Apr 132012

Among the Elderly, dry eyes are a common problem. Untreated they can lead to infection and even permanent damage including blindness.

Our eyes normally produce a flow of tears that provide moisture to lubricate and clean the eyes for comfort and vision. Our tears also contain proteins and antibodies that help prevent infection. When our eyes do not produce enough tears we may experience pain, grittiness or feeling like something is in your eye, light sensitivity, itching, and blurring of vision.

Medications, dry air and other environmental factors, declining tear production and some medical conditions can all cause dryness. ¬†Sometimes the eyes will try to compensate by producing more tears until they are running down the face. Unfortunately these tears are mostly water and do not lubricate the eye. Not only is this annoying, your parent’s skin can become raw and painful from the constant moisture and wiping.

Artificial tears and lubricants are available over the counter and Restasis for chronic problems is available with a prescription. It may be necessary for the eye doctor to insert a plug (called punctal plugs) into the ducts that drain the eye to see if this will keep tears in the eye longer. Try a temporary one first to see if it works before having permanent ones placed. Usually this can be done in the office with little to no local anesthetic. See Punctal Plugs for more information.

There are times when your parent may have to use artificial tears episodically. When taking medications that dry out the mouth, such as antihistamines or diuretics, the eyes will become dry as well. If using more than one kind of eye medication, such as antibiotic drops or glaucoma drops, ask your health care professional (eye doctor, pharmacist, nurse) for the correct order of use and wait 5 -10 minutes between medication application. Wait at least 15 minutes after administration before putting in contacts. Many eye medications may cause blurred vision for a few minutes after application. Instruct your parent to avoid walking until their vision clears.

Extra care needs to be taken with eye medications to avoid infections. Only use medications that are manufactured and labeled for use in the eyes. Double check your bottle as many ear and nasal medications may have similar packaging. Store these medications separately.

Remove contacts and any makeup from the eyes. Wash your hands. To maintain sterility and avoid cross contamination do not let the tip of the dropper, bottle or tube touch the eye. If the dropper touches the eye, discard and get a new one. If the bottle tip touches the eye call your pharmacist about getting a replacement. (This is the recommendation. In reality, most people will just wipe the tip with alcohol. However, if the eye is infected, I would not use the medication in the unaffected eye.) Use a separate tissue to wipe each eye. Replace cap immediately. Never share eye medications! Ever!

Administering eye drops can be quiet challenging for caregivers and their parent’s alike. First, try having them rest their head against the back of a recliner or chair, tilting the head back slightly. Instruct them to roll their eyes upward as if trying to see the top of their head while you gently pull down on the lower lid and instill the drops. You may find it helpful to rest the hand holding the bottle on the bridge of their nose, their forehead or the finger holding down the eyelid.

It may also help to have them look upwards and to the side of the head opposite the eye being medicated. If your parent cannot keep their eyes open to put drops in, try this trick: have them lay down on their back and with their eyes closed, place a drop on the inside corner of your eye. Have them open their eye and the drops will flow into the eye. Blink to distribute the medication. When administering eye medication to someone who shuts their eyes so tight that you can not open them, have the person open their mouth wide. You can’t close your eyes as tight when your mouth is open. (I’ll wait why you try). There are also c

For best results, after applying eye drops, your parent should squeeze their eyes shut or squeeze the bridge of the nose near the inner corner of their eyes to prevent the medication from draining down the tear ducts. This also helps to keep the medication from entering the bloodstream which can cause changes in your blood pressure among other things, depending on the medication. (I had this happen to a patient and we could not figure out what was going on until his wife mentioned that he had seen the eye doctor recently and been started on a new medication for his glaucoma. Tell your doctor everything you take).

Another thing to note is the expiration date. Once they are open, eye medications should be discarded after a week, though if they have a preservative they can be kept up to four weeks, if stored properly. Ask your pharmacist. Many people use recently expired medications but I would never use expired eye medications. It’s really not worth the risk to your vision.

Caring for you elderly parent’s eyes isn’t difficult and a little extra care can prevent problems.




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  14 Responses to “Elderly Eye Care”

  1. Thanks for the heads up and the advice!

    Cherie Miranda
    Meditation Helps Reduce Background Noise

  2. I had no idea our tears contained proteins and antibodies. Talk about learning something new every day! Thanks for providing a wealth of knowledge through your blog.

    Thorne Smith – Topper

  3. Thanks for the advice. I’ll keep an “eye” out for my Mom [ 92 and still going strong ].

    Be Well.


  4. Again! Another informative Article! You are the Go-to Expert in this feild!

    Getting to Yes

  5. Suzanne, I just LOVE the tip about keeping the mouth open so the eyes can’t be shut so tightly – wonderful!

    EcoFriendlyMatters @ EcoFriendlyLink
    7 billion people – how to cope? The answer may surprise you!

  6. Suzanne,
    I really need to follow your advices about skin care. The problem is that I’ll do it for a while, and then just give up. Any tips about how to stick with it?
    Thank you

  7. My dad is 93 and I sometimes wonder if his itchy skin and water, red eyes are caused by stress, as nothing the doctor prescribes seems to help. What has been your experience, do this issues sometimes happen as a result of stress????
    Sonya Lenzo

    • Sonya,
      I am assuming they have ruled out allergies. I have heard of stress causing some people to itch, I can’t say I’ve ever seen it affect they eyes but it would not surprise me if that was the cause. Is your dad taking B vitamins? That sometimes helps with stress.


  8. Great tip / reminder that we all need to be aware of expiration dates on medications.

    Yours In Health!

    G.E. Moon II

  9. I know I have a hard time putting drops in my eyes by myself. It has to be more difficult trying to put them in someone else’s eyes. Thanks for the tips.

    Yours in Health!

    Dr. Wendy

  10. I have always been a little bit scared about eye caring not because my grandmothers are patient and nice! It is just me being scared! Any tips?

    Qué es la Ansiedad

  11. I am finding your blog to be very interesting.


  12. Phenomenal information, Suzanne,

    To me, the eyes are the most important and valuable asset and these tips will help to ensure they are properly cared for as I start getting up in years.

    Stay Amazing, Neil

  13. Great tip about lieing on the back with the eyes closed – thanks!

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