Updated 08/2021

How your eyesight may change as you age

By Mia James

Hot flashes, mood swings, vaginal dryness, and eye changes? It’s true: your eyes are among the various parts of your body and well-being that menopause can affect. You can make these changes less uncomfortable or disruptive by knowing what to expect and being ready to manage any alterations in your vision or eye comfort.

The way hormones affect the eyes as we age is not entirely understood, yet experts tend to agree that from just before puberty and beyond, changing hormone levels appear to have an impact on vision and other aspects of eye health. One explanation of the link between hormonal changes (including puberty, pregnancy, the use of birth control pills, and menopause) is that the eyes contain estrogen receptors, which are affected as levels of the hormone rise and fall.1

We are likely to see changing theories on eye health and menopause as research continues, but according to our current understanding many women can expect some difference in their eyes as they undergo menopause. Some of these changes may be a direct result of changing hormone levels, whereas others may just coincide with age at menopause.

The following are some of the ways we know your eyes may change during menopause and how you can manage them.

Dry Eye. With a condition called dry eye, the eyes don’t produce enough tears, or tears are not of the correct consistency and evaporate too quickly. Your eyes can feel scratchy and become swollen and red, making you look as though you’ve been crying. You may also find that your vision is blurred and you are more sensitive to light. You can experience dry eye in any climate, but it may occur more frequently in drier conditions. Some medications, including antidepressants and allergy medicine, can also make eyes drier.

What You Can Do. You can take steps on your own to protect your eyes and reduce dryness, and you can also get help from your doctor.

  • Over-the-counter artificial tears (eye drops), gels, gel inserts, and ointments might offer temporary relief by replacing natural tears. Even though you can get these treatments without a prescription, be sure to ask your doctor about which products to try and how to use them.
  • When you are outdoors, wearing glasses or sunglasses that fit close to your face can help keep your eyes from drying out too much.
  • When indoors try using a humidifier to keep moisture in the air.
  • Your doctor may prescribe cyclosporine (Restasis®), an anti-inflammatory medication to treat dry eye.
  • If you wear contact lenses, your doctor may recommend that you try a different type of lens, reduce the time that you wear lenses each day, or switch to glasses.
  • Doctors can also treat dry eye by temporarily or permanently plugging drainage holes at the inner corner of the eyelids. This helps keep moisture (tears) from draining from the eye.
  • Some people also find that omega-3 fatty acids, either in the diet or from supplements, can help manage dry eye. Talk to your doctor before trying a supplement.2

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Cataracts. A cataract is a clouding of the lens in the eye that affects vision. The condition is very common as men and women age, though older (postmenopausal) women tend to be affected at a higher rate than older men, making cataracts a concern for women around menopausal age. Currently, however, there is no evidence to link cataracts with hormonal changes during menopause or at any time in life. Symptoms include cloudy or blurry vision, colors appearing faded, sensitivity to glare, poor night vision, double vision, and the need to change prescriptions for contact lenses or eyeglasses.

What You Can Do. Cataracts can be treated with nonsurgical approaches or with surgery when other management is ineffective.

  • New eyeglasses might help improve your vision. Brighter lighting in your home or office, anti-glare sunglasses, and using a magnifying lens to see very small print or objects can also be useful.
  • If you try the measures above and still aren’t seeing well enough—in other words, vision problems are interfering with your everyday activities—you may need surgery. Cataract surgery involves removing the cloudy lens from your eye and replacing it with a clear artificial lens.3

Glaucoma. The term glaucoma refers to diseases that damage the eye’s optic nerve, which creates pressure and fluid buildup and can cause vision changes and blindness. Early glaucoma might not cause symptoms, but as it progresses people with the disease start to lose their vision, beginning with side (peripheral) vision, and without treatment can progress to blindness. The risk of glaucoma increases with age, placing you at a higher risk as you approach menopause.

What You Can Do. Treatment for glaucoma is most effective when the disease is diagnosed and treated early. Regular eye exams with an ophthalmologist (eye doctor) as you age can increase the chances of finding glaucoma early. Here are some common treatments:

  • Medications, including eye drops and pills, are often used as early treatment for glaucoma. They help lower the eye pressure caused by the disease and help the eye make less fluid.
  • In laser surgery, or trabeculoplasty, the doctor uses a high-intensity beam of light, aimed at the eye. The procedure helps drain fluid from the eye.
  • Doctors use conventional surgery to make a new opening in the eye, which allows the fluid to leave the eye. You would have conventional surgery only if medication and laser surgery have been ineffective.4

References

  1. Menopause and Eye Health. More magazine website (in collaboration with the North American Menopause Society). Available at: http:// www.more.com/menopause-and-eyes. Accessed October 26, 2015.
  2. Facts about Dry Eye. National Eye Institute website. Available here. Accessed October 26, 2015.
  3. Facts about Cataract. National Eye Institute website. Available here. Accessed October 26, 2015.
  4. Facts about Glaucoma. National Eye Institute website. Available here. Accessed October 26, 2015.