Hormonal imbalance and dry eye syndrome

Dr Aditya Sethi
Dr Aditya Sethi
The author is an experienced Ophthalmologist (Eye Surgeon) practising at Arunodaya Deseret Eye Hospital. He specialises in Dry Eye Disease, refractive LASIK and FemtoLasik surgeries, pediatric cataract correction, and complex squint treatments.

Imagine your body as a delicate balance of threads, and hormones are a key part. Now, think about dry eyes. It turns out that these hormones are more important than we may realise. Understanding their relationship helps us see the bigger picture of women’s health and why dry eyes happen. Lets talk about the oft-overlooked connection between hormonal fluctuations and dry eye syndrome in women, emphasizing the critical importance of understanding this link and the potential consequences of neglecting it.

Role of hormones in female bodily functions

Hormones are the body’s messengers, orchestrating a wide range of essential functions. From regulating the menstrual cycle and pregnancy to controlling metabolism and mood along with maintaining the body’s homeostasis, hormones play a crucial role. While hormones are often associated with their role in reproductive and endocrine systems, their influence extends to various bodily functions, including tear production.

In particular, oestrogen, progesterone, and androgens have been identified as key players in preserving eye health. These hormones affect the lacrimal glands, responsible for tear secretion, as well as the meibomian glands, which produce the oily layer of the tear film. Any hormonal imbalances disrupting these functions can lead to Dry Eye Syndrome.

Hormonal fluctuations on eye health in women

Hormonal fluctuations, a common occurrence in women throughout different life stages, can profoundly impact eye health. Some key moments in a woman’s life where hormonal imbalances can contribute to Dry Eye Syndrome are as follows:


Menopause is marked by a significant drop in estrogen levels. This hormonal shift can lead to changes in tear production and composition, making post-menopausal women more susceptible to dry eye. Studies estimate that over 60% of menopausal women experience dry eye symptoms.


Pregnancy brings about substantial hormonal changes, with increased levels of estrogen and progesterone. These hormonal shifts can affect tear production, causing temporary dry eye symptoms. Additionally, the changes in hormone levels during pregnancy can lead to an increased risk of autoimmune diseases, which can contribute to dry eye.

Birth control

The use of hormonal birth control methods, such as oral contraceptives, can influence tear production and may lead to dry eye symptoms. Women must discuss potential side effects with their healthcare providers when considering birth control options.

Thyroid disorders

Hormonal imbalances associated with thyroid disorders, including hypothyroidism and hyperthyroidism, can impact the function of meibomian glands in the eyelids. These glands produce the oily layer of tears that helps prevent evaporation. When these glands are affected, it can result in an evaporative dry eye.

Mechanism of hormonal imbalances leading to dry eyes

Hormonal imbalances can exert their influence on dry eyes through several mechanisms:

  • Altered tear production: One of the primary mechanisms is the alteration of tear production. Hormones play a pivotal role in signalling the lacrimal glands, which produce the watery component of tears. When hormones like estrogen, progesterone, or androgens fluctuate, they can influence the lacrimal glands, resulting in changes in the quantity of tears produced.
  • Meibomian gland dysfunction: Another critical factor is the meibomian glands, which produce the oily layer of the tear film. This layer is essential for preventing rapid tear evaporation. Hormonal imbalances can disrupt the function of these glands, leading to meibomian gland dysfunction (MGD). As a result, the tear film’s composition is altered, impairing its ability to provide proper lubrication to the eyes.

Symptoms of Dry Eye Syndrome and consequences of ignoring it

Recognising the symptoms of Dry Eye Syndrome is critical because ignoring them can have both immediate and long-term consequences. Let’s delve into the common symptoms and the potential long-term effects of this condition.

  • Dryness: Dry eye typically begins with a persistent sensation of dryness in the eyes. This dry, scratchy feeling can be uncomfortable and may worsen as the day goes on.
  • Burning or Stinging: Many individuals with dry eyes experience a burning or stinging sensation, akin to having a foreign object in the eye. This discomfort can be quite distressing.
  • Redness: The eyes may appear bloodshot and red, primarily due to the irritation caused by the lack of adequate lubrication.
  • Itching: Dry eyes can lead to persistent itching, compelling the affected individuals to rub their eyes, which can further exacerbate the symptoms.
  • Blurry Vision: Insufficient tear film can distort and blur vision, affecting the ability to see clearly, especially during activities like reading or using digital screens.
  • Sensitivity to Light: Photophobia, or sensitivity to light, is a common symptom of dry eyes. Bright lights can intensify discomfort and lead to squinting.
  • Mucous Discharge: Dry eyes may trigger the production of excessive mucous in the eyes, creating a sticky discharge that can be bothersome.

Potential long-term consequences of dry eye syndrome

Neglecting the symptoms of Dry Eye Syndrome can lead to several long-term consequences, including:

  • Corneal Damage: The cornea, the clear front surface of the eye, relies on the tear film for nourishment and protection. Without adequate lubrication, the cornea is vulnerable to damage, potentially resulting in corneal abrasions or ulcers.
  • Eye Infections: The compromised tear film can provide a breeding ground for bacteria and pathogens. This increases the risk of eye infections, which, if left untreated, can lead to vision-threatening complications.
  • Reduced Vision Quality: As the condition progresses, untreated dry eyes can lead to decreased visual acuity and overall vision quality. This can impact daily activities and reduce the quality of life.
  • Chronic Discomfort: Ignoring dry eye symptoms can result in chronic discomfort and reduced eye comfort. Individuals may find it challenging to perform routine tasks, such as reading, driving, or working on a computer.
  • Increased Risk of Corneal Surgery Complications: For those considering vision correction procedures like LASIK or cataract surgery, pre-existing dry eye can increase the risk of post-operative complications and hinder the success of these procedures.

Dry eye syndrome, particularly in women experiencing hormonal imbalances, is a condition that warrants our attention. It is important to understand the intricate link between hormonal fluctuations and eye health.

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