• Written By: Michael G. Haas, MD
    Comprehensive Ophthalmology, Cornea/External Disease

    This case-control study found that having low levels of 17-β-estradiol, estrone and total testosterone was associated with severe evaporative dry eye syndrome (DES) in postmenopausal women.

    The authors hypothesize that hormone treatment may be useful to increase tear production and restore the physiologic layer composition of tears, and say that a randomized clinical trial is needed to demonstrate this.

    They evaluated two groups of postmenopausal women: 22 with severe evaporate DES and 22 without DES.

    Serum levels of the three hormones measured were significantly lower in the DES group (P < 0.05). In the DES group, 17-β-estradiol, estrone and total testosterone levels were inversely correlated with the tear film osmolarity (r=−0.7, −0.88, −0.81, respectively). Schirmer’s testing and tear-film break up time were significantly worse proportional to these hormone levels.

    The authors say these results suggest that deficiency in sexual hormones may cause not only a reduction in tear production leading to aqueous-deficient dry eye but also a dysfunction in meibomian gland function related to an evaporative dry eye.

    They conclude that this study demonstrates that postmenopausal women are at risk for DES, and low levels of sex steroids, both androgens and estrogens, are related to the occurrence of dry eye in its evaporative form.