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RESEARCH PRODUCT

Presbyopia and the aging eye: Existing refractive approaches and their potential impact on dry eye signs and symptoms.

subject

description

Every part of the human body is subject to aging, including the eye. Increased prevalence of dry eye disease with age is widely acknowledged: aging threatens ocular surface homeostasis, altering the normal functioning of the lacrimal functional unit and potentially leading to signs and symptoms of dry eye. Parallelly, two additional degenerative processes take place within the crystalline lens, leading to presbyopia and cataractogenesis. With continuously increasing life expectancies both conditions are expected to impact society further. Correction strategies for presbyopia and cataracts either directly or indirectly challenge ocular surface additionally. On one hand, contact lens presbyopic correction has gained many adepts in recent years. Contact lenses disturb the normal structure of the tear film and interact negatively with the ocular surface eventually initiating the closed loop of inflammation vicious circle, similarly to dry eye. On the other hand, cataract and corneal refractive surgeries sever corneal nerves and disrupt corneal epithelium and ocular surface, further inducing dryness. In the present review we address the invasive nature of the different contact lens and refractive surgery correction strategies. In addition, we deeply discuss how contact lenses, cataract surgery and various types of corneal refractive surgical strategies play a role in inducing/worsening signs and symptoms of dryness in an aging population.