Ask the Expert: What is the Link Between Dry Eye & Menopause?

Eye Health Care

12 February 2025

Menopause most commonly occurs when a woman is aged between 45 and 55. With menopause, a woman experiences significant hormonal changes, affecting their overall health and well-being – including vision.

Dry eyes are commonly linked to menopause as a shift in hormonal levels can lead to discomfort, irritation and blurred vision.

To help alleviate the common misconceptions and anxiety, our experts will be exploring the link between menopause and dry eyes. Examining how hormonal fluctuations impact eye health and the best ways to manage symptoms and maintain overall well-being during this stage of life.

Can Menopause Affect Your Eyes?

Menopause causes many bodily changes, including eyesight, specifically dry eyes. As hormone levels start to fluctuate, it significantly impacts eye health. It’s not uncommon for women in perimenopause or menopause to experience issues such as dryness, irritation, or even changes in vision clarity. The imbalance of oestrogen and androgen levels disrupts the body’s ability to produce sufficient tears and maintain a healthy tear film, often leading to dry eyes during menopause. This hormonal imbalance can also affect other parts of the eye, contributing to symptoms like blurred vision or increased light sensitivity, making it crucial to address these changes early for optimal eye health.

Common Eye Problems Linked with Menopause

The following are commonly encountered eye problems that arise with the menopause:

Dry Eyes in Menopause

Hormonal decline during menopause can result in dry or irritated eyes. This happens mainly from reduced production of the tear film that lubricates our eyes.

The oestrogen and androgen levels in women drop – this imbalance of natural oils and tears, leads to low moisture on the eye’s surface. Resulting in women going through menopause (or perimenopause) experiencing dry eye symptoms.

These include itching, burning, redness, and a gritty feeling in the eyes. It does mean activities such as an increased use of digital screens or reading can become uncomfortable.

An Increased Rate of Developing Cataracts

Women experiencing menopause are more likely to develop cataracts compared to similar-aged men.

Cataracts of course are more common with increased age, but the risk is heightened in menopausal women – again mainly caused by the decline in oestrogen levels, which appear to accelerate cataract formation.

Oestrogen aids in preserving a healthy lens – when oestrogen is reduced, the eye is exposed to oxidative stress and protein clumping, both of which are cataract formation factors.

Light Sensitivity (Photophobia)

Light Sensitivity in Menopause: What to Know

Light sensitivity (also known as photophobia) is common for menopausal women. When experienced, it causes squinting in bright environments.

It happens to menopausal women because the hormonal changes impact the production and stability of the tear film. As the tear film becomes thinner, it leaves the eyes more exposed causing discomfort in the presence of bright lights.

Many women find, that as hormonal fluctuations settle down, light sensitivity typically lessens or goes away completely.

Changes in Eye Shape

During menopause, the cornea’s elasticity and thickness can change. Reduced oestrogen and androgen levels make the cornea thinner and a little less flexible. This impacts how the cornea is shaped, meaning contact lenses may not fit as they did before. Using preservative free lubrication that is synergistic with contact lenses and having a contact lens review to modify fit can improve comfort and vision.

Glaucoma

Research suggests a link between menopause and an increased risk of glaucoma, but this doesn’t mean every woman who goes through menopause will develop the condition.

Early menopause (before age 45) is associated with a higher risk of open-angle glaucoma compared to later menopause.
The decrease in oestrogen levels during menopause may contribute to slight increases in eye pressure, which is a risk factor for glaucoma.
Women who experience menopause at a later age tend to develop glaucoma later, if they develop it at all.
Regular eye check-ups are important, especially after menopause, to monitor eye health and detect any changes early.
Hormone replacement therapy containing oestrogen may help reduce eye pressure in some postmenopausal women.

Remember, while these findings are important, they don’t mean glaucoma is inevitable. Many women go through menopause without developing glaucoma.

The key is to stay informed, have regular eye exams, and discuss any concerns with your healthcare provider.

Can Menopause Cause Eye Floaters?

Menopausal women may experience cobweb like shadows called floaters in their vision. This could be a part of the natural ageing process, and some studies suggest menopause may cause these.

If you experience new, an increased number or floaters associated with flashes or a curtain veil over vision this could signify a retinal detachment which is a sight threatening condition requiring immediate attention. If you experience these signs and symptoms, visit your local A&E or eye casualty for medical attention.

Maintaining Eye Health During Menopause

Women going through menopause can help optimise their eye health and manage symptoms like dryness, sensitivity, and vision changes.

Several useful tips can help – for starters, a balanced, nutrient-rich diet. Eating foods rich in omega-3 fatty acids (salmon, flaxseeds, and walnuts) can help keep tear film healthy while reducing dry eye menopause symptoms.

Spinach and kale (and other leafy green vegetables) are high in lutein and zeaxanthin – these protect against oxidative damage, while vitamins A, C, and E – found in foods like citrus fruits, carrots and almonds – are also great for eye health.

It’s also important for women going through menopause to have regular eye exams for their overall eye health and timely intervention based on the symptoms they experience.