How Hormones May Be Affecting Your Eyes

Hormone fluctuations can influence and impact health in a variety of ways, especially ocular health and vision.

This might manifest in thyroid related orbital disease, which Sophie Liao, MD, Robert H. Bell Endowed Chair and associate professor in the Department of Ophthalmology at the University of Colorado School of Medicine, says can outnumber women to men by as much as 5 to 1.

While it’s not abundantly clear why sex hormones play such a heightened role in autoimmune diseases that affect eyes and vision, Liao explains it’s important to seek out appropriate care from an ophthalmologist when necessary.

Some hormones — typically described as messengers that travel the body through the bloodstream — can exacerbate dry eye symptoms, which potentially impact up to about 15% of the U.S. population. Estrogen and progesterone help to regulate the eyes’ oil glands and keep tears from evaporating and drying out the ocular surface.

In other instances, thyroid hormones can affect muscles around the eye, potentially impacting the optic nerve and vision.

Liao, who is also associate chief medical officer of ambulatory services for UCHealth University of Colorado Hospital, explains more ways hormones interact with vision and eye health and when to seek treatment from an ophthalmologist.

What are some of the most common diseases in which hormones impact eye health?

Fluctuations in sex hormone levels in both men and women are a common reason we experience ocular symptoms, like dry eyes, for example. Additionally, autoimmune problems like thyroid disease and diabetes involve hormone changes that also may influence the overall health of your eyes.

Women are much more prone to thyroid related orbital disease than men. What kinds of hormone shifts can lead to eye symptoms?

Changes in your body's sex hormones levels — estrogen, progesterone, testosterone — can lead to eye problems. Increasing estrogen during menstruation can impact the quality of the oily component of tears for women in a way that worsens dry eyes and increases the chance of having a backed-up oil gland, commonly known as a style in the eyelid. In men, prostate treatments that decrease testosterone levels can have this effect as well. Changes in thyroid hormones also tend to predispose patients to developing dry eye, a leading cause of eye irritation, pain, red and watery eyes, and blurry vision.

What are some signs that hormones may be at play with eye and vision problems?

There may be new changes in the quality of vision, or gritty, irritated, watery or red eyes in conjunction with a new autoimmune disease diagnosis, such as diabetes or thyroid disorder, while starting a new hormone treatment like birth control, gender-transitioning treatment, prostate treatment, or post-menopausal hormone replacement therapy.

Certain age-related milestones — puberty, pregnancy, and menopause — might also prompt eye changes. These symptoms can often benefit from evaluation and sometimes treatment is straightforward. On the other hand, evaluation is critical to determining if more extensive management is needed.

Can hormones impact common ocular diseases, such as age-related macular degeneration or glaucoma?

There may be a linkage between elevated levels of certain thyroid hormones and the risk of developing age-related macular degeneration, but more research is needed to better understand this. Testosterone levels may increase the risk of certain retinal diseases, such as central serous chorioretinopathy. Also, estrogen fluctuations during women's menstrual cycles, pregnancy, and at menopause have been linked to changes in intraocular pressure and may impact the risk of glaucoma.

Is there an age or a regular checkup schedule to ensure people catch any signs of these diseases early?

If you have a family history of any eye disorders and have never seen an eye doctor before, you should visit one to establish a baseline. The doctor will then be able to determine what frequency of visits is best for you based on their findings. If you are experiencing any new eye symptoms, such as change in vision, irritation or pain, or are undergoing life changes that may be affecting hormone levels, you should consult with an eye professional. For most adults, a once- to twice-yearly checkup will keep your eyes healthy.