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Relation Between Menopause and the Development of Dry Eye

by | Oct 1, 2025 | Manuscripts | 0 comments

Akshaya. V, M. Optom.

Assistant Professor, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India

 

Dry eye also called Dry Eye Syndrome (DES), Dry Eye Disease (DED). Dysfunctional Tear Syndrome (DTS), Keratoconjunctivitis Sicca (KCS) is a multifactorial ocular condition in which a person does not have enough tears to provide lubrication and nourishment to the eyes. According to Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop II (DEWS II), dry eye is a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiologic roles. (1,2)

Dry eye is prevalent mostly in females, especially in the menopausal and post-menopausal group, which could be due to a variation in the balance of sex hormones involved, androgen and oestrogen, which stimulate components of the tear film layer. Estimated that 61% of women with menopause are experiencing dry eye symptoms. (3)

Biological Mechanism

Menopause is a normal condition involving the lasting end of the menstrual cycle due to the end of the production of reproductive hormones. It usually occurs between the ages of 45 and 56 years in most women. There will be a lesser amount of Luteinising hormone if the ovulation process does not occur, resulting in the end stage of menstruation. During menopause, secretion of androgen hormone reduces and affects the meibomian and lacrimal gland, resulting in inflammation in eyelids as well as reduction in tear production, resulting in Dry eye. Also, some researchers depict that changes in oestrogen levels also result in dry eyes. (4) So, it is depicted by researchers that a reduction in the secretion of androgen and oestrogen hormones results in menopause, and the consequence involves development of dry eyes.

Colour Vision Deficiencies typically arise from genetic anomalies affecting the opsin genes that encode for these cone pigments. Red-green deficiencies (protan and deutan types) are X-linked and are the most prevalent, as shown in Table 1, whereas blue-yellow deficiency (tritan type) is rare and autosomal. (5,6) Below mentioned table presents the inheritance pattern of X-linked red-green colour blindness..

Figure 1: Flowchart Representing the Mechanism of Dry Eye in Menopause Stage

Image Courtesy: Created by Author

Symptoms

Early detection of CVD is essential in clinical practice, especially in children and people whose careers may depend on their ability to perceive colour accurately. Colour vision tests that are frequently used include:

  1. Red Eyes: Menopause related hormonal changes result in reduction in tear production.
  2. Burning Sensation: Some women will report a burning sensation in their eyes.
  3. Itching: A common symptom associated with dry eyes during menopause.
  4. Blurred Vision: Dry eye can result in fluctuation in vision.
  5. Excessive Tearing: Dry eyes can trigger reflex tearing for eyes to compensate for dryness. (3,4)

Treatment

  1. Over the counter medication: It involves lubricating eye drops like artificial tears which lubricates and moistens the tear film surface.
  2. Prescription medication: Warm compression, take herbal supplements, take more vitamin D intake, participate in yoga, wear sunglasses on exposure to sunlight, reduce airflow, reduce screen time. (3,4)

Conclusion

By this, we can understand that dry eyes occur not only as an occupational consequence but also during the stage of menopause for females. As a result, it is important for all healthcare providers to understand dry eyes to recognise, treat and seek ophthalmic intervention, even during the menopause stage. Optometrists play a major role in treating patients with dry eyes by prescribing medications and providing lifestyle advice to patients.
 

References

  1. Golden, M. I., Meyer, J. J., Zeppieri, M., & Patel, B. C. (2024). Dry eye syndrome. In StatPearls [Internet]. StatPearls Publishing.
  2. Peck, T., Olsakovsky, L., & Aggarwal, S. (2017). Dry eye syndrome in menopause and perimenopausal age group. Journal of mid-life health, 8(2), 51-54.
  3. Bahoshy, L. P. (2021). Is dry eye a symptom of menopause?
  4. Lazarus, R. (n.d.). Dry eye and menopause. The College of Optometrists.

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