Dry eye common in postmenopausal women; mechanism unclear

Seattle-Meibomian gland dysfunction is a common contributor to dry eye disease, especially in postmenopausal women. Dry eye disease occurs more frequently in women, and increases with advancing age. 

In a study presented at the annual meeting of the American Academy of Optometry in Seattle, Lisa Jones-Jordan, PhD, and colleagues attempted to determine the prevalence of dry eye in postmenopausal women, as well as to evaluate the distribution of aqueous deficient, evaporative, and mixed etiology in this population.

“As we know, dry eye disease appears more in women, and [increases with age],” said Dr. Jones-Jordan, a research associate professor in the College of Optometry at The Ohio State University.  “There is not really enough tear production, and there may be a function of some kind of dysfunction.”

There are new diagnostic techniques and potential treatment options, but there is a lack of information on how we should be treating dry eye.

“The existing estimates for the prevalence of dry eye does not reflect the current understanding,” said Dr. Jones-Jordan.

Researchers looked at two sets of postmenopausal women (n = 440 and n = 499; N = 939) and combined them to evaluate clinical dry eye examination findings including: the Schirmer test, meibomian gland (MG) status (gland blockage 0-3), and symptoms.

Of this group, roughly two-thirds of women (62.5%) met the criteria for one of the categories of dry eye. In addition, 11.1% were classified as normal, and 26.4% did not meet any of the criteria. When the researchers included symptomatology in the classification, fewer women met the criteria for having dry eye (11.6% of the sample). This demonstrates the variability in symptom reporting combined with diagnostic testing.

“We found that meibomian gland dysfunction play a role in developing dry eye dysfunction,” said Dr. Jones-Jordan, and adds that further study is needed to determine whether meibomian changes occur as part of the dry eye disease process or as a normal part of aging.