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How Hormone Shifts Can Affect Your Vision + What To Do, From An MD

Kyrin Dunston, M.D.
Author:
March 27, 2022
Kyrin Dunston, M.D.
Board Certified OBGYN
By Kyrin Dunston, M.D.
Board Certified OBGYN
Dr. Dunston is a board certified OBGYN and functional medicine specialist.
Closeup portrait of a woman with gray hair and fine lines
Image by Viktor Solomin / Stocksy
March 27, 2022

Here's something you may not know: The hormonal changes associated with menopause directly increase the risk of blindness. Unfortunately, these changes are often asymptomatic, so someone may not even know it's a problem until it's too late. In fact, more than 65% of blindness occurs in older women. That's a pretty sobering and preventable statistic.

Yet, despite these statistics, most of us give very little time, attention, or concern to preserving this most precious aspect of our health. That's pretty troubling, because your eyes are not only the windows to your soul but also to your health. Let's take a closer look at what happens to a woman's eyes during menopause and why it matters.

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Your eyes on hormones.

Our eyes are microcosms of our overall health. During menopause, a woman's whole body chemistry shifts. Hormone levels decrease and parts of the eye—including eyesight and eye shape—start to change, as well. 

The hormonal shifts may seem subtle at first: dry eyes after a long day at the computer, itchy eyes during certain seasons, red eyes, and vision loss. But each symptom is a message from the vision center in our brain trying to tell us that something in our body is out of balance. 

Most women aren't aware that sex hormones have power outside of menstruation and reproduction. In fact, they have more responsibilities outside the reproductive system than they do inside.

You can see evidence in the brain and central nervous system, which has more receptors for sex hormones than you do anywhere else in your body. The eyes are a part of the central nervous system, and so our sex hormones play a key role in eye health

In your fertile years, estrogen, testosterone, and progesterone bathe the specialized tissues of your eye. Their job is to keep the eyes moist, vital, and alive. But during menopause, the amount of sex hormones in the body decreases dramatically.

One of the most common results of the drop in sex hormone levels is dry eye. All three sex hormones work together to control our eyes' oil glands. 

Estrogen also affects the elasticity of the cornea, which changes the way light travels through the eye. Even small variations in the shape, elasticity, and moisture of the eye can have dramatic effects on our vision. Over time, fluctuating estrogen levels can lead to partial or full vision loss. 

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Common eye problems.

Women in their forties and fifties are disproportionately affected by these issues compared to their male counterparts. They are also 12% more likely to experience vision loss than men

Some evidence suggests that gender disparities in vision problems are cultural. Women have less access to routine vision care and fewer funds to finance it. Women also generally live longer than men, giving them more time to develop these eye diseases, which are more common at the end of our lives. 

Sex hormone imbalances are partly responsible for the four most common eye problems:

1.

Glaucoma

Glaucoma affects the optic nerve at the back of the eye. Studies suggest that low levels of estrogen can increase a woman's risk of developing open-angle glaucoma during menopause

Your eye makes fluid to nourish the parts of the eye that do not have blood vessels. However, too much fluid or problems in draining the fluid can cause damage to the optic nerve. Damage to the optic nerve and increased pressure in the eye cause peripheral vision loss. 

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2.

Age-related macular degeneration

Also known as AMD, it begins with the deterioration of the retina at the back of the eye. Macular degeneration gets more common the older you get and results in blurry vision and central vision loss. While AMD is not reversible, a healthy lifestyle focused on preventing inflammation can help prevent AMD and keep the macula from degenerating faster. 

While the link between sex hormones and AMD is still undergoing study, estrogen is known to have the capacity to be both anti-inflammatory and anti-oxidative. This implies that lower estrogen levels may cause an increase in inflammation and oxidation. 

3.

Thyroid eye

Thyroid eye is associated with Graves' disease (hyperthyroidism), Hashimoto's (hypothyroidism), and the presence of high thyroid autoantibodies. The tissues in our eye sockets have receptors that are similar to those of the thyroid gland. So if the thyroid activates, the eye sockets activate. This causes inflammation in the eyes including bulging, dryness, puffiness, double vision, and vision loss. 

Since the thyroid hormones and the eye are so tightly tied together, changes to our hormones influence the health of our eyes. A hypoactive thyroid can cause testosterone to drop. Estrogen helps spread the thyroid hormone throughout the bloodstream. Too little estrogen results in inadequate thyroid tissue, while too much can result in the formation of a goiter.

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4.

Cataracts

Cataracts can occur postmenopause but their link to hormones is still inconclusive. The same way the headlights on your car accumulate a film over time that blocks the light from getting through, your eyes can start to cloud with age. Most older women experience problems with cataracts at some point or another. Studies show that low estrogen levels may increase the likelihood that you will develop cataracts

Solutions for better eye health.

Healthy eye habits and practices can prevent the onset of many eye diseases including glaucoma, AMD, and thyroid eye. 

Try a few of these healthy eye habits to prevent vision problems: 

  1. Support hormone balance. Thyroid, cortisol, estrogen, progesterone, testosterone, insulin, and DHEA are the seven main metabolic hormones. When working in harmony, your hormones ensure that your eyes have everything they need to function. 
  2. Schedule regular vision exams. Checking in with your ophthalmologist is the No. 1 way that you can take care of your vision. Many eye problems can be asymptomatic in the beginning, so scheduling a yearly appointment will increase the likelihood that you will discover these vision problems before they can increase in severity. 
  3. Rest your eyes by decreasing screen time. Our generation spends a disproportionate amount of time looking at computer screens. The increasing exposure to blue light can alter our sleep schedule and result in dry, itchy eyes. Since blue light passes straight through to the back of our eye, some scientists believe that blue light may increase our risk of AMD. Blue light during the day will keep you awake but will hinder your sleep at night. Try wearing blue-light-blocking glasses if you are looking at blue light screens after the sun goes down.
  4. Nurture your body with a healthy diet and lifestyle. Prioritize leafy green vegetables, carrots, pumpkin, and egg yolks. These foods contain two carotenoids, zeaxanthin and lutein, which help our eyes naturally block blue light.
  5. Prioritize omega-3 fatty acids. The eye has the highest concentration of omega-3s in the body, and the fatty acids are essential to retinal health. Taking an omega-3 supplement can help prevent dry eyes, among other benefits. You can also add foods containing omega-3s to your diet, like salmon, mackerel, sardines, flaxseeds, and chia seeds. 
  6. Support healthy blood pressure. If your BP is either high or low, it can negatively affect the retina and optic nerve. Healthy blood flow means healthy vision. The retina has one of the highest metabolic rates in the body, which means that it needs plenty of nutrients and oxygen to work well. Blood brings nutrients and oxygen to your eyes. 
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While preventive measures may seem like a hassle, they are still easier than treating an irreversible case of AMD or glaucoma later in life. Incorporate a few or all of these vision habits for healthy eyes in midlife and beyond. 

The bottom line.

Our vision is precious, but you may not realize how precious until it's gone. If you don't want to know what it's like to forget your loved one's face, miss the sparkling of light on water, or miss out on the beauty of a full moon, you have to be proactive about vision health. 

Hormonal changes are often asymptomatic, so get your eyes checked regularly and nurture them always so that they can function optimally for decades to come. 

Kyrin Dunston, M.D.
Kyrin Dunston, M.D.
Board Certified OBGYN

Kyrin Dunston, M.D., FACOG, is a Board Certified OB/GYN with Fellowship training in Anti-Aging, Metabolic and Functional Medicine. She specializes in bioidentical hormones, gut restoration and anti-aging medicine.

Leading by example OBGYN Dr. Kyrin Dunston lost a life changing 100 pounds and healed herself from chronic disease using natural treatments. Now, she specializes in helping women heal, lose weight and regain energy at midlife naturally by treating the root cause in her digital clinic.

She hosts the weekly Her Brilliant Health Revolution podcast, the Her Brilliant Health Secrets YouTube channel, and the Stop the Menopause Madness Summit where 53 experts share their top strategies to lose weight, regain energy, balance hormones and moods, feel sexy and confident, look great and master midlife.