Aging Changes of the Lacrimal System

Question 1

Due to age, what two factors can cause a decrease in miebum secreted by the meibomian glands?

Answer 1

Keratinization of the meibomian gland ducts resulting in meibomian gland drop out. pt’s will complain of dry eyes due to tears evaporating at a quicker rate since lipids are no longer there.

Decrease in sex hormones (androgen and testosterone), especially in women after menopause.

Question 2

How do corneal and conjunctival nerves change with age?

Answer 2

With age, the number of nerves branched from CN IV will decrease. Due to less sensory interaction, there will be less reflex tearing and less basal tearing after blinking.

Question 3

Lacrimal gland duct fibrosis

Answer 3

Deposition of collagen in the lacrimal gland duct. This results in scarring and can cause occlusion.

Question 4

What may be the case of poor tear drainage/tears running down face?

Answer 4

Eversion of lower puncta.