Women and Eye Health

by Parul Khator, M.D.

There are many eye diseases that cause reversible and irreversible vision loss. Of these, the top four include age-related macular degeneration, glaucoma, cataracts, and diabetic retinopathy. According to Prevent Blindness America, a volunteer group dedicated to fighting blindness and saving sight, the number of Americans with age-related eye disease – and resulting vision impairment – is expected to double within the next three decades.

Eye Conditions and Women: the Facts

1. Women Live Longer than Men

Women are living longer than men in the United States. This discrepancy widens as the population ages. United States Census Bureau data shows that there are twice as many women as men over the age of 85. Because they are living longer, women are naturally more susceptible to developing diseases of the eye related to aging, such as age-related macular degeneration.

2. Women are More Likely to Have Eye Disease in General

To support these increased estimates of age-related eye disease, Blindness America recently published Vision Problems in the United States: Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America, which also revealed that women are more likely to have these four eye diseases than men. In fact, as our U.S. population ages, more women than men are likely to have eye disease in general. Of the 4.1 million Americans age 40 and older who are visually impaired or blind, 2.6 million are women.

3. More Women than Men Have Untreated Refractive Errors

In addition to these four major eye diseases, women are also more likely to have untreated refractive errors, including near-sightedness (or myopia), far-sightedness (or hyperopia), and astigmatism. These refractive errors can cause significant vision problems, but are can be treated with glasses, contact lenses, or laser procedures, such as LASIK.

Refractive errors are determined by three variables: (a) the length of the eye, (b) the shape of the cornea, and (c) the shape of the lens. The first two variables usually remain constant throughout life; however, there are age-related changes that occur in the lens.

The lens is a clear crystalline structure in the front of the eye that focuses light. It can dramatically change shape as it hardens and becomes more opaque, or cloudy. When the lens undergoes this change it is called a cataract, and a cataract progresses as a person ages. Early cataracts create many of the untreated refractive errors in the aging female population.

You can learn more about this process at An Introduction to Cataracts and Cataract Surgery on the VisionAware website.

4. More Women than Men Have Dry Eye Syndrome

Dry eye syndrome can result in decreased vision, as well as irritation, redness, and pain. The eyes are lubricated by tears that are produced by glands on the surface of the eye. The glands of the eyelids contribute an important component to tears to make them more effective. Dry eye syndrome can result from both a decreased volume of tear production as well as abnormal tear composition.

Increasing numbers of research studies show that the glands of the eyes and eyelids are affected by hormonal issues. As women age, and especially as they reach menopause, they can experience hormonal imbalances that are thought to contribute to dry eye syndrome. Hormone replacement therapy was thought to combat this situation, but some newer studies show that hormone replacement therapy can actually cause dry eye syndrome to worsen.

According to the National Eye Institute Dry Eye Fact Sheet, "Dry eye is more common after menopause. Women who experience menopause prematurely are more likely to have eye surface damage from dry eye."

Chronic dry eye is an often unrecognized, unattended part of the aging process and is quickly becoming an important public health issue impacting both the quality of life as well as the physical health of nearly 10 million Americans each year. Chronic dry eye occurs in both men and women; however, women are affected two to three times more often, with the onset of dry eye occurring most frequently when women are entering menopause, during menopause, and in the post-menopausal years.

Recognizing the ever-increasing prevalence and long-range impact of the disorder, the National Eye Institute, together with the Office on Women's Health in the U.S. Department of Health and Human Services and the Society for Women's Health Research have initiated a comprehensive, evidence-based, educational initiative to increase awareness of chronic dry eye and provide clinicians with state-of-the-art diagnostic and treatment strategies to effectively manage this dynamic disease process.

You can learn more about dry eye symptoms, causes, and treatments at Dry Eye on the VisionAware website.

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