Hormone level changes due to growth and development or disease can lead to various eye health issues. Eye changes occur during puberty and menopause, as well as due to low thyroid hormone levels.

A hormone is a vital chemical that travels to organs and tissues to trigger actions in cells. Hormones help regulate vital functions, including hunger, sexual development, blood sugar management, and sleep.

Their levels rise and fall as a natural part of long-term development and in response to conditions and diseases. Hormonal imbalances can contribute to various health concerns, including those affecting the eyes.

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Changing levels of several hormones can affect eye health. According to a 2022 review, researchers have found receptors that recognize and respond to sex hormones all the way through the eye, including:

  • the tear ducts
  • the meibomian glands, which keep the eyelids lubricated
  • the conjunctiva, which keeps the eye moist by making mucus and tears
  • the cornea, or the eye’s outer surface
  • the lens, which allows people to focus on objects at different distances
  • the retina, the layer of cells at the back of the eye that detects light
  • the choroid, where blood vessels bring nutrients and oxygen to the eye

Natural hormonal processes, including the drop in estrogen during menopause and the release of growth hormone to stimulate growth during puberty, can affect vision. Eye problems can also develop due to hormonal disorders, such as thyroid eye disease.

A child’s vision may change as their eyes grow, and increased growth hormone levels play a key role in triggering growth throughout puberty. The eyes grow considerably during a child’s first 2 years and go through another growth spurt during puberty, reaching their final adult size of around 24 millimeters.

According to the American Academy of Ophthalmology, as the eyeball gets longer, nearsightedness may develop, which can lead to blurry vision. However, this tends to self-correct as growth hormone levels stabilize. Eye doctors recommend that children undergo a yearly eye test to address any vision needs during and after this time.

In particular, changing levels of female sex hormones, such as estrogen and progesterone, can affect the oil glands, causing dry eyes. They can also make the cornea less stiff, changing how light enters the eye and leading to blurred vision. Androgens, including testosterone, might also have links to dry eye disease, per the above 2022 review.

In a 2021 study, 76.4% of the females in the sample had dry eye around the time of menopause, and 80% of females had dry eye symptoms after menopause. During menopause, fluctuating hormones may change the eye’s shape, making contact lenses less comfortable to wear.

Other eye problems with a direct link to sex hormones include:

  • cataracts, which can cause cloudy vision, reduced night vision, sensitivity to glares, dulled colors, and double vision
  • glaucoma, which leads to increased pressure in the eye due to optic nerve damage, risking vision loss and blindness
  • other optic nerve disorders, such as Leber hereditary optic neuropathy and demyelinating optic neuritis
  • disorders of the cornea

The thyroid is a small, butterfly-shaped gland in the neck that releases hormones that play a crucial role in how the body uses energy and how quickly the heart beats. Certain conditions or autoimmune disorders can affect how much thyroid hormones the gland can produce.

A condition called Graves’ disease involves the immune system incorrectly attacking healthy thyroid tissue, reducing thyroid hormone output. It commonly affects the skin and the eyes, and Graves’ eye disease develops in around one-third of all people with Graves’ disease. The immune system might also attack tissues behind the eyes.

This can lead to the following symptoms:

  • bulging eyes
  • dry, irritated eyes
  • a sensation of grit in the eye
  • eyelids that do not fully close or pull back more than normal
  • increased light sensitivity
  • eye pain
  • eye pressure
  • finding it difficult to look around
  • vision loss due to possible swelling putting pressure on the optic nerve

Symptoms often affect both eyes but may only affect one. They often resolve without treatment after 1 to 2 years.

Vision changes during puberty or menopause are normal. However, the following symptoms or vision changes warrant a visit to an eye doctor or ophthalmologist, as they could be caused by hormone issues or other health concerns:

  • bulging eyes
  • a dark smudge at the outer edge of the vision
  • vision loss, even if it does not last long
  • visual distortions
  • double vision
  • excessive tearing or watering
  • colored circles forming around lights, also known as halos
  • loss of side vision
  • floaters
  • flashes
  • eye pain
  • red eye

People should visit an eye doctor or ophthalmologist if any of the above symptoms develop or vision changes happen suddenly. They can provide medications such as eye drops for dry eye, rule out other serious eye problems, or change prescriptions for contact lenses or glasses if they are no longer suitable or comfortable.

If an ophthalmologist feels that hormone changes or issues are responsible for vision problems, they may refer an individual to their physician or endocrinologist to check their hormone levels.

Hormones may contribute to vision problems. Growth hormones can lead to nearsightedness during puberty, sex hormone changes often cause dry eye and other eye issues throughout and after menopause, and low thyroid hormone levels have links to Graves’ eye disease.

People with dry eyes, irritation, pain, pressure, or vision changes should speak with an ophthalmologist for an eye exam. A physician may also need to test for hormonal changes.