Menopause and Dry Eyes: Why you’re probably not blinking enough

Dry eyes and menopause: yes, there’s a link.

Now that many of us are in the thick of allergy season, it may be hard to differentiate itchy, burning eyes due to pollens and itchy, burning eyes due to other causes.

But if your gritty, blurry eyes are year-‘rounders now, you may be dealing with Dry Eye Disease, or DED. Twice as common in women over 50 than it is in men of the same age, keratoconjunctivitis sicca is a symptom to not ignore.

If you are a woman suffering from dry eyes, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

What is Dry Eye Disease?*

According to the National Eye Institute, dry eye is when your body doesn’t make enough tears, or when your eyes make the wrong kind of tears or tear film. Tears have three layers: oily, watery, and mucus. The oily on the outside (farthest from your eye) keeps the tear from drying too fast. The middle watery layer keeps eyes clean from dust, lashes, pet hair, and all that other stuff that seems to find its way to our eyeballs. Finally, the mucus layer on the inside keeps eyes moist. If normal production of one or more of these layers is disrupted, that can result in DED.

What causes dry eyes in menopause?

Like so many bits of the body that are moist, production of that moisture in the eyes depends in large part on the sex hormones estrogen and testosterone. As these hormones decline with menopause, so does the lubrication.

There are other causes of Dry Eye Disease, so if you believe you may be suffering DED, it’s a good idea to (a) check that there’s not a more serious underlying cause, and (b) avoid those factors that are within your control.

1. Medications such as hormone replacement therapy (HRT), antihistamines, blood pressure meds, antidepressants, birth control pills, and decongestants can contribute to dry eye.
2. People who have had laser eye surgery report a higher incidence of DED development.
3. Those with autoimmune diseases such as rheumatoid arthritis, diabetes, Sjogren’s Syndrome, lupus, scleroderma, and some thyroid disorders are more likely to develop DED symptoms.
4. Environmental factors are big contributors: smoke, wind, not giving your eyes relief from screens, a dry climate, even not blinking enough.

How do I know if I have Dry Eye Disease or normal irritation?

Those suffering DED usually have chronic stinging and burning. You may have blurred vision that’s briefly relieved by blinking, or feel like you have something in your eye. Your eyes are painful, red, gritty, and easily irritated by smoke or wind, and wearing contacts is painful or impossible. Oddly, if your eyes are generating excessive tears, that’s also a symptom of dry eye, as your body attempts to compensate for tears that aren’t the right consistency or that evaporate too fast. You may also experience sensitivity to light and impaired night vision.

If this sounds familiar, and it’s long-term and not associated with irritants like seasonal allergies, you should definitely get to an eye doctor for help. Leaving DED untreated can cause damage to the front of the eye, leave your eye more vulnerable to infection, and impair your vision.

Dry Eye diagnosis should be done by a licensed professional. An optometrist may want to add some dyed drops in your eyes to check if tear flow is normal and if there’s any damage to the eye already. The doc will check your eye to make sure the lid doesn’t turn outward or inward (both can cause dry eye) and to evaluate (my favorite medical term of all time) your “ blink dynamics” (if you’re blinking often enough).

Is there anything I can do about Dry Eyes and Menopause?

There are lots of things you can do about your dry eyes, including both lifestyle and environmental changes. For more serious cases, there are treatments by a health care practitioner that can relieve symptoms and head off long-term damage.

Ways to control your environment and reduce irritants

• Get a humidifier. In dry climates and over the winter, these can be a huge help by adding moisture to the air. If you’re in a dry place and can’t add a humidifier (like an airplane), be sure to close your eyes a lot and for a few minutes at a time. Make sure that airplane fan is tilted to hit the top or back of your head – you want to minimize air flow directly into your eyes.
• Cover your eyes. When you’re out and about, particularly in a windy place or on a bike, find wraparound sunglasses that protect your eyes completely. Hey, wraparounds are cool.
• Give your eyes a break. If you’ve been reading or focused on your screen a while, close your eyes. Blink. A lot. Try to remember to do this every few minutes, as we tend to blink less when focused on close-up tasks. Mayo Clinic says to lower your screen a little; looking down means your eyes aren’t as wide open.
• Stop smoking. Avoid others who smoke, at least while they’re actually smoking.
• Use eye drops. Unless you have a sensitivity to the preservatives in eye drops, you should be OK to use them as much as you need, even when your eyes seem OK.
• Adding omega-3 and omega-6s (try our women's omega-3 supplement!) to your diet might help improve the situation: think flaxseeds, fatty fish, and some vegetable oils.
• Drink plenty of plain, still, unflavored, un-bubblied water.
• Wash your eyes gently with a very mild soap and warm water to make sure there’s nothing blocking the flow of oil to your eye.

Treatments for dry eye

If your dry eye is mild or moderate, over-the-counter eye drops may be enough to control your symptoms. For more severe cases, docs may recommend antibiotics to reduce inflammation, prescription eyedrops, eye inserts that release a lubricant, plugs to block tear ducts and keep tears in your eyes longer, light therapy and eyelid massage, or special contacts called “scleral” lenses that trap moisture next to the eye.

Yes, drier eyes may be part of getting older, but like so many things, you don’t have to just put up with the reduced quality of life. An eye doctor can diagnose the issue and get you set up to control the symptoms and avoid long-term damage.

*As always, these blogs are not intended as a self-diagnosis tool and should never be used to replace care by a licensed health care professional. If you think you have Dry Eye Disease, or any other serious medical condition, schedule a visit with your doctor.