Enough to make you cry: Menopause also affects eyes

MADISON, Wis. — As if hot flashes and insomnia aren’t enough, women after menopause often suffer another vexing symptom of hormone changes — dry eye.

Optometrist Dr. Janet Cushing said that while dry eye can affect people of any age and either sex, “the majority of the people I see for this condition are postmenopausal women.” Cushing practices at a clinic affiliated with the University of Wisconsin-Madison.

“It affects millions of people, and most of them are women,” she said.

And most of them have no idea why their eyes are watery and irritated.

“Often people come in because they believe there is something in their eye,” Cushing said. “It’s what we call ‘foreign body sensation.’ ”

What’s really happening is that one or more of the three layers of tear film — the outer lipid layer, the aqueous layer and the inner mucin layer — that normally protect the cornea have decreased, leaving the eye open to irritation.

Besides hormone changes, dry eye can be caused by the low humidity and dry air of winter; air conditioning in summer; and, more rarely, by thyroid conditions; inflammatory diseases such as lupus and rheumatoid arthritis; allergy and blood pressure medications; and chronic inflammation. Even overuse, such as prolonged reading or computer work, can lead to dry-eye symptoms.

Strangely, one of the most common symptoms of keratoconjunctivitis sicca (the medical name for dry eye) is watery, teary eyes.

“Because the cornea is dry and irritated, this triggers tearing,” Cushing said. “It sounds illogical, but it’s the same thing that happens when cold, dry wind triggers teary eyes.”

Other symptoms may include blurring of vision that comes and goes, stringy mucus, burning and redness.

After having an eye-care provider check to make sure it really isn’t a foreign body or other problem, there are several solutions. Artificial tear drops are available over the counter, as are gels or ointments, which tend to be more effective because they’re thicker and remain in the eye longer.

“Many of my patients swear by warm compresses — putting a clean, warm, wet washcloth over the closed eyes,” Cushing said.

Other at-home remedies include using a humidifier to keep the room air more moist; staying hydrated; and avoiding heat vents, including those in the car, that blow directly on the eyes. Cushing says there is evidence that fish-oil supplements, which are rich in Omega-3 fatty acids, are also helpful.

Sometimes, these measures aren’t enough and doctors will be more aggressive. The prescription medication cyclosporine (Restasis) can relieve chronic inflammation of the ocular surface. Another treatment is a procedure called a punctual occlusion, in which doctors plug the duct that carries tears to the nose in order to keep the tears from draining away.