What to know about dry eyes and menopause

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Dry eye is a multifactorial condition, meaning a combination of factors can cause it.

It can affect anyone; however, research shows that dry eye occurs most frequently in females, particularly those going through menopause. This is because of the link between the condition and hormone levels.

Sex hormones influence the main mechanisms that keep the ocular surface of the eye stable; as such, hormones have involvement with:

• producing tears
• evaporating tears
• draining tears
• maintaining corneal epithelial cells
• maintaining the nerves behind the cornea
• maintaining the immune system of the eye

Sex hormones mostly play a role in dry eye in women experiencing perimenopause or menopause.

Other factors which may increase a person’s chances of developing dry eye include:

• thyroid disease
• diabetes
• Parkinson’s disease
• regular use of antihistamines
• laser eye surgery
• age

Dry eye causes changes in the structure of tears and lesions on the surface of the cornea, which can result in the following symptoms:

• visual discomfort
• visual disturbance, such as blurry vision
• pain
• burning
• itchiness
• redness
• tired eyes
• dry eyes
• light sensitivity

Dry eye symptoms can have adverse effects on a person’s overall quality of life, but treatments are available. Options include:

• over-the-counter (OTC) medication
• prescription medication
• alternative treatment

A doctor will generally decide the best treatment option by looking at what the person has already tried. They will usually suggest OTC medication before progressing to prescription treatment.

OTC medication

The first treatment method that a doctor is likely to suggest is lubricating eye drops. These are available at most drug stores.

If the eye drops do not work, a doctor may recommend using scleral contact lenses, which protect the cornea. They may also suggest using autologous serum tears, which work by mimicking natural tears.

Although easily accessible, OTC medication can cause adverse side effects if not used correctly. Always check the label and follow the instructions for use. Do not exceed the recommended dosage.

Prescription medication

If OTC options do not work, a doctor may prescribe anti-inflammatory medication. This may be immunomodulatory eye drops, such as Restasis (cyclosporine). Immunomodulatory eye drops work with the immune response to reduce inflammation on the surface of the eyes.

Alternatively, a doctor may offer corticosteroid, or steroid, eye drops. These also work by altering the normal immune function, preventing the response that causes inflammation.

Oral antibiotics are a way of reducing swelling around the eyelids, as they have anti-inflammatory functions. The swelling can interfere with the process of producing tears, restricting essential oils from mixing in.

In cases where dry eye becomes severe, eye surgery may be necessary.

Within the scientific community, there is some discussion about using hormone therapy to treat menopause-related dry eye. However, there is little research to show that the treatment is effective in reducing dry eye symptoms.

Learn more about treating dry eye permanently here.

Alternative treatments and home remedies

Alternative ways of treating dry eyes during menopause include the following:

• using a warm and moist compress
• taking herbal supplements, such as St. John’s wort
• increasing vitamin D intake
• participating in yoga and practicing mindful breathing techniques
• acupuncture
• wearing sunglasses when leaving the house
• reducing airflow, for example, avoiding sitting in front of a fan
• reducing screen time

Methods of managing menopause will depend on the symptoms, as the process affects people in different ways.

Guidelines from 2014 suggest that it is possible to control menopausal symptoms through diet. For example, women between 51–70 years should aim to consume six servings of grain products per day.

Indeed, a recent study found a Mediterranean diet, which consists of grains, delayed the onset of menopausal symptoms.

However, other research suggests that evidence for the association between diet and menopause is inconsistent and inconclusive.

Managing menopause will help to control hormone levels. This may reduce the severity of symptoms such as those affecting the eyes.

An eye doctor will be able to diagnose dry eye using slit-lamp bi-microscopy techniques. They may also use Schirmer’s test during a diagnosis. This is a method that checks to see if the eye is producing enough tears to maintain moisture.

Further complications can arise with dry eye, such as:

• eye infection
• scratches on the cornea
• difficulty seeing
• ulcers on the eyelid
• scarring on the eye

These complications may lead to vision loss. If a person thinks they are developing any complications, they should seek medical help from a doctor.

The following practices can reduce the risk of developing dry eye:

• staying hydrated
• getting plenty of sleep
• using regular eye drops
• consuming omega-3 fatty acids
• minimizing exposure to irritants, such as dust
• maintaining a humid environment at home
• reducing time on electronic devices

Below are some commonly asked questions about menopause and dry eyes.

How can a person treat dry eyes during menopause?

A person experiencing dry eyes during menopause can treat them with over-the-counter eye drops. If eye drops do not work, a doctor may prescribe anti-inflammatory medication.

Can low estrogen cause dry eyes?

Estrogen’s impact on dry eyes is complicated. During menopause, women experience a decline in estrogen levels which may potentially worsen dry eye symptoms. However, more research is needed to understand how hormones interact with ocular structures in dry eye.

What are the worst menopause symptoms?

Menopause can feel different for everyone. Some symptoms of menopause include:

• a cessation of periods
• brain fog
• hot flushes
• difficulty sleeping

According to a 2016 study, however, symptoms noted to have a greater negative association with menopause are:

• mood symptoms
• vaginal itching
• weight gain
• breast tenderness
• fatigue

What vitamin deficiency causes dry eyes?

Research suggests that a deficiency in the following vitamins may cause or worsen symptoms of dry eyes:

• vitamin A
• vitamin D
• vitamin B12
• omega 3

Menopause is when the menstrual cycle ends. During menopause, the balance of sex hormones in the body changes, which can cause various symptoms to develop. The type and severity of symptoms differ between individuals.

Dry eye is a condition that can result from hormonal changes caused by menopause. It can be extremely uncomfortable, causing symptoms that include burning and itching sensations, and it may cause visual impairment.

There are various treatment options for dry eye, ranging from lubricating eye drops to eye surgery, depending on the severity of the condition. If a person develops symptoms, they should see an eye doctor for a diagnosis and treatment plan.