La most common cause in dry eye It is the one associated with menopause. The decrease in sex hormones produces alterations in the epithelium of the ocular surface, in the lacrimal glands and the meibomian glands, causing the annoying sensation of "grit", of dryness in the eyes.

En Área Oftalmológica Avanzada We give you all the necessary information about the Dry Eye and its relationship with menopause.

menopause and dry eye

Menopause and dry eye syndrome

When we talk about menopause, we must consider a period of time that goes from 3-5 years before the withdrawal of menstruation, up to 10 years after, is what we call perimenopause or climacteric. There is always a reduced sex hormonesbasically estrogens and progesterone And what we currently know is that these hormones act in multiple areas of the body, including the eyes.

The box of Dry Eye that occurs associated with menopause, has special characteristics, it is a ocular process that is usually accompanied by other general disorders typical of menopause. Perhaps what stands out most in our patients is the anxiety caused by dry eye.

This is usually a patient who refers severe eye discomfort that does not allow him to carry out his normal life, he has many difficulties concentrating, keeping his eyes on a text, computer or simply watching television. This box of dry eye appears upon awakening and marks the future of what will be the rest of the day, annoyances that prevent normal tasks, generating a feeling of helplessness that can end up resulting in a depressive picture.

Syndrome Dry Eye usually usually caused by two reasons:

  • Decreased tear production.
  • Poor tear quality.

When the syndrome is produced by the poor quality of the tear, we speak of a pathology known as evaporative dry eye, whose most frequent cause is menopause in patients who suffer from it.

It is usually accompanied by other common symptoms, such as:

  • Common disorders in menopause.
  • Severe annoyances in the eyes that prevent a normal life.
  • Difficulty concentrating your eyes while doing daily activities (such as reading or watching television).

This dry eye is a loss of quality of life which causes frustration in many patients, sometimes even leading to depression.

Dry eye associated with menopause and depression

It is important to remember that menopause is usually accompanied by a certain degree of depression. We do not know if it is a consequence of hormonal changes or simply of an exogenous process resulting from the physical changes that accompany it, but the fact is that in these cases, when a certain degree of depression is established, it is usually accompanied by more subjective discomfort and dry eye usually appears among them, with a very disabling experience for those who suffer from it, especially if the environment does not help.

In these cases it is essential cope with the problem jointly between the ophthalmologist and the endocrinologist or gynecologist. It is essential to establish a strategy to treat the problem in its entirety. Experience has taught us that treating only eye discomfort will not solve the problem.

At ocular level it is usually used artificial tears and gel or creams that lubricate but, in most cases they do not solve the problem since they are abused and they end up trigger a toxic condition that further aggravates the discomfort. They are a good complement but you have to approach the treatment in another way.

This vicious cycle between the combination of menopause and dry eye and the persistence of the discomfort caused on many occasions caused by the consumption of antidepressant and anxiolytic drugs, which can further aggravate dry eye.

It is essential to assess the hormonal status of the patient, the possible hypothalamic-pituitary-ovarian axis dysfunctions and neurotransmitter levels, with the aim of designing a treatment that balances them.

Treatment of dry eyes in menopause

The Available treatments for dry eye during menopause are the following:

Blood plasma eye drops

Eye treatment should be aimed at improving areas sensitive to hormonal changes, basically reinforcing the epithelium of the ocular surface, through eye drops prepared from blood plasma (autologous serum), specifically, anti-inflammatory to improve the lacrimal gland.

Meibomian gland probing

Meibomian glands are glands located in the Eyelids which are responsible for secreting the lipids, the fat, that the tear needs to lubricate the ocular surface and prevent the rapid evaporation of the tear.

In menopause, atrophy of the meibomian glands occurs, a process that begins with the obstruction of the outlet duct, thus the content cannot be released, it accumulates inside and contributes to the atrophy of the gland, for this reason it is important to carry out the reopening of the exit orifice and probing the gland to clean its contents and help get it working again.

El probing of the meibomian glands it is performed in the operating room. We leave you a video of this surgical procedure performed by our dry eye specialists.

Next to the ophthalmological treatment would be systemic measures, basically aimed at regulating the symptoms associated with hormonal changes. It is true that in the majority of cases hormone replacement therapy is not performed, even at the ocular level it was found that it produced an aggravation of the symptoms, the opposite effect to the one intended.

Gynecologist and endocrinologist collaboration

It is vitally important to face the problem jointly between the ophthalmologist and the endocrinologist or gynecologist. These professionals must establish a strategy to treat the problem from the root.

Selective treatment of symptoms and possible side effects, such as cardiovascular disorders and osteoporosis. Physical exercise, a good diet and skin care are usually the basis for the discomfort to be significantly reduced.

Special mention deserves the issue of depression associated with menopause. Experience shows us that patients who suffer from it are very reluctant to admit it and even more reluctant to carry out any type of treatment. It is necessary to face it with special care but establishing a guideline that helps to improve it, otherwise the general symptoms increase, as well as the ocular ones, being able to reach totally disabling situations.

Artificial tears

All the artificial tears and gels serve to lubricate, but in most cases they do not solve the problem.

This is because they are often abused, triggering a toxic condition that aggravates the symptoms of dry eyes.

Tips to keep in mind if you suffer from dry eye

Finally, if you are in menopause and you have dry eye, you should follow the following recommendations:

  • Protect eyesight with sunglasses when you are outdoors.
  • blink frequently when using electronic devices.
  • Protect your eyes well if you are going to use toxic products such as bleach.
  • Sleep well and during the appropriate hours.
  • Maintain good hygiene on the skin of the eyelids.
  • No Smoking and avoid smoke.
  • Visit the ophthalmologist to prescribe the appropriate treatment.

Conclusions

In our ophthalmological center we recommend a joint action with gynecologists and especially with endocrinologists, who assess the hormonal status of patients, possible dysfunctions of the hypothalamic-pituitary-ovarian axis and neurotransmitter levels, to establish a treatment that balances them.

In these cases, the experience has been very good, achieving that the patients improve not only eye discomfort but the whole general picture that accompanies the climacteric, a period of time that can extend up to 10 years after the moment of menopause.

En Área Oftalmológica Avanzada we are experts in the treatment of dry eye during menopause. Do not hesitate to ask us what you need, we are happy to assist you!

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Dry eyes and menopause
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Dry eyes and menopause
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One of the most common causes of dry eye syndrome is menopause. This pathology, also known as evaporative dry eye, mainly affects tear quality.
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Área Oftalmológica Avanzada
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