How can hormonal changes and menopause impact dry eye?

Specific hormones play an important role in the development of dry eye in women of menopausal or post-menopausal age, due to their influence on the production of various components of tears. Survey results from women of menopausal or post-menopausal age showed there is a lack of understanding about their risk of dry eye.

  • 3 in 4 (75%) women of menopausal or post-menopausal age surveyed weren’t aware they were most at risk of dry eye.
  • More than 2 in 5 (42%) women of menopausal or post-menopausal age didn’t know what groups are most at risk of suffering from dry eye, despite being the most at risk themselves.

Mr Sai Kolli, Consultant Ophthalmic Surgeon, Cornea, Cataract & Refractive Surgery, University Hospitals Birmingham NHS Foundation Trust

"Dry eye is associated with many different diseases, such as rheumatoid arthritis, Sjögren’s syndrome, thyroid disease, systemic lupus erythematosus, as well as Parkinson’s disease and diabetes. There are several commonly used medications that are also known to increase the risk of dry eye, including certain medications for allergies, blood pressure and nasal congestion, as well as antidepressants. A simple change of treatment may improve the severity of dry eye."

Glaucoma

Dry eye in people with glaucoma is common. In fact, studies suggest that 50-60% of people who are being treated for glaucoma also have dry eye.

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Ms Laura Crawley, Consultant Ophthalmic Surgeon & Glaucoma Specialist

"Despite having dry eye, people on glaucoma treatment often find that their eyes water or tears run down the side of their face. This is because of an imbalance in the tears’ oil-to-water ratio caused by blocked oil glands, which can lead to insufficient nourishment and protection of the surface of the eye. Dry eye treatment is vital for these glaucoma patients. Using a lubricant or artificial tear regularly to smooth and soothe the dry surface of the eye will improve vision and reduce the gritty feeling. This then makes it easier to apply and tolerate glaucoma treatment. Like a lip salve or a hand cream, using a treatment before the eyes become very sore helps to keep them in better condition. Keeping a treatment by the bed is a useful tip as the eyes tend to feel most dry first thing in the morning."

Sjögren’s syndrome

Sjögren’s is a condition that usually affects areas of the body that produce fluids, such as tears and saliva. But other parts of the body, such as nerves and joints, can also be affected. As a result of this disruption, certain glands stop working, leading to dry eyes and other bodily dryness, including dryness of the mouth and skin.

Thyroid disorders

There are two main thyroid disorders: Graves’ disease, which causes the thyroid to make too many hormones, and Hashimoto’s thyroiditis, which causes low levels of hormones. Dry eye is most common in those with Graves’ disease but all patients with thyroid disorders can experience issues due to reduced moisture in the eye.

References

  1. Peck T et al. J Midlife Health 2017;8(2):51-54
  2. Santen survey. Data on file 2020
  3. Glaucoma UK. Dry eye. Available at: https://glaucoma.uk/about-glaucoma/dry-eye/ Last accessed October 2020
  4. The British Sjögren’s Syndrome Association (BSSA). Sjögren’s Syndrome information sheet. Available at: https://www.bssa.uk.net/pdfs/information-sheet.pdf Last accessed October 2020
  5. Web MD. Dry Eyes and Thyroid Disorders. Available at: https://www.webmd.com/eye-health/dry-eyes-thyroid Last accessed October 2020
Document number: PP-CATION-UK-0065. Date of preparation: November 2020