HOW MENOPAUSE AFFECTS YOUR EYES

One of the most common eye problems associated with menopause is dry eyes. This occurs when there is not enough moisture in the eyes, which can cause discomfort, redness, and a gritty feeling. The decrease in oestrogen levels can lead to changes in the tear ducts and reduce the production of tears.

Cataracts are a clouding of the lens in the eye, which can lead to a decrease in vision. It is a common condition, especially among older adults. The lens of the eye is mainly made of water and protein. As we age, some proteins may clump together and cloud a small area of the lens. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.
Oestrogen is known to have antioxidant properties, which means it helps to fight off free radicals in the body. Free radicals can cause damage to the cells in the eyes, leading to conditions like cataracts. Therefore, the decline in oestrogen levels during menopause may increase the risk of developing cataracts.
Read further down for more details (including prevention & care).

There is a connection between menopause and an increased risk of Glaucoma. Menopause is associated with a decline in the levels of the female hormone oestrogen. Research suggests that oestrogen may play a protective role in the eyes. Oestrogen receptors are found throughout the eye - including in the retina and the optic nerve. A decline in oestrogen levels during menopause may lead to changes in the eye that increase the risk of developing glaucoma.
Studies have shown that postmenopausal women have a higher glaucoma prevalence than premenopausal women of the same age.
Moreover, hormone replacement therapy (HRT), sometimes used to manage menopausal symptoms, has been associated with a reduced risk of glaucoma. However, HRT also carries potential risks, so carefully weigh the benefits and risks.
Read further down for more details (including prevention & care).

The hormonal changes during menopause can lead to decreased tear production and altered tear film composition, resulting in dry eyes. Dry eyes can make wearing contact lenses uncomfortable and lead to dry eye syndrome if left untreated. Additionally, decreased oestrogen levels can change the cornea’s shape and thickness, making it more difficult for contact lenses to fit correctly. This can cause discomfort, blurred vision, and an increased risk of corneal abrasions or infections.
Read further down for more details (including prevention & care).

Blepharitis is an inflammation of the eyelids, usually affecting the area where the eyelashes grow. It causes red, swollen eyelids, a gritty sensation in the eyes, and dandruff-like flakes on the eyelashes. While it is a common condition affecting people of all ages, postmenopausal women are at a higher risk of developing blepharitis.
The link between menopause and blepharitis lies in the hormonal changes during this phase of a woman’s life. Oestrogen, a hormone that decreases during menopause, plays a crucial role in maintaining the moisture levels of various tissues in the body, including the eyes. A drop in oestrogen levels can lead to dry eyes, making the eyes more susceptible to infections and inflammations like blepharitis.
Additionally, menopause is associated with a decrease in androgen levels, a group of hormones that affect the meibomian glands’ function and produce the oily layer of the tear film. This reduction can lead to meibomian gland dysfunction (MGD), a significant contributor to blepharitis.
Read further down for more details (including prevention & care).

Age-related Macular Degeneration (AMD) is a common eye condition and a leading cause of vision loss among people aged 50 and older. It causes damage to the macula, a tiny spot near the centre of the retina and the part of the eye needed for sharp, central vision. While the exact cause of AMD is unknown, several risk factors contribute to its development, including ageing, smoking, and family history. Menopause is also considered a risk factor due to decreased oestrogen levels, a hormone known to have antioxidant properties that protect the eyes.
Read further down for more details (including prevention & care).

The hormonal shift during perimenopause and menopause can lead to various ocular surface changes, including increased itchiness and soreness of the eyes.
Dry Eye Syndrome: The decline in oestrogen levels affects the meibomian glands, which produce the oily layer of the tear film. This results in a condition known as Dry Eye Syndrome, characterised by inadequate tear production or poor tear quality. The lack of sufficient tears increases friction between the eyelid and the cornea, causing itchiness and soreness.
Inflammation: Oestrogen has anti-inflammatory properties. A decrease in oestrogen levels can lead to increased ocular surface inflammation, causing itchiness and soreness.
Changes in Corneal Sensitivity: Oestrogen receptors are present in the cornea. A decline in oestrogen levels can lead to changes in corneal sensitivity, making the eyes more susceptible to environmental factors such as wind, smoke, and dust, which can cause itchiness and soreness.

This hormonal shift triggers a cascade of physiological changes, one of which is the paradoxical symptom of watery eyes.
The eye’s surface is coated with a tear film composed of three layers: an outer oily (lipid) layer, a middle watery (aqueous) layer, and an inner mucin layer. This tear film is essential for maintaining the eye’s health and comfort.
During perimenopause and menopause, the hormonal fluctuations, particularly the decline in oestrogen and androgen levels, adversely affect the function of the meibomian and lacrimal glands, responsible for the lipid and aqueous layers of the tear film, respectively.
The decline in oestrogen levels reduces the production of aqueous tears by the lacrimal glands, resulting in Dry Eyes. This condition, known as Dry Eye Syndrome, triggers a compensatory response by the lacrimal glands to produce more tears, leading to the paradoxical symptom of watery eyes. This reflex tearing, however, does not resolve the underlying dryness as the tears produced are of poor quality and evaporate quickly.
Moreover, the decline in androgen levels affects the meibomian glands’ function, reducing the lipid layer of the tear film. This increases tear evaporation and contributes to the dryness and reflex tearing cycle.
Additionally, the decrease in oestrogen levels affects the cornea’s sensitivity, making the eyes more susceptible to environmental irritants such as wind, smoke, and dust, which can further exacerbate the reflex tearing.
Understanding this intricate relationship between hormones and eye health is crucial for managing ocular symptoms during perimenopause and menopause - and maintaining optimal vision and comfort.

Light sensitivity, or photophobia, is another common eye-related symptom experienced during menopause. When exposed to bright light, eyes experience discomfort or pain in the eyes.
The hormonal fluctuations during menopause can lead to dry eyes, significantly contributing to increased light sensitivity. Dry eyes occur when there is insufficient tear production or poor tear quality, leading to a lack of lubrication on the eye’s surface. This dryness can make the eyes more susceptible to irritation from bright lights, resulting in discomfort and a tendency to squint or close the eyes.

Eye floaters are tiny specks or cobweb-like strands that float around in your field of vision. They are tiny pieces of debris floating in your vitreous humour - a gel-like substance that fills the back of the eye. While they can be annoying, they are usually harmless and a common part of ageing. However, the hormonal changes that occur during menopause can exacerbate the occurrence of eye floaters.

Oestrogen has anti-inflammatory properties and is crucial in maintaining the eyes’ health. A decline in oestrogen levels during menopause can lead to inflammation and thinning of the vitreous humour, making it more susceptible to degeneration and the formation of floaters. Additionally, lower oestrogen levels can lead to a reduction in the production of collagen. This protein helps maintain the structure of the vitreous humour. This can cause the vitreous humour to become more liquid and less gel-like, allowing debris to move around more freely and become more noticeable as floaters.

While the appearance of a few new floaters is usually nothing to be concerned about, a sudden increase in the number of floaters, especially if accompanied by flashes of light or a loss of peripheral vision, could indicate a more severe problem, such as a retinal detachment, and should be evaluated by an eye care professional immediately.

The eye is a complex organ with various structures that can be affected by hormonal fluctuations. Oestrogen receptors, including the cornea, retina, and optic nerve, are found throughout the eye. Oestrogen plays a crucial role in maintaining the thickness and curvature of the cornea, the eye’s clear front surface. During menopause, the decline in oestrogen levels can lead to changes in the cornea’s shape and thickness, affecting its refractive properties and resulting in blurry vision.

Additionally, oestrogen regulates the production of tears and the lipid layer of the tear film, which is essential for maintaining ocular surface health and clear vision. Reduced oestrogen levels during menopause can lead to Dry Eyes, a condition characterised by insufficient tear production or poor tear quality. Dry eyes can cause many symptoms, including burning, itching, and blurred vision.

Moreover, menopause is associated with an increased risk of developing Age-related Macular Degeneration (AMD), a condition that affects the macula, the central part of the retina responsible for sharp, central vision. The decline in oestrogen levels is thought to contribute to the development and progression of AMD, leading to blurry or distorted vision.

Night vision refers to the ability to see in low-light conditions. During menopause, many women experience a decline in night vision, which can be attributed to several factors. Firstly, the decrease in oestrogen levels affects the eyes’ overall health, including the retina, which is responsible for low-light vision.
Secondly, menopause is associated with decreased rhodopsin production, a retina pigment that helps with night vision. This decline can make it more challenging for menopausal women to see clearly in dimly lit environments, impacting their ability to drive at night or navigate in the dark.

The eye’s surface is protected by a thin film of tears produced by the lacrimal glands. This tear film consists of three layers: an outer oily layer, a middle aqueous layer, and an inner mucin layer. Each layer plays a crucial role in maintaining eye health by lubricating the eye, preventing the evaporation of tears, and trapping and flushing out foreign particles and microbes.
Function of Meibomian Glands: During perimenopause and menopause, the decrease in oestrogen levels affects the function of the meibomian glands, which produce the lipid component of the tear film. This results in a condition known as meibomian gland dysfunction (MGD), leading to an unstable tear film, increased tear evaporation, and Dry Eye Syndrome. The dry eye surface becomes more susceptible to infections as the natural antimicrobial properties of the tear film are compromised.
Altered Immune Response: Moreover, oestrogen has immunomodulatory effects on the ocular surface. A decline in oestrogen levels can alter the eye’s immune response, making it more prone to infections. For instance, oestrogen influences the production of lysozyme, an enzyme in tears with antibacterial properties. Decreased lysozyme levels can reduce the eye’s ability to fight off bacterial infections.
Microbiota on the Eye's Surface: Additionally, perimenopause and menopause are associated with changes in the composition of the microbiota on the ocular surface. A healthy ocular microbiota prevents pathogenic bacteria from colonising the eye surface. However, hormonal changes during menopause can disrupt this delicate balance, increasing the risk of infections.
Regular eye check-ups and good eyelid hygiene can help prevent eye infections during this transitional phase of life.

This hormonal shift during menopause and perimenopause includes visual disturbances such as flashing lights or blind spots - medically known as scintillating scotoma.
Changes in Blood Flow to Retina: The retina, the light-sensitive tissue lining the back of the eye, plays a crucial role in visual perception. It contains photoreceptor cells (rods and cones) that convert light into electrical signals, which are then transmitted to the brain via the optic nerve. During menopause and perimenopause, the decrease in oestrogen levels can lead to changes in blood flow to the retina, causing temporary visual disturbances.
Migraines: Flashing lights or blind spots are often associated with migraines, a headache characterised by intense, throbbing pain, usually on one side of the head. Migraines are more common in women and can be triggered by hormonal fluctuations. A migraine with aura involves visual disturbances such as flashing lights, zigzag lines, or blind spots before or during the headache. The aura is believed to be caused by a wave of electrical activity in the brain, followed by decreased blood flow, known as cortical spreading depression.
Decrease in Collagen Production: Additionally, the decline in oestrogen levels during menopause and perimenopause can lead to a decrease in collagen production, affecting the vitreous humour, the jelly-like substance that fills the eye. This can lead to vitreous detachment, where the vitreous pulls away from the retina, causing flashing lights or floaters.
While these symptoms are usually harmless, it is always advisable to consult an ophthalmologist for a thorough evaluation to rule out any serious underlying conditions.

Adequate rest is crucial for eye health during menopause. Tiredness significantly affects the eyes, leading to symptoms such as dryness, redness, and blurry vision. Therefore, getting enough sleep and allowing your eyes to rest is essential. Minimise screen time whenever possible and take regular breaks when it’s not. Engaging in relaxation techniques before bedtime, such as meditation or reading a book, can promote better sleep quality.

A lack of sleep can contribute to stress and negatively affect eye health. Chronic sleep deprivation can lead to problems like dry eye syndrome, where the eyes do not produce enough tears to stay adequately lubricated. It can also increase the risk of developing Glaucoma, a condition characterised by increased pressure in the eye that can lead to vision loss. Aim for 7-9 hours of quality sleep each night.

Additionally, maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding caffeine and electronic devices before bedtime can also help improve sleep quality and, consequently, eye health.

The importance of nutrition for maintaining eye health cannot be overstated. The oils you consume directly affect your eye’s meibomian glands, which produce the oily layer of your tear film. This oily layer is essential for preventing the rapid evaporation of tears and maintaining eye moisture. Opt for foods rich in Omega-3 and Omega-6 fatty acids, like oily fish (salmon, mackerel, sardines), nuts (walnuts, almonds), seeds (flaxseeds, chia seeds), eggs, and leafy greens (spinach, kale), to keep your eye’s oil levels balanced. This not only helps reduce dry eyes, a common symptom during menopause, but also lowers the risk of cardiovascular, neurodegenerative, and osteoporotic diseases associated with menopause.

Additionally, Omega-3 fatty acids have anti-inflammatory properties that can help reduce inflammation in the eyes and the body. Chronic inflammation is a significant factor in developing several eye conditions, including Age-related Macular Degeneration (AMD) and diabetic retinopathy. Therefore, maintaining a diet rich in Omega-3 and Omega-6 fatty acids is beneficial for alleviating dry eyes and preventing other eye conditions.

Maintaining a healthy level of antioxidants is crucial for protecting the eyes from oxidative damage during menopause. The hormonal changes during this period increase oxidative stress, making the eyes more susceptible to Cataracts and Age-related Macular Degeneration (AMD).

Lutein, Zeaxanthin, and Vitamin C are essential antioxidants for eye health. Lutein and Zeaxanthin, carotenoids found in the retina and lens, help filter harmful blue light, reduce glare sensitivity, and maintain healthy eye cells.

Vitamin C is crucial for collagen synthesis, a protein providing eye structure, and regenerating other antioxidants like Vitamin E. A diet rich in these antioxidants, found in leafy greens, corn, eggs, oranges, citrus fruits, strawberries, bell peppers, and broccoli, can help prevent Cataracts and AMD.

Besides a healthy diet, wearing UV-protective sunglasses, quitting smoking, and managing diabetes and high blood pressure are essential for optimal eye health during menopause. The eyes are particularly susceptible to oxidative stress due to their high metabolic activity and light exposure. Studies have shown that higher dietary intake of Lutein and Zeaxanthin is associated with a lower risk of developing cataracts and AMD. Vitamin C deficiency can weaken eye structure, increasing cataract risk.

Pollutants, air conditioning, and air travel can all adversely affect your eyes. Although often unavoidable, it’s essential to take extra care of your eyes if you fly regularly or spend long hours in air-conditioned environments (e.g. on flights). Using preservative-free, lubricating eye drops and sprays can help.

Regular eye tests are crucial for monitoring any changes in your eye health. These tests can help detect glaucoma, cataracts, and macular degeneration, allowing for timely intervention before conditions worsen. Eye tests can also reveal other health problems like diabetes and high blood pressure.
It is recommended to have a comprehensive eye exam at least once every two years and more frequently if you have a history of eye problems or are at a higher risk due to factors such as age, family history, or lifestyle.

Wearing Contact Lenses for extended periods can cause dryness and irritation, especially during menopause when the eyes are already prone to dryness. It is essential to take regular breaks from wearing contact lenses to allow your eyes to breathe and recover. Additionally, follow your optician's recommendations on looking after your contact lenses to prevent infections and other complications.

Stress is a common trigger for inflammation in the body, which can worsen dry eye symptoms. Chronic stress leads to the release of stress hormones like cortisol, promoting inflammation. This inflammation can affect various body parts, including the eyes, leading to increased dryness, redness, and irritation. During menopause, the eyes are already more susceptible to dryness due to hormonal changes, making managing stress levels more critical.

Improving your well-being by staying socially, physically, and cognitively active can positively impact your eyes. Regular physical exercise, maintaining a healthy social network, engaging in activities that bring joy, and keeping the mind active with puzzles, reading, or learning new skills can all help reduce stress levels. Additionally, mindfulness practices such as meditation, deep breathing exercises, and yoga can also be beneficial in managing stress and improving eye health.

Dry eyes can be particularly uncomfortable and are a common issue during menopause. Suppose you’re already experiencing the effects of dry eyes, such as itching, burning, or a gritty feeling. In that case, there are several ways to provide relief. A hot shower, bath, or applying a hot flannel to the eyes can help emulsify hardened fluid build-up in the meibomian glands, which are the tiny oil glands located at the base of the eyelashes. This helps to provide much-needed lubrication to your eyes.

Additionally, using preservative-free eye drops and sprays can also be beneficial. These products are specially formulated to mimic natural tears and help maintain moisture on the eye’s surface. Preservative-free formulations are recommended as they are gentler on the eyes and are suitable for frequent use without the risk of causing irritation or allergic reactions associated with preservatives.

It is also essential to blink regularly, especially when using screens, as blinking helps to distribute tears evenly across the eye’s surface. Remember to take frequent breaks from screen time and practice the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.

Dry eyes are a common symptom experienced during menopause, and it is essential to keep the eyes well-lubricated to prevent discomfort and potential damage. Eye sprays, anti-inflammatory drops, and wipes are available to help with the cleansing and healing process and provide relief against dry eye symptoms.

Eye sprays containing liposomes can help stabilise the tear film and moisten the eyes. Liposomes are tiny, spherical vesicles that encapsulate water and adhere to the eye’s surface, providing prolonged hydration.

Anti-inflammatory drops, such as those containing cyclosporine or corticosteroids, can help reduce inflammation and increase tear production. However, these should be used under the supervision of an eye care professional as they may have side effects.

Hormone Replacement Therapy (HRT) is commonly used to manage menopausal symptoms such as hot flashes, night sweats, and mood swings. However, its effects on eye health are still a subject of ongoing research and debate. Some studies suggest that HRT may protect against conditions such as Dry Eyes, Cataracts, and Age-related Macular Degeneration (AMD). In contrast, others indicate that it may increase the risk of these conditions.

Oestrogen, a hormone that decreases during menopause, plays a significant role in maintaining ocular surface health. HRT helps in replenishing the oestrogen levels, which may, in turn, help in maintaining the tear film and ocular surface. However, there are also concerns about the potential side effects of HRT, including an increased risk of breast cancer, blood clots, and stroke.

Given the conflicting evidence and potential risks associated with HRT, it is essential to approach its use cautiously and consider all available options. A pragmatic and holistic approach to eye health during menopause, including a balanced diet, regular exercise, proper eye care, and regular check-ups with an eye care professional, maybe a more comprehensive and safer strategy.

Hydration is vital to maintaining overall health; your eyes are no exception. Drinking plenty of water throughout the day can help maintain eye moisture and reduce dryness. The eyes are surrounded by fluid, which protects them by washing away debris and dust every time we blink. Staying well-hydrated is crucial for maintaining this protective fluid layer.

Dehydration can lead to Dry Eyes without tears to nourish and lubricate the eye. Tears are essential for maintaining the eye’s front surface’s health and providing clear vision. Dry eyes can cause discomfort, burning, stinging, and blurred vision.

Additionally, staying hydrated is essential for the production of tears. Tears are made up of three layers: an oily layer, a watery layer, and a mucous layer. Each layer is produced by different glands around the eye, and a proper balance of each layer is essential for the eyes’ overall health.

Drinking at least 8-10 glasses of water daily is recommended to stay hydrated. However, the exact amount of water needed can vary based on age, climate, and physical activity levels.

Regular blinking exercises can help spread tears evenly across the eye’s surface, reducing dryness and discomfort. Blinking is a crucial function that helps maintain the ocular surface’s health by spreading a thin layer of tears, known as the tear film, across the cornea. This tear film is essential for keeping the eyes lubricated, removing small debris, and ensuring clear vision.

During menopause, hormonal changes can lead to a reduction in the quality and quantity of tears produced, resulting in Dry Eyes. Regular blinking exercises can help stimulate tear production and ensure a healthy tear film.

To practice blinking exercises, find a comfortable and quiet space to sit or stand relaxed. Close your eyes gently, hold for 2 seconds, open your eyes wide, and repeat. Do this exercise for 2-3 minutes several times a day. Additionally, make a conscious effort to blink more frequently throughout the day, especially when doing activities that require prolonged focus, such as reading or working on a computer.

Remember, while blinking exercises can help alleviate dryness and discomfort, it is essential to consult an eye care professional for a comprehensive evaluation and personalised treatment plan if you are experiencing persistent dry eyes or any other eye-related symptoms.

Prolonged screen exposure can exacerbate Dry Eyes, a common condition during menopause. Staring at screens for extended periods can cause eye strain and reduce the blink rate, leading to decreased tear production and dry eyes. It is essential to manage screen time effectively to prevent these issues.

Practising the 20-20-20 rule is highly recommended. Every 20 minutes, take a break and look at something 20 feet away for 20 seconds. This simple exercise helps to relax the eye muscles and reduce eye strain.

It is also advisable to adjust the brightness and contrast of your screen to a comfortable level and position the screen so that your eyes are level with the top of the monitor. This will help reduce the need to open your eyes wide and decrease tear evaporation.

Remember to blink frequently to maintain a healthy tear film on the eye’s surface, and consider using preservative-free, lubricating eye drops and sprays to keep your eyes moist and comfortable.

Dry eyes can be a common symptom during menopause, and one of the contributing factors to dry eyes is the environment in which you spend most of your time. Air conditioning, heating systems, and dry climates can all reduce the moisture level in the air, exacerbating dry eye symptoms. A humidifier can be a valuable tool in managing dry eyes as it adds moisture to the air, creating a more comfortable environment for your eyes.

A humidifier can help maintain the tear film’s stability, the thin layer of liquid covering the eyes’ surface. This tear film is essential for clear vision and comfort. It consists of three layers: an oily layer, a watery layer, and a mucous layer. The oily layer, produced by the meibomian glands in the eyelids, prevents the watery layer underneath from evaporating. However, during menopause, the function of the meibomian glands can be affected, leading to increased evaporation of the tear film. Using a humidifier to increase the humidity in the environment can reduce the tear evaporation rate, helping to keep the eyes lubricated and comfortable.
Remember to clean your humidifier regularly to prevent the growth of mould and bacteria, which can be harmful to your eyes and respiratory system.

Green tea is a powerhouse of antioxidants, notably catechins and polyphenols, known to help reduce inflammation throughout the body, including the eyes. These antioxidants work by neutralising free radicals, unstable molecules that can cause oxidative stress and damage to the cells in the eyes. Oxidative stress is a significant factor in developing several eye diseases, including Age-related Macular Degeneration (AMD), Cataracts, and Glaucoma.

Additionally, green tea contains a unique antioxidant called Epigallocatechin Gallate (EGCG). EGCG has anti-inflammatory properties that can help reduce eye inflammation and the risk of dry eyes, a common issue during menopause. Dry eyes occur when there is insufficient tear production or poor tear quality, leading to discomfort, redness, and blurred vision.

Moreover, a study published in the Journal of Agricultural and Food Chemistry found that the antioxidants in green tea could be absorbed by the eye’s tissues, providing direct benefits to eye health. The study showed that consuming green tea could reduce the risk of developing cataracts.

In conclusion, drinking green tea regularly can be a beneficial addition to your eye care routine, especially during menopause. It helps reduce inflammation and provides direct benefits to the eye’s tissues, helping to prevent cataracts and other age-related eye diseases.

Smoking is a well-known risk factor for various health issues, including cardiovascular diseases, respiratory problems, and cancers. However, its adverse effects on eye health are often overlooked. Smoking can worsen dry eyes and other menopausal symptoms by altering the tear film and increasing the evaporation rate of tears. This can lead to increased ocular surface inflammation, discomfort, and a higher risk of developing chronic Dry Eye syndrome.

Moreover, smoking is associated with a higher risk of developing Cataracts, the clouding of the eye’s natural lens, and Age-related Macular Degeneration (AMD), a leading cause of vision loss in older adults. The toxins in cigarette smoke can cause oxidative stress and damage the eyes’ delicate tissues, including the retina and lens.

Quitting smoking can positively impact overall eye health by reducing the risk of cataracts, AMD, and Dry Eyes. It can also improve blood circulation, essential for maintaining healthy eyes and vision.

Regular physical activity is essential for overall health, including heart, muscles, mental well-being, and eye health. Exercise enhances blood circulation throughout the body and eyes, ensuring adequate oxygen and essential nutrients reach the eyes, helping remove harmful toxins, reducing oxidative stress, and potentially lowering the risk of eye conditions like Age-related Macular Degeneration (AMD), Glaucoma, and diabetic retinopathy.

Improved blood flow helps lower intraocular pressure, a key factor in Glaucoma, by activating the trabecular meshwork, a specialised eye tissue responsible for fluid drainage. This can prevent optic nerve damage and vision loss.

Additionally, exercise boosts the body’s antioxidant defence system and anti-inflammatory responses, reducing AMD risk by up to 70%. It also helps regulate blood sugar levels, minimising the risk of blood vessel damage in the retina, a common diabetic retinopathy complication.

Moreover, regular exercise helps manage weight, reduce diabetes risk, and maintain healthy blood pressure levels, which is essential for preventing hypertensive retinopathy, another vision-threatening condition caused by high blood pressure.

Engaging in at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or cycling, is recommended. Choose an exercise suitable for your fitness level and enjoyable. Remember to wear protective eyewear during outdoor activities to shield your eyes from harmful UV rays and other environmental factors.

In summary, regular exercise is a holistic approach to eye care, offering multiple benefits, from improved circulation and reduced intraocular pressure to lower risks of AMD, diabetic retinopathy, and hypertensive retinopathy.

Vitamin C, or ascorbic acid, is a water-soluble antioxidant that plays a pivotal role in maintaining the health of various tissues in the body, including the eyes.
Antioxidant Properties: The eye is highly susceptible to oxidative stress due to its constant exposure to light and oxygen. Reactive oxygen species (ROS) generated in the eye can cause oxidative damage to the ocular tissues’ proteins, lipids, and DNA. This oxidative stress is a crucial contributor to the development of age-related eye diseases such as Cataracts and Age-related Macular Degeneration (AMD). Vitamin C, a potent antioxidant, neutralises ROS by donating electrons, thereby preventing oxidative damage.
Collagen Synthesis: Collagen is a crucial component of the cornea, sclera, and the blood vessels in the retina. (Vitamin C is essential for the biosynthesis of collagen. It acts as a cofactor for the enzymes prolyl hydroxylase and lysyl hydroxylase, which are necessary for the hydroxylation of proline and lysine residues in collagen. This hydroxylation is essential for the stability of the collagen triple helix structure.)
Preventing Cataract Formation: Cataracts are characterised by the clouding of the lens in the eye. The lens contains high concentrations of Vitamin C, which helps maintain its transparency by preventing the glycation of lens proteins. Glycation is a process where sugar molecules attach to proteins, leading to the formation of advanced glycation end products (AGEs), which contribute to lens opacification.
Sources: To support your eye health during Perimenopause and Menopause, incorporate foods and supplements with high-quality Vitamin C. Citrus fruits, strawberries, and bell peppers are excellent sources of dietary vitamin C.

During Menopause, the body experiences an increase in oxidative stress due to a decline in oestrogen, which has antioxidant properties. This oxidative stress can lead to the formation of free radicals. These unstable molecules can damage the cells in the eyes, contributing to Age-related Macular Degeneration (AMD) and Cataracts, two common eye conditions associated with ageing.
Protection from Oxidative Damage: Vitamin E, scientifically known as alpha-tocopherol, is crucial in protecting the eyes from oxidative damage. It is a fat-soluble antioxidant that neutralises free radicals, preventing them from damaging the eye cells. Specifically, Vitamin E helps maintain the integrity of the cell membranes in the retina, the light-sensitive tissue at the back of the eye.
Supporting Tear Production: Dry Eyes are a common complaint during Menopause, partly due to decreased androgen levels, which affect the meibomian glands responsible for producing the oily layer of the tear film. Vitamin E helps maintain the function of these glands, supporting healthy tear production and preventing Dry Eyes.
Sources: To support your eye health during Perimenopause and Menopause, incorporate foods and supplements with high-quality Vitamin E. Good food sources include nuts and seeds, leafy green vegetables, and vegetable oils.

ViVitamin A is a fat-soluble vitamin crucial for maintaining the retina’s health, the light-sensitive tissue at the back of the eye. The retina contains photoreceptor cells, rods, and cones, essential for low-light and peripheral vision and colour vision and detail, respectively.
Vision in Low-light Conditions: Retinal, a form of Vitamin A, combines with opsin to form rhodopsin in the rods, a light-sensitive pigment essential for vision in low-light conditions. This pigment absorbs light and initiates a series of chemical reactions that create electrical signals, transmitted to the brain via the optic nerve and interpreted as images.
Tear Film Stability: During Menopause, the decline in oestrogen levels can lead to a decrease in the tear film’s aqueous layer and the thickness of the cornea, resulting in dry eyes. Vitamin A is essential for maintaining the integrity of the conjunctiva and cornea, the outermost layers of the eye, and the mucous membranes lining the eyelids and covering the eye’s surface. It helps produce mucin, a glycoprotein component of the tear film. It spreads the tear film evenly across the eye’s surface, preventing dry spots, keeping the eye moist and lubricated, and reducing the risk of eye infections.
Sources: Foods rich in Vitamin A include animal sources (liver, fish liver oils, dairy products, eggs) and plant sources (dark leafy greens, carrots, sweet potatoes, pumpkins).

Zinc is a vital trace mineral in high concentrations in the eyes, specifically in the retina and choroid (the vascular layer of the eye). It plays a key role in maintaining the retina’s health and may help prevent Age-related Macular Degeneration (AMD), which can lead to vision loss in older adults.
Antioxidant Defense: Zinc is a superoxide dismutase (SOD) component, an antioxidant enzyme that helps protect the eye’s cells from oxidative stress and damage caused by free radicals. Oxidative stress is a significant factor in developing AMD and Cataracts, common eye conditions associated with ageing and Menopause.
Vitamin A Metabolism: Zinc is essential for metabolising Vitamin A, a critical nutrient for eye health. It helps convert Vitamin A from the liver to its active form, retinaldehyde, necessary for producing rhodopsin, a pigment in the retina that aids low-light vision.
Cell Membrane Stability: Zinc helps maintain the integrity of cell membranes in the eye, preventing cell breakdown and supporting the eye’s structure.
Zinc absorption decreases during Perimenopause and Menopause: During Menopause, the body’s ability to absorb zinc decreases, and the requirement for this mineral increases. A zinc-deficient diet can lead to a decline in vision and increase the risk of developing AMD and Cataracts.

Omega-3 Fatty Acids, specifically Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA)
Retina Function: Both play a crucial role in maintaining the structural and functional integrity of the retina. DHA is a major structural component of the retina, and its adequate levels are necessary for proper retinal function.
Anti-inflammatory: Omega-3 Fatty Acids have anti-inflammatory properties that can help reduce inflammation in the tear glands and ocular surface, thereby improving tear quality and alleviating Dry Eye symptoms.
Regulates Tear Film’s Lipid Layer: During Menopause, the body’s androgen levels and oestrogen levels fluctuate, impacting the fluid coating the eye and leading to dry or irritated eyes. Omega-3 Fatty Acids help regulate the tear film’s lipid layer, preventing tears’ evaporation and ensuring a stable tear film.
Sources: Incorporating Omega-3 Fatty Acids into your diet is essential, especially during Menopause. Foods rich in Omega-3 include oily fish (such as salmon, mackerel, and sardines), nuts, seeds, and leafy greens. High-quality supplements should be considered if natural food sources don’t provide enough.

Lutein and Zeaxanthin are carotenoids, naturally occurring pigments found in the retina and macula of the eye. The macula is the region of the retina responsible for central vision.
Antioxidant Reducing Oxidative Stress: These carotenoids act as antioxidants, protecting the eyes from oxidative stress and damage caused by harmful Blue Light and Ultraviolet light damage.
Neutralise Free Radicals: During Menopause, the body’s antioxidant defence system weakens, making it more susceptible to oxidative stress. This can lead to the oxidation of lipids and proteins in the eye, contributing to Age-related Macular Degeneration (AMD) development. Lutein and Zeaxanthin help neutralise free radicals, preventing oxidative damage to the retina.
Reduce Oxidative Damage: Lutein and Zeaxanthin absorb blue light, preventing it from reaching the underlying structures in the retina, thereby reducing the risk of light-induced oxidative damage. These carotenoids also have anti-inflammatory properties. They inhibit the activation of nuclear factor-kappa B (NF-κB). This protein complex controls the transcription of DNA and plays a key role in the inflammatory response.
Integrity of Blood-Retinal Barrier: Lutein and Zeaxanthin enhance the integrity of the blood-retinal barrier, preventing the infiltration of inflammatory cells into the retina. This is crucial as inflammation is a significant factor in the development of AMD.

Dry Eyes, a common complaint during Menopause, are attributed to an imbalance in the tear film’s three layers: the outer oily (lipid) layer, the middle watery (aqueous) layer, and the inner mucin layer. This imbalance is exacerbated by hormonal fluctuations during Menopause, particularly the decline in androgen levels, which adversely affects the meibomian glands responsible for the lipid layer of the tear film.
Antioxidant Reducing Oxidative Stress & Inflammation: Enter the Maqui Berry (Aristotelia chilensis), a superfruit native to the wild forests of Patagonia in Chile and Argentina, renowned for its unparalleled antioxidant properties. The berry is rich in anthocyanins, a type of flavonoid that imparts the berry its deep purple colour. Anthocyanins are potent antioxidants that combat oxidative stress and inflammation, two key culprits behind dry eyes and other ocular conditions.
High Levels of Vitamin C & Vitamin E: The Maqui Berry also contains high levels of Vitamin C and Vitamin E, essential nutrients that contribute to healthy blood vessels in the eyes and prevent oxidative damage.
Omega-3 & 6 Fatty Acids: The Maqui Berry is a rich source of essential fatty acids, Omega-3 and Omega-6, which are crucial for maintaining the integrity of the lipid layer of the tear film.
Enhances Tear Production: One of the key compounds in Maqui Berry is MaquiBright®. This standardised extract has been clinically proven to enhance tear production and alleviate dry eye symptoms. MaquiBright® works by promoting the healthy function of the lacrimal glands, thereby increasing the aqueous layer of the tear film. Incorporating Maqui Berry into your diet, either as a supplement or in its natural form, can significantly bolster your eye health during Menopause

One of the first signs of menopause is irregular menstrual cycles. Women may experience lighter or heavier bleeding, or their periods may become more or less frequent.

Hot flashes are a common symptom of menopause, characterised by a sudden feeling of heat that spreads throughout the body. This can be accompanied by sweating, redness, rapid heartbeat and palpitations.

Night sweats are hot flashes that occur during sleep, leading to disrupted sleep and insomnia.

Hormonal changes during menopause can cause fluctuations in mood, leading to irritability, anxiety, and depression.

Decreased oestrogen levels can cause the vaginal tissues to become thinner and drier, leading to discomfort during sexual intercourse and an increased risk of vaginal infections.

Due to vaginal dryness and thinning of the vaginal tissues, some women may experience pain or discomfort during sexual intercourse.

Menopause can also cause a decrease in sexual desire or libido. This can be due to physical and emotional symptoms, such as vaginal dryness and mood swings.

Some women may experience increased headaches, particularly migraines, during menopause.

Menopause can cause weight gain, especially around the abdominal area. This weight gain is often due to hormonal changes and increased body fat.

Some women may experience fatigue and decreased energy levels during menopause - due to reduced hormone levels and trouble sleeping.

Decreased oestrogen levels can cause joint pain and stiffness, particularly in the hands, wrists, and knees, due to hormonal changes and increased inflammation.

Hormonal changes during menopause can cause memory problems, including difficulty concentrating and forgetfulness.

Menopause can increase the risk of urinary tract infections, urinary incontinence, and frequent urination.

Menopause can cause dry, itchy skin and a loss of elasticity due to decreased oestrogen levels.

Some women may experience hair thinning and loss during menopause - especially around the hairline and crown.

Menopause can affect the eyes, including dry eyes, eye floaters, light sensitivity, blurred vision, and more. Read the section above.

Hormonal changes during menopause can cause muscle cramps, especially in the legs.

Menopause can cause changes in body odour due to hormonal changes and increased sweating.

Menopause can cause digestive problems such as bloating, indigestion, and constipation.

Some women may experience ringing in the ears or tinnitus during menopause.

Symptoms can vary in severity and duration, and not all women will experience all of them.

Dry, tired gritty eyes. Sometimes red, sore eyes. Your glands (meibomian and lacrimal) and microbiomes in the mucin layer of your tears are affected by hormonal changes during menopause. It's gradual (almost in the background) and increases as perimenopause and menopause progress.

Yes, you can. With allergies, your eyes have a constant itching feeling - and when you look under the microscope, the surface of your eyes looks like cobbled streets. You'll also get morning stickiness (stringy mucus) and possibly an irritated, runny nose. Also likely to trigger asthma. Antihistamines (tablets or drops) can help with this. With menopause, you get a dry, sore, deep achy feeling. You just feel like you want to close your eyes. Drops, sprays and a good, targeted supplement will help alleviate this.

It has always been known that perimenopause and menopause cause symptoms in your eyes. I'm not sure why it's not talked about more widely.

Apart from HRT, approach it more naturally - a good diet with plenty of omegas and green leafy vegetables. You will have some good days and some (very) bad days. When you’re having a bad day - remember that the good days are just over the horizon. It tends to worsen in the wintertime, in urban areas with pollution, or when you’ve had less sleep. Get yourself some preservative-free drops and sprays - to help you through this. You should see an optician if it becomes unmanageable (even after the drops and sprays).

During menopause, the secretions from your meibomian glands go from an olive oil to a stiff toothpaste-like consistency. Warm compresses and hot showers help melt these...almost like butter in a pan.

Menopause is a chapter in your life that eventually finishes. Unfortunately, the symptoms can continue for some people.

Your cornea needs this silky, smooth, soothing mucin layer to cover it. During menopause, with the changes in your glands and secretion, you get dry patches on the surface of your eyes. This causes 'reflex tearing' - when you get tears streaming down your face. This tearing doesn't solve the dry patches and creates a vicious loop. The mucus, water and oil in your tear film are out of kilter. Use preservative-free drops and sprays to help stabilise your tear film.

When you have poor tear quality, the top fat layer in your tear film cannot contain the water layer beneath, resulting in dry patches on the eye's surface. Your eyes respond by tearing – but the issue of dry patches remains. Using a liposomal eye spray reinforces the top fat layer of the tear film and seals in the water layer, removing the dry patches. It may sound counter-intuitive, but when you're tearing excessively, apply more liposomal eye spray - to strengthen and seal your tear film. Eventually, this will stop the dry patches and deal with the streaming tears.

That's a whole topic on its own. Dawn's written a whole blog on Eye Makeup and your Eyes.

Yes, they do. With age, you tend to get more redness, yellowness, and sometimes a bumpy vein on the surface. With age, your lids change shape as your skin changes. This affects how your eyelids shut and how they spread tears across the surface of your eyes.

In short, you can't. I suggest you minimise the risk of infections and keep your eyes moisturised. Any drops or sprays must always be preservative-free to avoid sensitivity reactions. There are many vasoconstrictors (stopping or reducing blood to the surface of your eyes) on the market. But the long-term effects have not been studied, and I urge caution. Your eyes can also have a 'rebound' vasodilation when you stop using them, making them redder. And once you've got the redness, it's had to get rid of it.