
3) Adjust the environment
Small changes often create big comfort improvements:
Aim car vents away from your face
Use a humidifier during winter
Take breaks during reading and TV time
Wear wraparound sunglasses outdoors to block wind
4) Address inflammation when needed
Some dry eye cases have significant inflammation. In these cases, your optometrist may recommend prescription drops or other therapies to calm the ocular surface and improve tear quality. This can be especially helpful for seniors whose symptoms have become chronic.
5) Consider in office treatment options
If home care is not enough, there are in office procedures that target the eyelid oil glands and tear film stability. These can be a good option for seniors who have persistent burning and grittiness despite using drops.
The right procedure depends on your eye findings, not just symptoms.
6) Review medications and overall health
If medications are contributing, your eye care provider can often adjust the plan to compensate. Sometimes coordination with your family doctor is helpful, particularly if you have dry mouth as well as dry eyes.
When dry eye symptoms need urgent attention
Most dry eye is not an emergency, but you should seek prompt care if you have:
Eye pain that is significant or worsening
Sudden light sensitivity
A big change in vision
Thick discharge
A very red eye that does not settle
These symptoms can indicate something beyond routine dry eye.
How long does treatment take?
Many seniors feel some improvement quickly with better drops and a good routine, but lasting improvement often takes several weeks. Dry eye is a surface health condition, and the eye surface needs time to stabilize. The goal is steady comfort, less burning, fewer flare ups, and clearer vision between blinks.
Dry eye and quality of life in seniors
Dry eye is not just annoying. It can affect reading enjoyment, social activities, and confidence with night driving or bright environments. The good news is that seniors respond very well to structured treatment when the cause is identified and the routine is practical.
Book a dry eye focused eye exam
If your eyes burn, feel gritty, water excessively, or your vision fluctuates, you do not need to “just live with it.” A dry eye assessment can identify what is driving your symptoms and build a plan that fits your daily life.