5 min

MENOPAUSE& DRY EYES

DAWN SIM, Professor & Ophthalmic Surgeon at MOORFIELDS EYE HOSPITAL, CO-FOUNDER AT MTHK

it starts with your eyes

Hot flushes, mood swings, night sweats - symptoms we all recognise as part of menopause. But not many people make the link between menopause and eye health. It can take years for menopause to present itself, and very often, the first signs manifest in your eyes.

Up to 60% of menopausal women may experience red eyes, blurred vision, a scratchy or stinging feeling in the eye, or a build-up of mucus along the eyelids. These are all indicators of Dry Eye, which affects twice as many women as men over the age of 50. We break down exactly what goes on with your eyes during menopause and some helpful (science-based) advice to help you manage.

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“Menopause is similar to puberty - a time when we undergo huge hormonal changes. Except, during menopause, we feel the effects much more because, emotionally, we’re starting from a more stable place.”

PROFESSOR DAWN SIM, CONSULTANT OPHTHALMIC SURGEON AT MOORFIELDS EYE HOSPITAL, CO-FOUNDER AT MTHK.

HOW TO MANAGE DRY EYE DURING MENOPAUSE

Get more rest: Tiredness makes a huge difference to the eyes in menopause, so try to get as much sleep as possible, and allow your eyes to rest. This means minimising time spent on screens when possible, and taking regular screen breaks when it’s not.
Eat for your eyes: The oils you ingest impact the oil makeup in your glands. Opt for foods rich in Omega-3 and 6, such as oily fish, nuts, seeds, eggs and leafy greens to keep your eye’s oil levels in balance. This also helps reduce your risk of cardiovascular, neurodegenerative and osteoporotic disease with menopause.
Clean air: Pollutants, air conditioning and air travel can all play havoc with your eyes. Although these factors are often unavoidable, it’s worth taking extra care of your eyes if you fly regularly or spend long hours in air-conditioned environments.
Regular checks and breaks: Keep your eyes in check by getting regular eye tests and taking breaks from wearing contact lenses. This will help you monitor any changes that might crop up, so you can take steps before things get worse.
Less stress: Stress drives inflammation in the body, making Dry Eye symptoms worse. Anything you do to improve your wellbeing will positively impact your eyes - so make sure you stay socially, physically and cognitively active.
Wash it out: If you’re already feeling the effects of Dry Eye, a hot shower, bath or hot flannel can emulsify the hardened fluid build-up and provide much-needed lubrication to your eyes.
Moisture boost: Eye sprays, anti-inflammatory drops, and wipes are available that help with the cleansing and healing process and provide relief against Dry Eye symptoms.
HRT or not to HRT: Current studies offer differing opinions on whether Hormone Replacement Therapy (HRT) helps or hinders eye health. Taking a pragmatic and holistic approach to eye health during menopause by following some of the tips above would be a good approach.

HORMONES: A DELICATE BALANCE

Any time you go through a transition in hormonal balance, the regulation of certain glands in your body will change. During puberty, biological changes are overshadowed by enormous personal and emotional shifts. With menopause, however, the changes start from a period of relative homeostasis – making them feel much more impactful.

Those going through menopause often assume that Dry Eye is simply a reaction to their body’s natural ageing process and moisture loss. But it’s actually caused by changes to the levels of androgen and oestrogen present in the body. These fluctuations can impact the fluid coating your eye, making it feel dry or irritated.

Eye Spray & Vitamins

“During menopause, the oils that keep your eyes nourished and moisturised, turn from an olive oil, silky smoothness to a sticky, toothpaste-like consistency. This leads to scratching and inflammation as your eyeballs move around their sockets.”

PROFESSOR DAWN SIM, CONSULTANT OPHTHALMIC SURGEON AT MOORFIELDS EYE HOSPITAL, CO-FOUNDER AT MTHK.

THE INFLAMMATORY CASCADE

It starts in the meibomian and lacrimal glands, located under you eyelids. These glands secrete lipids (a mixture of fats, oils and hormones). During menopause, the change in hormonal balance causes these lipids to thicken to a toothpaste-like consistency. Over time this may harden, and block some of your glands, leading to scratching and inflammation in your eyes and lids.

Menopause can also affect the goblet cells in your eyes. They produce and secrete less mucins (bottom layer of your tear film) onto the eyes' surface.

Once the symptoms of Dry Eye occur, it creates what’s known as an ‘inflammatory cascade’, making it harder to remedy at home without medical treatment. A combination of prevention and maintenance is essential to prevent this.

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