3 May 2024
Spring 2024

Becky McCall looks at the effects of menopause on the eye, and asks how optometrists can us their expertise to advise women.

Domains covered

Communication Clinical practice

Most people associate menopause with hot flushes and mood swings, but few draw the connection between fluctuating hormones and eye health. Dry eye is typical, and glaucoma and cataracts can also be triggered by this mid-life physiological shift. 

In fact, research shows that only 14% of women were aware of the connection between menopause and the eye, and 61% of menopausal women suffer from dry eye (National Eye Health Week, 2023; 2022 ). 

Around two-thirds of optometry assessments are for women (Welsh Government, 2023 ), so greater understanding is needed, and more robust evidence around the effects of hormonal fluctuations on the eye, as well as if, and how, optometrists can help to manage it. 

Sarah Farrant MCOptom, at Earlam and Christopher, Taunton, Somerset, has a special interest in dry eye disease (DED). “We encounter women with DED all the time, but it is often difficult to know whether changes in vision are menopause-related or not. However, we do see many more women coming in with dry eye than men, especially in their 40s and 50s.”

Unfortunately, eye symptoms associated with menopause are easily dismissed, says Dr Daniel Reisel, Specialist Registrar in Obstetrics and Gynaecology at University College Hospital London. “Often people say: ‘Oh, it’s just age.’ But because hormones go everywhere in the body, menopause can affect every organ system and every cell type, including mucous membranes, skin, hair and brain tissue. And, yes, glands in your eyes are also affected.”

But he says that this is not well recognised, not even among GPs. “There’s this cliché that menopause is just hot flushes, but really it’s much more like a menopause industrial complex.”

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