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Aims/Purpose: To determine the association between dry eye with higher order aberrations (HOAs) and contrast sensitivity in 60 years old people and over. Methods: This population‐based study was conducted in Tehran, the capital of Iran, using stratified multistage random cluster sampling. All participants underwent complete ocular examination including measurement of uncorrected and best‐corrected visual acuity, refraction, slit‐lamp biomicroscopy. Zywave was used for measuring HOAs aberrations. Contrast sensitivity was measured with best correction visual acuity using the CVS1000 grating charts. Schirmer and tear break‐up time (TBUT) tests were used for evaluating dry eye in participants. Results: After applying exclusion criteria, the data of 397 individuals were analysed. A total of 415 people were invited, of whom 397 (62.8%) were females. The mean age of the participants was 68.32 ± 5.49 years. After adjusting with age and sex, in the multiple regression model that the TBUT test has a direct association with spherical aberration (p = 0.017) and an inverse association with coma, trefoil and the third, fourth and fifth order aberrations (p < 0.05). Schirmer test results also had a positive relationship with spherical aberration (p = 0.046) and an inverse relationship with coma, trefoil and the third, fourth and fifth order aberrations (p < 0.05). Contrast sensitivity had a significant association with Schirmer test result only in spatial frequency of 3CPD. Conclusions: The results of this study indicated the association between dry eyes and HOAs, and that the TBUT and Schirmer test results are of the most important factors in this relationship. Treating dry eye, can improve HOAs and quality of vision in elderly people. [ABSTRACT FROM AUTHOR]