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How Hormonal Changes Affect Dry Eye

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Business women experiencing dry eye due to hormonal change while working on her desk

Dry eye disease is one of the most common eye conditions worldwide, and the causes of dry eyes are numerous. One thing that can affect our ability to produce adequate tears is a change in hormones — for example, women are more susceptible to developing dry eyes during pregnancy. If you are currently experiencing dry eyes, book an appointment at Aurora 2020 to receive a comprehensive eye exam and our eye doctors can help you pick an effective treatment that fits your specific needs. 

What is Dry Eye Disease?

Dry eye disease occurs when the tears you produce to lubricate your eyes are considered inadequate; either your tears are not high enough quality, or not dispersed in a large enough quantity to lubricate your eyes properly. Instability of tear production can lead to developing inflammation and damage on the eyes’ surface, and symptoms such as stinging or burning sensations.

Symptoms of Dry Eyes

Signs and symptoms of dry eye disease can include:

  • Feeling a stinging, burning, or scratchy sensation in your eyes
  • Developing mucus in or around your eyes
  • Sensitivity to light
  • Your eyes look red and feel irritated
  • Feeling the sensation of having something foreign in your eyes
  • Difficulty wearing contact lenses
  • Blurred vision
  • Eye fatigue

Causes of Dry Eyes

Dry eyes occur when the balance of your tear film is disrupted. A healthy tear film has three layers that are balanced in a specific ratio: the fatty oil layer, the water layer, and the mucus layer. If your tear film has been disrupted and the ratio between these layers is incorrect, it can cause dry eyes due to decreased tear production or an increase in tear evaporation.

Tear film dysfunction can happen for a variety of reasons, including:

  • Hormonal changes
  • Autoimmune disease, 
  • Inflamed eyelid glands 
  • Allergic eye disease

Hormonal Changes and Dry Eyes

Hormones can be described as natural chemicals that guide and control activities throughout your body. Hormones travel through your bloodstream and other bodily fluids to different organs and tissue, signifying to your body that it requires something. Hunger, behaviour, sleep, and reproduction are all activities coordinated by hormones

Hormonal changes are completely natural, and everyone will go through shifts in their hormonal make-up. During these changes, all parts of your body can be affected — including your eyes.

Women Have an Increased Risk of Developing Dry Eye

A lower quantity of tear production is more common in women — especially if they are experiencing hormonal changes due to pregnancy, birth control pills, or menopause.

Due to hormones, women can be subject to changes in their vision throughout their adult lives. Changing levels of estrogen and progesterone can affect the meibomian gland (where the oil layer of your tear film is produced), which can lead to dryness or irritation. Estrogen can also make the cornea more elastic, which can affect how light is refracted by the eye. Dryness and the difference in refraction can cause blurry vision and make wearing contact lenses difficult. 

Blurry vision or dry eyes caused by hormonal changes will disappear when the hormones in your body stop fluctuating. If you are pregnant or going through menopause, symptoms of dry eyes can start disappearing once your hormones level out. If symptoms do not subside, talk to an eye care professional right away.

How to Treat Dry Eyes

If you think that your immediate environment or lifestyle is the root cause of your dry eyes, you can:

  • Try to avoid smoke, wind, and air conditioning
  • Use a humidifier in the winter
  • Limit screen time and take breaks often
  • Try to remember to blink
  • Wear wraparound sunglasses
  • Drink plenty of water
  • Get enough sleep
Women sitting on couch with her head up putting eye drops in eyes for dry eyes

If your condition is not being caused by external factors in your environment, what treatment option you choose for your case of dry eyes will entirely depend on what’s causing your symptoms. Some effective treatments for dry eyes are:

  • Over-the-counter eye drops — The most common treatment for mild dry eye is artificial tears. These eyedrops do not require a prescription and aim to replicate the function of your natural tears.
  • Prescription medicines — If you have a more severe case of dry eye disease, your doctor may suggest a prescription for medicines called cyclosporine (Restasis) or lifitegrast (Xiidra), which assist in tear production. Try to avoid medicines that will abruptly affect your hormones, as they may make your dry eyes worse.
  • Tear duct plugs — If your tears are draining too quickly from your eyes and evaporating before they can provide adequate lubrication, your doctor may suggest putting removable punctal plugs in your tear ducts. These plugs will help hold moisture in your eyes for a longer period of time.
  • Surgery — Dry eye disease can occur because your lower eyelids are too loose, which causes tears to drain too quickly out of your eyes. Your eye doctor may suggest surgery to fix your eyelids, but this type of treatment is not very common and is usually reserved for severe cases.

Written by Dr. Robert MacAlpine

Dr. MacAlpine graduated from Queen’s University, and attended the New England College of Optometry in Boston, MA. He graduated in 1999 with clinical and academic honours and was recipient of the Alcon Award for Most Outstanding Contact Lens Clinician. His internships included Pediatric and Low Vision focused training, several Veteran Affairs Hospitals in the greater Boston area, and the Barnet Dulaney Cataract and LASIK Center in Phoenix, Arizona. After graduating, Dr. MacAlpine established a successful practice and optical store in the Boston area. Practicing in the United States allowed him privileges of treatment and prescribing for eye diseases that were not permitted to Ontario Optometrists until 2011. Robert was thrilled to return to his native Ontario in 2011 to raise his two daughters, Deanna and Ella with his wife Amy. He enjoys playing hockey and being active with his family.
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