Dry Eye Disease: Consideration for Women's Health

Abstract

Dry eye disease (DED) is a multifactorial disorder of the ocular surface and tear homeostasis that can result in discomfort, pain, and visual disturbance. Untreated, DED can become chronic, progressive, and significantly affect an individual's quality of life. Women are disproportionately affected by DED, are diagnosed at a younger age, and experience more severe symptoms compared with men. DED is associated with a wide range of comorbid conditions; there is a strong association between DED and autoimmune disorders, especially those that affect women at many times the rate of men. Treatment response questionnaires indicate women respond better to a wellness model of treatment for DED than men. Furthermore, women's health care-seeking behaviors provide opportunities for general practitioners, specialists, and women's health centers to help identify women with DED or at risk for DED for referral to an eye care specialist. This review of the prevalence of DED in women, and gender and sex-specific aspects of DED, highlight a significant opportunity for action. Earlier diagnosis and treatment of this common but burdensome condition could significantly improve a woman's quality of life.

Study of dry eye in post-menopausal women

“…Rahul Verma et al [11] found that 46% had mixed type of dry eye, 22% had tear film instability and 6% had aqueous deficient dry eye. Cynthia Matossian et al [12] found that women with autoimmune diseases like Sjogren`s syndrome, Systemic lupus erythematosus, Rheumatoid arthritis, Rosacea, Hashimoto`s thyroiditis and Graves` disease had higher chances of developing dry eye. Also, women who used contact lenses or had undergone any ocular procedure like LASIK, blepharoplasty, botulinum toxin injection and cosmetic eyelid surgery had higher chances of developing dry eye.…”

Eye Conditions in Women

“…Women are disproportionately affected by DED, especially with increasing age, making postmenopausal women the most likely to suffer from DED. 5,[54][55][56][57][58][59][60][61][62] Dry eye disease not only causes ocular discomfort but also interferes with quality of vision. As vision is integral to performing almost every daily task, from eating to getting dressed to performing in a professional setting, poor vision can have a significant impact on capacity to function in daily life.…”

“…Iatrogenic causes and gender-specific behaviors also contribute to the increased prevalence of DED in women. 5 For example, women make up two-thirds of contact lens wearers in the United States. 92 Contact lens wear has been associated with increased incidence of DED.…”

“…Sex-associated differences in ocular physiology have been identified in not only the meibomian glands 1 but also the lacrimal glands (differences in lacrimal gland size), 2 conjunctiva (women have fewer goblet cells than men), 3 and cornea (thickness, hydration, curvature, sensitivity, endothelial pigmentation, contact lens tolerance, and higher prevalence of decreased visual acuity during the menstrual cycle, pregnancy, and menopause), 4 as well as other ocular structures (Figure 1). 5 Maintenance of vision has a significant impact on quality of life, especially among an aging population, and women make up two-thirds of the blind and visually impaired in the United States. 6 This may not entirely reflect the direct impact of sex on eye function and has been attributed, for some conditions, to the fact that women live longer than men.…”

State-of-the-art etiology and pathogenesis of dry eye

“…Так, например, в последнее 10-летие наблюдается рост заболеваемости ССГ у пожилых людей [1,5,[8][9][10], в связи с чем возраст старше 40 лет является одним из факторов риска возникновения синдрома. У женщин субъективные и объективные признаки ССГ обнаруживаются в 1,7 раза чаще, чем мужчин [11], что обусловлено возрастным дефицитом андрогенов [1,12,13]. Однако симптомы ССГ выявляются и у лиц молодого возраста: у 25% студентов и 30-65% офис ных работников [5,7,14].…”