To mark World Menopause Day (18 October 2023) we’re taking a look at how the menopause can affect your eye health.
There’s a huge array of symptoms linked to the menopause, but few women make a connection between their fluctuating hormones and their eye health. In fact, research, conducted by Eye Health UK in collaboration with Thomas Pocklington Trust, found a whopping 86 per cent of women were unaware there was a connection between the two, despite ‘the Change’ being said to trigger conditions such as Dry Eye syndrome, Glaucoma and Cataracts.
Hormonal Dry Eye (HDE)
According to the Society for Women’s Health Research, almost two thirds (61%) of menopausal women suffer from dry eyes.
Changing hormone levels can affect all three layers of the tear film, reducing the quantity and quality of your tears and increasing the risk of evaporation. It is often associated with drier eyes and irritation.
Symptoms commonly experienced by sufferers of HDE include: dryness, burning, a gritty sensation that gets worse throughout the day, blurred vision, tearing, and more sensitivity to light.
Even mild HDE symptoms can have a negative effect on your physical and emotional wellbeing so it’s important to seek clinical advice if you notice any signs of the condition.
Speak to your local optician/optometrist or pharmacist. Dry Eye can also be detected during a routine sight test, so make sure you are up to date with your regular eye tests.
Treating Dry Eye is relatively straightforward. Your optometrist can advise on, and supply, a range of artificial tears and eye ointments to soothe and lubricate the eye.
Over-the-counter sprays that help re-establish the film of tears and prevent loss of moisture are also available from most pharmacies. A warm compress can also be used to relieve symptoms.
In severe cases, your optometrist may advise you about ‘punctum plugs’, a plug that is inserted into your tear duct to stop tears draining away The procedure is more commonly undertaken by an optometrist with a special interest in Dry Eye Management – ask your local practice for details of appropriate practitioners. Patients are given a local anaesthetic before silicone plugs are inserted into each puncta (small tear drainage holes in the inner corner of your eyes).
As well as treating the condition with drops or tear supplements, sufferers may find that making small lifestyle adjustments help to relieve their symptoms.You could try…
- Eating a diet rich in Omega-3 fatty acids. Oily fish such as tuna, salmon and sardines are all excellent sources of Omega-3. You may also find that an Omega–3 supplement with flaxseed oil, fish oil and vitamin E will help.
- Keeping hydrated. Drink plenty of fluids (at least two litres a day) especially water or herbal teas.
- Avoiding air-conditioned atmospheres. A humidifier can help keep your eyes comfortable.
When looking at screens for long periods don’t forget to follow the 20-20-20 rule – look away every 20 minutes at an object about 20 feet away for 20 seconds And, remember to keep blinking! This will ensure that your HDE symptoms aren’t exacerbated by digital eye strain.
The Glaucoma Link
Hormone levels can affect Intraocular pressure (IOP), increasing the risk of ocular hypertension and glaucoma.
Glaucoma is the name given to a group of eye conditions, which affect the optic nerve and lead to the progressive loss of your peripheral vision. If left untreated glaucoma can lead to total loss of sight.
Patients with glaucoma are often unaware that there are any problems with their vision as there are no obvious symptoms until it is well down the line and sight has been irrecoverably lost.
Premature loss of oestrogen in women who go into an early menopause (<45 years), is associated with a significant increase in the risk of Primary Open Angle Glaucoma (POAG).Research also shows that glaucoma risk is linked to oestrogen levels and a woman’s lifetime exposure to oestrogen.
A routine sight test will pick up the signs of glaucoma long before you notice symptoms, and if detected early, glaucoma can usually be managed with eye drops, although sometimes a minor operation is needed. Regular monitoring is required once the condition is diagnosed.
Causing Cataracts
Research also indicates that reduced oestrogen levels may play a role in the cataract formation and progression
The prevalence of cataracts (clouding of the lens in the eye) is higher in post-menopausal women than in men of the same age.
Symptoms of cataract include blurred vision, ghosting, problems with glare, impaired colour perception and poor sight that is not corrected with spectacles or contact lenses.
It’s thought that oestrogen helps to keep the lens clear and hydrated however, when oestrogen levels drop during and after menopause the risk of cataract increases.
An estimated 2.4 million people aged 65 plus in England and Wales have a visually impairing cataract in one or both eyes. In most cases, cataracts can be treated very simply with routine surgery as a day-patient.
Eye Irritation
The hormone changes that occur during the menopause can also trigger blepharitis as the oil glands in the eyelids become irritated and inflamed.
Symptoms of blepharitis include red eye, burning, stickiness, excessive watering, discomfort, light sensitivity and foreign body sensation.
Good eye care is essential at all times to manage the condition and prevent symptoms of blepharitis recurring. Your optometrist or pharmacist will advise on the application of a warm compress, lid massage and wipes to help manage the condition. In severe cases, an antibiotic ointment or eye drops may be used to help minimise symptoms and relieve discomfort.
Vision Changes
Over time, fluctuating oestrogen can lead to changes in vision as shifting hormone levels cause small changes to elasticity of the cornea. If you are a contact lens wearer this may lead to some discomfort. It can also lead to slight distortion of your vision.
Essential Eye Tests
It’s especially important that women going through the menopause have regular eye tests –once every two years unless advised otherwise by your optometrist – to ensure early detection and treatment of any problems. Also speak to the team at your local optician about any changes to your vision or eye health.
If you are on Hormone Replacement Therapy (HRT) chat to your prescriber about any eye health issues you experience. If necessary, they can review your medication, and, also refer you to an eye care practitioner for further help and support.
