Hormones are powerful regulators of the body and have a profound impact on various systems — including the eyes. Research has shown connections between hormones and conditions such as dry eye syndrome, cataracts, glaucoma, and age-related macular degeneration. Estrogen and progesterone, in particular, have significant effects on the eyes, especially during life stages marked by hormonal fluctuations such as puberty, menstruation, pregnancy, and menopause.

One of the most common hormone-related eye conditions is dry eye syndrome (DES), which affects women two to four times more often than men. Symptoms include burning, blurred vision, light sensitivity, and a gritty sensation. Hormonal changes — especially after menopause — can disrupt the tear film by affecting the meibomian and lacrimal glands, making postmenopausal women more prone to chronic dry eye.

Pregnancy also brings about hormonal shifts that can temporarily affect vision. Elevated estrogen and progesterone levels can cause fluid retention, which thickens the cornea and alters its shape. This may result in temporary changes in vision, usually resolving after childbirth.

Hormonal changes have also been linked to cataract development. A cataract is a natural age-related clouding of the lens, often described as looking through a dirty windshield. While cataracts are the leading cause of blindness globally, studies show a higher incidence in women — particularly after menopause — suggesting that declining estrogen levels may play a role.

Estrogen is also thought to have a protective effect on the optic nerve in glaucoma.

Postmenopausal women show a higher incidence of glaucoma and increased intraocular pressure (IOP) compared to premenopausal women of the same age. Glaucoma is a progressive, neurodegenerative disease that affects the optic nerve, leading to gradual loss of peripheral vision and, potentially, blindness. While elevated IOP is common in glaucoma, it is not necessary for diagnosis. Though there is no cure, disease progression can be slowed with IOP-lowering treatments, such as eye drops or surgery. Family history is also an important risk factor, as the disease can be hereditary. About 60% of glaucoma patients are women; therefore, those with a family history should be especially proactive with regular eye exams.

Emerging research also points to a connection between hormonal changes and age-related macular degeneration (AMD) — a progressive disease that affects central vision. AMD can be associated with aging, smoking, obesity, high cholesterol, hypertension, and atherosclerosis. Although gender is not typically considered a primary risk factor, some studies suggest that postmenopausal women may be at increased risk. The potential role of estrogen in reducing oxidative stress may be crucial in understanding its link to AMD, as oxidative stress is a key factor in the development of this condition.

These findings highlight the importance of monitoring eye health during all phases of life. Hormones play a significant and multifaceted role in eye health, with pronounced effects during menstruation, pregnancy, and menopause. Annual comprehensive eye exams with dilation are essential for early detection and prevention of vision-threatening conditions — especially those linked to hormonal changes and aging.

For more information, call Eye Specialty Group at 901.685.2200 or visit Eyespecialtygroup.com.

Shermita Mitchell, OD, is a board-certified optometrist with a passion for educating patients on the connection between systemic health and vision. She specializes in comprehensive eye and ocular disease management. Dr. Mitchell sees patients at all Eye Specialty Group locations, including Collierville, Memphis, and Southaven.

By Shermita Mitchell, OD