Articles about Eye Health and Disease 2002
 

Hormone Replacement Therapy is Associated with Dry Eye Symptoms in Women

(From Schaumberg DA, et al., JAMA 2001;286:2114.)

Symptoms of eye dryness are common in older individuals, especially post-menopausal women.  These symptoms can include ocular grittiness, redness, a sensation that something is in the eye, dryness, sensitivity to light and wind, pain, burning, blurred vision, and even bouts to tearing.  For many patients, dry eye problems can be significant and debilitating.  Frequent use of artificial tears and lubricating ointments may be needed.  Post-menopausal women frequently use hormone replacement therapy to reduce symptoms of menopause.  Recent studies have cast doubt on the ability of hormone replacement therapy to reduce the risk of heart disease in women.

In the study mentioned above, a survey of 25,000 post-menopausal women was undertaken as part of the Women's Health Study (a randomized trial originally designed to determine the risks and benefits of using aspirin and vitamin E in the prevention of heart disease and cancer).  In the 4-year follow up questionnaire in the study, questions concerning dry eye syndrome were included.  Questions included, "How often do your eyes feel dry?", "How often do your eyes feel irritated?", and "Have you ever been diagnosed with dry eye?".  

The survey found that women who used hormone replacement therapy were at increased risk for dry eye syndrome:

• Women who used estrogen alone were 69% more likely to have dry eye syndrome than those who did not.

• Women who used hormone replacement therapy consisting of estrogen with progesterone or progestin had a 29% increase rate of dry eye syndrome.

• For every 3 years of hormone replacement therapy use, the risk of severe dry eye increased by 15%.

Estrogen receptors have been found in the lacrimal glands (tear producing glands) of both men and women, but receptors that respond to androgens (male hormones such as testosterone, which are also found in women at low levels) may be more important in stimulating the production of tears.

 

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