Did you know that women are at a higher risk of several eye diseases compared to men? The National Eye Institute states 2/3 of people living with blindness or visual impairment are women. Hormone changes during pregnancy/contraceptive use/menopause, the higher incidence of auto-immune conditions, certain cancer treatments, make-up use, and longer life expectancy can all impact women’s ocular health. Let’s take a deeper look!
Pregnancy and Eye Health: Hormonal changes in all trimesters of pregnancy can cause unique changes in a woman’s vision. Increased estrogen and progesterone can decrease your tear production and alter the thickness of meibomian gland secretions leading to dry eye disease. Fluid retention can cause corneal swelling, resulting in temporary changes to glasses prescriptions. Later trimesters of pregnancy have additional risks of high blood pressure and gestational diabetes, putting a woman’s eye at an increased risk of retinopathy. Symptoms such as blurry vision, flashes or sparkles in vision, or missing areas of vision would be reason to visit your optometrist and OB as soon as possible.
Contraceptive Use: Many hormonal birth control pills also put women at higher risk of dry eye as discussed above. More importantly, hormonal birth control can put women at an increased risk of sight-threatening vascular occlusions due to changes in hypercoagulable state (blood clotting).
PCOS: Polycystic Ovarian Syndrome (PCOS) puts women at greater risk of several systemic conditions including type 2 diabetes, thus increasing incidence of retinal disease. Newer GLP-1 drugs prescribed for PCOS and type 2 diabetes are being studied for their potential association with vision-threatening optic nerve damage. In vitro fertilization procedures, which can be used to treat infertility associated with PCOS, can cause hormonal fluctuations and raise the risk of eye health problems. A medication prescribed for ovulation induction called Clomid can cause rare visual disturbances (persistent after-images).
Menopause: Hormones are again the culprit of increased probability of ocular conditions! During menopause, there is a decline in estrogen and progesterone levels. Menopausal women are up to 3x more likely to develop dry eye disease in comparison to pre-menopausal women. Early studies (The Nurses’ Health Study) have indicated a possible connection between estrogen withdrawal and increases in intraocular eye pressures, which can increase the risk of glaucoma.
Auto-immune Conditions in Women: Women tend to be at higher risk of several auto-immune conditions such as Sjogren’s syndrome, thyroid disease, lupus, and rheumatoid arthritis. Dry eye is a top complaint from patients with Sjogren’s due to impaired moisture producing glands. Thyroid Eye Disease is 5-6x more likely in women, causing problems such as red eyes, double vision, or a bulging eye appearance. Lupus is associated with inflammatory conditions such as dry eye, scleritis, and optic neuritis. Rheumatoid conditions are often treated with Plaquenil, which can cause maculopathy. Yearly scans and visual fields are necessary to prevent vision loss in patients taking Plaquenil.
Breast and Gynecological Cancers: While important and often lifesaving, certain cancer treatments (such as radiation, chemotherapy, immunotherapy, or hormone-based therapies) can cause ocular toxicities. Women being treated for breast cancer or gynecological cancers should be monitored regularly for cancer-related ocular complications.
The Aging Women’s Eye: The statistically longer life expectancy in females also increases the chance of age-related eye conditions such as macular degeneration and cataracts. 65% of people in the US with age-related macular degeneration are women. Women can lower the risk of age-related eye conditions by getting yearly eye examinations, wearing UV protection outdoors, and maintaining a healthy diet including leafy green vegetables.
Make-up Use: Eye make-up, false lashes, and tattoo eye liner can all cause reactions and irritations to the eye. Keep your eyes healthy with these simple make-up tips: Be sure to clean make-up brushes and replace mascara often. Never share eye make-up. Avoid glitter near the eye. Apply eye liner outside the lash line to avoid clogging important oil glands. Wash all make-up off each night with a gentle cleanser and/or a clean microfiber cleansing cloth.
In Summary:
As women, it is important to be aware of the unique risks to our eyes due to factors such as hormones, common systemic diseases, and aging. Yearly eye examinations are always of value, even when you have no specific vision concerns.