Why do women suffer from dry eye more than men?

By Cristiano Antonino On Mar 20, 2023

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Dry eye was defined as a multifactorial pathology of the ocular surface characterized by an imbalance of the tear film and accompanied by ocular symptoms mainly derived from chronic inflammatory processes

What are the symptoms of dry eye?

The most common symptoms are:

burning
foreign body sensation
red and sore eyes
photophobia (discomfort in light).

Why does dry eye mostly affect women?

Women are significantly more affected than men, because they mainly have 3 more risk factors:

Greater swings in sex hormones

It has been demonstrated that the meibomian glands, which produce an oily substance with the task of preventing premature evaporation of the tear from the ocular surface, possess hormone receptors.

The cyclical fluctuations of estrogen (especially when in excess), testosterone (when it is low) and progesterone, therefore, affect the quality and quantity of tear production.

Even taking oral contraceptives, for example, can cause this syndrome to arise as the pill causes a decrease in androgens, or hormonal changes due to pregnancy or menopause.

Using cosmetics

Another risk factor for women is the use of cosmetic products, for make-up and make-up removal, which can inflame all the small glands responsible for producing the tear film, making it evaporate faster.

Incidence of autoimmune diseases

Furthermore, it has now become clear from the scientific literature that there is a greater frequency of autoimmune diseases to the detriment of women, especially as regards the pathologies that occur after puberty.

Many of these are primarily responsible for or contribute to keeping alive the vicious inflammatory cycle present in dry eye syndrome.

A striking example is Sjögren’s syndrome, where the female-male ratio is 9:1.

How to prevent dry eye?

To reduce the risk of developing a dry eye we recommend some rules:

Be careful not to apply makeup inside the eyelid so as not to irritate the eye;
Thoroughly remove make-up before going to bed using a mild soap or a preservative-free make-up remover based on para-aminobenzoic acid;
Use a humidifier at home and, if possible, in the workplace to reduce the dryness of the air;
Take breaks when using video terminals for a long time, opening and closing your eyes a few times to stimulate tears;
Take care of your diet by avoiding foods that can inflame the intestine and alter the intestinal microbiota, i.e. the set of good microorganisms that synthesize vitamins and hinder the attack of pathogens;
Drink plenty of water to keep your body and eyes well hydrated;
Wear sunglasses when outdoors to protect yourself from light and wind;
Always evaluate with your general practitioner the side effects you may incur when starting a therapy.

What should you do when dry eye symptoms arise?

The first thing to do is to hear the opinion of an ophthalmologist expert in this pathology rather than that of other health or paramedical professionals, such as pharmacists or opticians, who may not have the necessary skills.

Dry eye syndrome is a multifactorial condition that can have systemic origin and be supported by general internal medicine and rheumatological disorders.

Therefore, first of all, an adequate therapy is necessary to avoid its becoming chronic, and secondly, the etiological framework is the foundation of correct management and adequate therapy, not only symptomatic.

What diagnostic and therapeutic innovations have there been in recent years?

The latest therapeutic innovations are oriented towards the use of probiotics to restore good intestinal flora, but there is no equal cure for everyone.

This syndrome depends on many factors and each patient is a separate case, therefore the therapy must be personalized and the patient must be monitored monthly to modify the treatment based on both the symptomatic and objective response through a series of specific tests.

The most important therapeutic novelty of recent years in this field, however, has been the discovery that the use of Pulsed Light with Radiofrequency, IPLRF, around the eyes, significantly improves the clinical picture especially in patients suffering from dysfunction of the meibomian glands. With this revolutionary therapy, it has been demonstrated that not only does the oil production of the meibomian glands improve, but that the telangiectasias (small blood vessels) present on the eyelid margin, responsible for the continuous release of inflammatory cytokines and therefore for the maintenance of the symptoms, are closed.

Furthermore, this therapy has also proved to be very effective for treating blepharitis, chalaziosis and eradicating Demodex.

The completely painless treatment lasts a few minutes and consists of the application of 25/30 spots of light to be repeated once a month for 4 months.

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