To study the demographics and estimate the prevalence of dry eye among elderly Americans.

A population-based prevalence study was performed in 2,520 residents of Salisbury, Maryland, aged 65 years and older as of September 1993. The population was derived from the Health Care Financing Administration Medicare database. After completing a standardized questionnaire pertaining to dry eye symptoms, 2,420 subjects underwent Schirmer and rose bengal tests and anatomic assessment of the meibomian glands.

In this population, 14.6% (363/2,482) were symptomatic, defined as reporting one or more dry eye symptoms often or all the time; 2.2% (53/2,448) were symptomatic and had a low Schirmer test result (≤5 mm), and 2% (48/2,432) were symptomatic and had a high rose bengal test score (≥5). Furthermore, 3.5% (84/2,425) were symptomatic and had either a low Schirmer score or a high rose bengal score, and 0.7% (17/2,420) were symptomatic and had both a low Schirmer score and a high rose bengal score. No association of symptoms or signs was seen with age, sex, or race. Although anatomic features of meibomianitis were associated with the presence of symptoms (P = .01), 76% (67/88) of the individuals with these anatomic features were asymptomatic; 10.5% (260/2,480) reported that they currently use artificial tears or lubricants.

Symptoms and signs of dry eye are common among the elderly but were not associated with age, race, or sex in this population-based sample of elderly Americans. Extrapolating to the United States population aged 65 to 84 years, the study yields an estimate of 4.3 million who experience symptoms of ocular irritation often or all the time.