Dry eye after menopause

Dry eye syndrome is common among older Americans, and symptoms can range from mild and infrequent to constant and severe.  

And if you are a woman over age 50, your risk of dry eye problems is significantly higher than that of men your age. In a large study of aging adults published recently in American Journal of Ophthalmology, the prevalence of dry eyes (determined by self-reported frequency and intensity of dry eye symptoms by the study participants) was 17.9 percent among women and 10.5 percent among men.  

The exact role menopause plays in the development of dry eyes is not well understood, but many women who are beginning to experience menopause or who are post-menopausal suffer from dry eye symptoms.  

Hormone replacement therapy (HRT) used to treat menopause does not appear to reduce the risk of dry eyes. In fact, HRT may increase a woman's risk of dry eyes or worsen dry eye symptoms.   

Dry eyes are common in women after menopause.  In a study published in JAMA (the Journal of the American Medical Association), researchers found that post-menopausal women being treated with HRT had higher prevalences of dry eye syndrome than women of the same age who opted not to undergo HRT — 69 percent higher among women receiving estrogen alone, and 29 percent higher among those receiving estrogen plus progesterone or progestin. Also, the longer the duration of HRT, the higher the risk of dry eye syndrome among the study participants.  

The authors of this study concluded that the balance of sex hormones (i.e., estrogens and androgens) may be important in determining risk of dry eye syndrome, but that additional studies are needed to better understand this relationship. In the meantime, they recommended that women who are taking hormonal replacements for menopause or who are considering HRT should be aware of the potential increased risk of dry eye syndrome with this therapy.  

What Can You Do If You Are Older And Develop Dry Eyes? 

If you are nearing the age when menopause commonly occurs and have been diagnosed with dry eye, you may want to avoid laser vision correction surgery. Procedures such as LASIK and PRK can worsen dry eye problems.  

If you choose to have a refractive surgery consultation, be sure to tell your examining eye doctor about your dry eye condition. Your doctor can perform special tests to determine if your eyes are moist enough for laser vision correction.  

If you already have been diagnosed with dry eyes, make sure you are being treated appropriately for other conditions associated with both aging and dry eye, such as rheumatoid arthritis and thyroid autoimmune disease.  

Also, keep in mind that many medications required by adults over age 40 may cause or worsen dry eye problems. Examples include diuretics (often prescribed for heart conditions) and antidepressants.  

If you suspect a medications may be the underlying cause of your dry eye, be sure to discuss this with your doctor. It's possible that changing to a different medical treatment may be equally effective without causing dry eye problems.  

There are many causes of dry eyes that can affect people of all ages, including eye allergies and a variety of environmental factors.  

The first step in getting relief is to schedule an appointment to see your eye doctor for a thorough evaluation of your eyes and a discussion of any dry eye symptoms you may have. 

Though lubricating eye drops commonly are recommended for mild dry eyes, ask your doctor about the latest dry eye treatments and which one(s) might be best for you.