Perimenopause and dry eyes, oh my!

by WV Marshall

Hormone fluctuation and the natural aging process combine for a one-two punch to make dry eye syndrome a risk for perimenopausal women.

A Philadelphia-area expert in corneal diseases, ophthalmologist Christopher Rapuano, says in the Ophthalmology Times that perimenopausal women are at a higher risk of developing dry eye syndrome because of a deficiency in tear production and altered tear film composition.

If they have chronic dry eye, aggressive therapy, including anti-inflammatory agents, would be necessary.

“You need to consider the patient as a whole, especially since systemic conditions such as perimenopause can affect the eye,” Rapuano said, noting that hormones are “present throughout the eye” and regulate genes in several glands.

Both aging and hormonal changes affect how dry eye syndrome develop, Dr. Rapuano added.

Aging leads to decreased corneal sensory signaling, while hormonal fluctuations can affect inflammatory mediators stimulation around the eye.

At least two clinical trials in the 2000s examined the effect of menopausal hormone therapy on dry eye. The first, published in 2004, was a prospective comparative trial involving 70 women who were assigned to either MHT with the testosterone analogue tibolone, another MHT regimen, or no MHT.

Researchers found improved Schirmer test results on whether the eyes are producing enough tears to keep it moist, and tear break-up time with the tibolone MHT regimen, Rapuano said.

In a study conducted in 2005, 11 postmenopausal women with dry eye syndrome were treated with combined esterified estrogen and methyltestosterone. Ten of the 11 subjects noted improved signs and symptoms after an average treatment period of four months.

What’s more, studies have indicated that dry eye syndrome is shown to have affected 60 percent of women, empowher.com reported.

Even if studies are inconclusive concerning why hormone levels during menopause cause such changes, women can protect themselves against the eye ailment.

Dry eye syndrome can present itself in a combination form of: Scratchy or gritty feeling in the eyes. Itchy eyes. Tears flowing down cheeks. Mucus. Light sensitivity. Problems wearing contact lenses. Blurriness.

**Untreated, dry eye syndrome could cause the cornea to become scarred or develop ulcers. **

It also could cause a person’s vision to be affected; people also are more likely to contract eye infections because of the lack of tears needed wash out the eye.

To help maintain eye health, empowher.com offers these suggestions: A healthy diet that includes the proper amount of Omega 3s. Review your medication with your healthcare provider – some medications can contribute to dry eyes. Avoid smoking. Avoid touching eyes – too much rubbing can cause a loss of moisture and can promote bacteria growth in the eye. Drink fluids. Get the proper amount of sleep.

Take care of your eyes and aim for 2020 in 2020!