“I feel like my eyes are always dry.” “My contact lenses suddenly feel uncomfortable.” “My vision goes blurry off and on, especially during pregnancy.” These are some of the most frequent complaints women report when they come to an eye clinic, and most of them are shocked when the ophthalmologists often tell them that their hormones are usually the culprit. Hormonal changes throughout the life of a woman, through cycles each month, pregnancy, and finally menopause, can influence the feeling of the eyes and how well one can see. The changes can even be permanent and must be taken into account.

For example, during pregnancy, vision changes which may be puzzling at first. There is change to the cornea due to excess fluid retention, and this impairs vision and distorts contact lenses. Pregnancy also brings the condition of dry eyes. Hormones that are elevated during pregnancy suppress the production of tears. Perhaps more seriously, pregnancy may expose underlying medical conditions. Gestational diabetes affects the retina and causes damage that goes unnoticed. Preeclampsia causes dangerously elevated blood pressure and can begin with flagging symptoms of bright lights and vision loss. Most of these symptoms resolve after the baby is born, but extreme or drastic vision changes during pregnancy should be taken seriously.

Later on in life, menopause introduces its own set of problems. With the decreasing levels of estrogen, the eyes become constantly dry and inflamed. Being menopausal is associated with the onset of additional severe conditions such as glaucoma, which causes increased intraocular pressure, damages the optic nerve head, and may result in blindness; and age-related macular degeneration, which, as the name implies, gets worse with age and may lead to central vision loss. During this stage of life, cataracts, which is the clouding of the lens of the eye, may also accelerate in formation. Each of these changes, and especially all of them collectively, serves to limit the misconceptions of menopause being solely the experience of the decline of bone health and hot flashes. It is also a time when the eyes require maximum care.

Even the cyclical monthly hormone level can have its say. Throughout the monthly hormonal cycle, women might also notice shifts in the eyes and vision. Some women, throughout their menstrual cycle, will notice the mild manifestations of blurriness, light sensitivity, and even dry eyes. Most of the symptoms will not need treatment and will fade away with time. However, the symptoms listed do show the link between the eyes and the hormonal cycle.

Eye issues are more prevalent in women. Research shows that women are more likely to suffer from cataracts, macular degeneration, and glaucoma. This is somewhat attributed to their longer life spans, but the effect of hormones cannot be ruled out. With the current lifestyle of continuous screen time, stress, and the need to multitask, it worsens the situation more.

The good news is that women be proactive in protecting their vision. Routine eye examinations are extremely important, especially when one is 40 years old and above, as this is when glaucoma and cataracts become more common. To help reduce eye strain and avoid dehydration, one should drink plenty of water and take breaks from screens. Eating a diet high in omega-3 and antioxidants is also beneficial to eye health. Above all, unusual symptoms require prompt medical intervention.

Women’s eyes do have a story to tell that follows the hormonal path of life. There are the fleeting blurred vision of pregnancy and the dryness of the eyes that is associated with menopause. Each stage relays unique and important messages. Awareness and anticipatory care are the keys. By addressing the eyes with the same respect as the rest of their health functions, women can save not only vision but also independence and overall quality of life.

(The writer is a Chief Medical Officer – Viterioretinal Services, Sankara Eye Hospital, Coimbatore)