Munir Amjad Baig, Shakeel Ahmed Faiz, Rabeeya Munir.
Dry Eye Disease and its Association with Menopause.
Ophthalmol Update Jun ;16(1):507-10.

Background: Dry eye disease DED is a little-known symptom of menopause. According to the International Society for Women`s Health Research, 61 percent of perimenopausal and menopausal women suffer from dry eyes but only 16 percent blame menopause. Aim: To know the tear film changes in menopausal women as the target group. Methods :In a cross sectional study of 12 months duration (Jan`2012-Dec`2012), 992 willing female patients aged over 40 years attending Eye department Federal Government Services Hospital Islamabad and all perimenopausal women from the Obstetrics and Gynecology department were invited to undergo the dry eye (DE) tests after approval from Ethical committee. Dry eye questionnaire and perimenopause symptoms questionnaire administered by a trained interviewer while tear break-up time test (TBUT), Schirmer test ST, corneal fluorescein staining (CFS) and Slit lamp examination of the lids were performed by a single surgeon under the same physical conditions. The diagnosis was made on the presence of three out of five parameters. SPSS 17 was used to analyzed the data. Results :Among 992 patients, urban 705(71.1%) and rural 287(28.9%), teachers 170(17.2%), office workers 276(27.8%), housewives 36(37.2%) and 176(17.8%) were laborers. In this population, 49% (486/992) patients were symptomatic defined as presence of one or more dry-eye symptoms often or all the time. Among those, 75.3% (366/486) had a low TBUT, 60.6% (295/486) had a low ST result, 58.8% (286/486) had abnormal anatomic features of the meibomian glands and 51% showed CFS. Of the 49 % women having dry eyes, 32% had mild, 2% moderate and 5% severe dry eyes. Age adjusted prevalence was more for older women. Commonly seen DE symptoms in these women were burning 60.7%, foreign body sensation 60.2% and the hormone-related symptoms were 67% hot flashes/sweats, 62% sleep disturbances, 51% mood changes and 43% fatigue. Conclusion: DED is one of the main reasons that patients visit eye specialist in the United States. Majority of patients attending tertiary care hospital have DED. It is a multifactorial disease, is frequent in elderly women, especially menopausal and postmenopausal.

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