An illustration of an open eye and a closed eye

T he eyes may be the windows to the soul, but those windows can ­become dry, swollen, red, and itchy with age.

“Most older adults realize they’re at risk for serious eye diseases such as cataracts, glaucoma, and macular degeneration but often don’t realize they’re also more likely to develop other conditions, such as dry eye or eyelid inflammation, that can affect their vision, as well as just plain make them miserable,” says Craig See, MD, a cornea specialist at the Cleveland Clinic Cole Eye Institute.

Here’s how to recognize and treat four common eye conditions.

Dry Eye

Difficulty producing the necessary amount or quality of tears to keep eyes lubri­cated affects almost 20 percent of older adults. “As we age, tear glands naturally stop making tears, and oil glands also slow down, which can cause problems with tear quality,” See says. Older adults may also be more likely to have diseases, such as type 2 diabetes, that dry eyes. A blocked tear duct can dry eyes as well.

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Spot the signs: Eyes may be red and feel dry, burning, and gritty, or as if there’s a foreign object in them. You may be light-sensitive or have blurred vision.

Treat it right: You can first try over-the-counter (OTC) preservative-free artificial tears, says ophthalmologist ­Natasha Herz, MD, clinical spokesperson for the American Academy of Ophthalmology. Also, avoid excess heat, which can dry eyes, and consider using a humid­i­fier in the bedroom in winter.

If symptoms don’t improve in about three weeks, see your eye doctor. Prescription eye drops, such as cyclo­sporine (Restasis), might help ­increase tear production. If a tear duct is blocked, your doctor can perform a laser treatment or an outpatient surgical procedure called punctoplasty, says Angie Wen, MD, an ophthalmologist at New York Eye and Ear Infirmary of Mount Sinai.  

Blepharitis

The eyelid redness and swelling of blepharitis is more common in people older than 50. Bacteria or allergic skin conditions may be behind this inflammation of the eyelids, but another culprit could be skin mites, which can live in eyelashes.

Spot the signs: Symptoms include eye redness and a gritty feeling; red, swollen, itchy eyelids; and crust on your eyelashes when you wake up, Herz says.

Treat it right: Place an OTC heated eye mask on your eyes for 5 minutes two to four times a day, See says. (Test it on the back of your hand before use, to ensure that you don’t burn your eyelids.)

Each morning, gently clean eyelids and lashes with a mix of warm water and a drop of baby shampoo on a clean washcloth. If you see no improvement after a week or two, your eye doctor can prescribe an antibiotic cream or ointment. 

Sties and Chalazia

Both are marked by red lumps on the eyelids, but a sty occurs when a hair follicle or small gland on the edge of the eyelid gets infected and a chalazion is caused by oil gland blockage. Older adults may be more susceptible because they may be more likely to experience conditions, such as blepharitis, that can introduce bacteria into the eye, Wen says.

Spot the signs: Chalazia tend to occur only on the upper eyelids; sties can show up on lower eyelids, too. Sties are painful, but chalazia usually are not.

Treat it right: For both, apply dry heat for 5 to 10 minutes, two to three times a day, Wen says. Don’t squeeze or pop, which can cause infection. See an eye doctor if lumps don’t subside after a couple of weeks. A sty may require antibiotics, and a chalazion may need to be drained. 

Pink Eye

Pink eye, or conjunctivitis, is usually ­viral. But allergies, irritants such as chlorine and smoke, or a bacterial infection can be to blame, too. Pink eye may be a symptom of COVID-19, so alert your doctor right away. This is especially important if you also have well-known COVID-19 symptoms like fever, cough, and loss of taste and smell.

Spot the signs: Red eyes that may be itchy and painful.

Treat it right: Usually, pink eye can be treated at home with cold compresses and OTC artificial tears to relieve pain and itching, See says. Because it’s very contagious, don’t share towels, cosmetics, or bedding, and wash your hands frequently with soap and water to prevent spread.

It should ­resolve on its own within one to two weeks. But if it persists beyond that, or if you experience a thick, yellow-green discharge; light sensitivity; or vision trouble, call your eye doctor as soon as possible, See says. He or she can check for bacterial conjunctivitis or a problem such as a corneal ulcer, an open sore on your cornea. 

Editor’s Note: A version of this article also appeared in the February 2021 issue of Consumer Reports On Health