Many women experience a range of mental and physical symptoms as they transition through the menopause. These commonly include: hot flushes, night sweats, difficulty sleeping, problems with memory & concentration and low libido. But, did you know that fluctuations in your hormones during the menopause can also have a significant impact on your eye health?

Dry Eye Syndrome (DES) is a common, yet little known symptom of menopause. According to the Society for Women’s Health Research, about 61 percent of menopausal women suffer from dry, itchy eyes, but only 16 percent connect it to the hormonal changes they are experiencing. Changing hormone levels can affect the tear film reducing the quantity and quality of your tears and increasing the risk of evaporation. This leads to drier eyes and irritation.

Common symptoms of hormone induced DES include: dryness, burning, a gritty sensation, blurred vision, tearing, and light sensitivity. Your local optometrist can diagnose DES during a routine eye examination. Treating DES is relatively straightforward. Your optometrist can advise on, and supply, a range of artificial tears and eye ointments to soothe and lubricate the eye. Over-the-counter sprays that help re-establish the film of tears and prevent loss of moisture are also available from most pharmacies; whilst a warm compress can also help relieve symptoms. In some cases, your optometrist may advise you about ‘punctum plugs’, a plug that’s inserted into your tear duct to stop tears draining away.

As well as treating the condition with drops or artificial tears sufferers may find that making small lifestyle adjustments help to relieve their symptoms. You could try:

• Eating a diet rich in omega-3 fatty acids. An omega–3 supplement with flaxseed oil, fish oil and vitamin E may also help.

• Keeping hydrated.

• Avoiding air-conditioned atmospheres.

• Following the 20-20-20 rule – look away every 20 minutes at an object about 20 feet away for 20 seconds – when looking at screens.

Hormone levels can affect Intraocular pressure (IOP). Increased IOP is the most important risk factor for glaucoma. Studies have shown that early loss of oestrogen, i.e. women who go into an early menopause, is associated with an increased risk of Primary Open Angle Glaucoma (POAG) in women who are susceptible. Whilst an NHS study found that the risk of POAG in later-life is reduced in women who enter the menopause after the age of 54. Glaucoma affects the optic nerve and leads to the progressive loss of your peripheral vision. If left untreated glaucoma can lead to total loss of sight. A routine eye test will pick up the signs long before you notice the symptoms and if detected early, glaucoma can usually be managed with eye drops, although sometimes a minor operation is needed.

Research also indicates that oestrogen levels may play a role in cataract formation and progression The prevalence of cataracts (a clouding of the eye’s lens) is higher in post-menopausal women than in men of the same age. Symptoms of cataract include blurred vision, ghosting, glare problems, impaired colour perception and poor sight that is not corrected with spectacles or contact lenses. In most cases, cataracts can be treated very simply with routine surgery as a day patient. Menopause hormone changes can also trigger blepharitis as the oil glands in the eyelids become irritated and inflamed. Symptoms of blepharitis include red eye, burning, stickiness, excessive watering, discomfort, light sensitivity and foreign body sensation. Good eye care is essential at all times to manage the condition and prevent symptoms recurring.

Your optometrist or pharmacist will advise on the application of a warm compress, lid massage and wipes to help manage the condition. In severe cases, an antibiotic ointment or eye drops may be used to help minimise symptoms and relieve discomfort. Over time, fluctuating oestrogen can lead to changes in vision as shifting hormone levels cause small changes to elasticity of the cornea. If you are a contact lens wearer this may lead to some discomfort. It can also lead to slight distortion of your vision. It’s especially important that women going through ‘the change’ have regular eye tests to ensure early detection and treatment of any problems.