Dry Eye Is Common and Harmful for Midlife Women, Experts Warn

The report tells of Hilda Hernandez Nash, a woman in her late 40s, who woke up one morning and felt as if her eyes were rubbed with sandpaper while driving to work. Within days her eyes became red, watery and swollen, and at times she had trouble focusing. "I just didn't want to open my eyes. I couldn't tolerate the light," she recalled. What she thought might be pink eye turned out to be dry eye after an examination.

Dry eye is twice as common in women over 50 as in men over 50, according to large-scale studies cited in the report. "Dry eye is incredibly common," said Lauren Gormley, an optometrist and assistant professor of ophthalmology at Johns Hopkins University School of Medicine's Wilmer Eye Institute. She explained that the condition arises when the eyes cannot make enough tears or when tears evaporate too quickly.

One of the main causes in menopausal women involves the meibomian glands, oil-producing glands in the eyelids that slow tear evaporation. Gormley said sex hormones, particularly androgens, help regulate oil output, and as androgen levels fall with age, the glands produce less oil and lower-quality oil, accelerating tear evaporation and causing inflammation of the ocular surface. Dr. Kelly Nichols, dean of the School of Optometry at the University of Alabama at Birmingham, added that the lacrimal glands, which make the watery part of tears, have estrogen receptors, and shifts in estrogen levels are likely involved, though much remains unknown.

The report also notes that environmental and lifestyle factors can trigger or worsen dry eyes. Staring at computer screens all day reduces blink frequency, so tears do not spread well. Contact-lens wear, common medications including blood-pressure drugs and antidepressants, allergies, rosacea and eczema can also contribute.

Dry eye can take a toll on daily life, making reading, driving and work more difficult, Nichols said. Preeya Gupta, an ophthalmologist in Raleigh, N.C., who researches dry eye, said that as the disease advances, cells on the corneal surface can break down, causing blurred vision and higher risks of infection and scarring. Gupta encouraged anyone with persistent irritation, fluctuating vision or eye redness to see an eye-care provider.

Although dry eye is chronic and has no cure, a range of therapies can offer relief, the report says. Mild cases can be managed with warm compresses, over-the-counter artificial tears and prescription medications. In-office procedures that improve eyelid gland function are also available, though they can be pricey and often are not covered by insurance. Gormley suggests limiting screen time, taking regular breaks and consuming foods rich in omega-3 fatty acids, such as salmon, walnuts and flaxseeds, to improve gland function. Research on omega-3 supplements has been mixed, but some eye specialists report that patients benefit anecdotally.