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Some people with age-related macular degeneration (AMD) also experience dry eyes. The two are among the most common eye problems associated with aging. But what’s the connection?
Can dry eyes cause macular degeneration? Fortunately, dry eye does not appear to increase the risk of dry AMD, and dry AMD does not appear to increase the risk of dry eye. However, the conditions share some age-related biological processes, which may help explain why they can occur together.
Read on to learn more about the differences between them, what symptoms may occur with both, and how to live with dry eye syndrome and macular degeneration.
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Both AMD and dry eye are more common in people over 50 years old, but they are distinct conditions. AMD affects the retina, while dry eye disease (also called dry eye syndrome) affects the surface of the eye.
AMD affects the macula, the center of the retina, and can cause central vision loss. In dry AMD (the more common type), protein deposits called drusen develop under the macula. In wet AMD, abnormal blood vessels develop under the retina and leak blood and fluid, and this type can cause rapid vision loss while vision loss with dry AMD is usually gradual.
Dry eye disease happens when your tears don’t provide enough moisture and lubrication. It can cause discomfort and blurry vision. If severe dry eye is left untreated for a long time, it can damage the eye’s surface and may lead to vision loss.
Dry eye can result from decreased tear production or increased evaporation or from a tear film that doesn’t have the right balance of oils, fluid, and mucus.
Some risk factors for AMD overlap with factors that can affect dry eye. These include:
Dry eye and AMD can both contribute to the following visual symptoms:
Although dry eye and AMD do not cause one another, research suggests they may share some of the same age-related biological pathways. Aging is associated with processes that affect both tear production and retinal health. These include the following:
As we age, harmful molecules called reactive oxygen species can build up in eye tissues. This oxidative stress can damage cells and promote inflammation.
In dry eye, antioxidant defenses in the tear film can become overwhelmed.
In AMD, oxidative damage and inflammation can promote drusen formation and damage to light-sensing retinal cells.
Telomeres, DNA-protein “protective caps” at the ends of chromosomes, shorten as we age. Oxidative stress can contribute to faster shortening. When telomeres become critically short, cells can stop dividing and release inflammation-promoting proteins.
Several studies have linked shorter telomeres with increased AMD risk. Researchers have not established that telomere shortening causes dry eye. However, the same oxidative stress and inflammation may contribute to aging in the glands that produce tears.
Because dry eye and AMD share some age-related biology, researchers have studied whether certain nutrients in the diet or in supplements might support eye health. Some nutritional strategies may support both conditions, but the evidence depends on the nutrient and condition.
Antioxidants help neutralize free radicals. Lutein and zeaxanthin are concentrated in the macula, and both are found in high concentrations there. Our bodies do not produce them on their own.
For certain people with AMD, AREDS 2 research has shown that a specific supplement formula containing lutein and zeaxanthin, other antioxidants, and minerals can slow progression to advanced AMD.
Foods rich in lutein and zeaxanthin include cooked kale and spinach, broccoli, peas, squash, and egg yolk.
Omega-3 fatty acids have anti-inflammatory properties. They also contribute to cell membranes in the eyes and support visual function.
One study found that six months of supplemental gamma-linolenic acid (GLA, an omega-6 fatty acid) plus omega-3 fatty acids improved eye irritation symptoms and maintained corneal surface smoothness in people with postmenopausal dry eye.
Natural sources of omega-3 fatty acids include chia seeds, walnuts, flaxseed, and fatty fish like salmon and mackerel. Healthy sources of omega-6 fatty acids include sunflower seeds, peanut butter, egg yolks, cashews, and tofu.
If you are living with both AMD and dry eye, it may feel overwhelming to manage both. You’re not alone. Talk with your optometrist and ophthalmologist about all of your eye symptoms, whether they are related to AMD, dry eye, or both.
In one study of people with stable dry AMD, treating dry eye improved vision-related quality of life while the underlying AMD remained stable.
On myAMDteam, people share their experiences with age-related macular degeneration, get advice, and find support from others who understand.
How do you address dry eye with AMD? Let others know in the comments below.
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