In the ophthalmology field, April is Women’s Eye Health month. While anyone can benefit from learning about eye health, eye disease and long-term vision care, research shows women are at a greater risk of developing serious eye conditions that can cause visual impairment or blindness. According to a study conducted by the nonprofit Prevent Blindness America, women account for 2.6 million of the 4.1 million visually impaired or blind people in the United States.
In spite of this, 25 percent of American women have not received an eye exam in the past two years. The connection between eye disease, vision loss and women is explored below.
Why are women more vulnerable to visual impairment than men?
Longevity is the first reason for the higher levels of visual impairment among women. Women in industrialized countries tend to live longer than men. Because the chance of developing degenerative eye diseases such as glaucoma, diabetic retinopathy and macular degeneration increases with age, women have a greater likelihood of living to an age when these conditions typically occur.
In developing countries, the difference in life expectancy between women and men tends to be much smaller. However, women in these countries still experience vision loss and visual impairment more frequently than men. This mainly occurs because women have more difficulty accessing healthcare and treatments for eye conditions than men in these countries. This is especially true of medical conditions such as cataracts, which are treatable and yet currently cause up to 50 percent of unnecessary blindness globally. The vast majority of people with cataract blindness live in developing countries, and women in these areas are often limited by their lack of financial resources and inability to travel for treatment. They also have lower rates of literacy, which can prevent them from learning about eye health and eye disease treatment options.
How hormones may impact eye health
Women’s vision may also be affected by fluctuating hormones experienced during menopause and pregnancy. Under these circumstances, hormonal shifts may cause vision changes, inciting blurriness or even nearsightedness.
During menopause, hormone fluctuations may cause women to develop dry eye disease. The condition causes sensations of itching, burning, watering and blurry vision. Studies show the rate of dry eye disease in women older than 50 years of age is nearly double that in men of this age, at 7 percent and 4 percent, respectively. In addition, the Rotterdam Study found women who experience early menopause (before the age of 45) had an increased risk of developing open-angle glaucoma. Early menopause may also be associated with a higher risk of developing macular degeneration.
In March 2019, a study published in JCI Insight by researchers from the University of Birmingham suggested a new connection between hormones, women and a rare blindness-causing brain disease known as idiopathic intracranial hypertension (IIH). IIH is a condition in which intracranial pressure rises, causing severe headaches, ringing in the ears and nausea. It is also accompanied by blurred vision, double vision, loss of peripheral vision, the appearance of flashes of light, or brief, seconds-long episodes of blindness. In these cases, vision loss is caused by increased pressure within the brain. The high pressure causes the optic nerve to swell and can lead to permanent vision loss.
According to the University of Birmingham study, women experiencing IIH maintained excess levels of the male sex hormone testosterone, a condition known as androgen dysregulation. The new study suggests these unusual hormone levels may be the center of the cause for IIH and the subsequent vision loss many women with the condition experience.
What can women do to protect their eye health?
While research confirms women have a higher likelihood of developing serious eye conditions, there are simple but effective steps women (or anyone else) can take to protect their eyesight. Women who are concerned about long-term vision health should try to maintain a healthy weight, as research shows obesity is linked to higher intraocular pressure, which can cause glaucoma or lead to diabetes and diabetic retinopathy. In particular, a diet rich in omega-3 fatty acids (found in salmon, tuna, and trout) and leafy green vegetables provides the eyes with the nutrition they need to function optimally.
Even more important are routine visits to an ophthalmologist. Ultimately, only an ophthalmologist can diagnose serious eye diseases in the earliest stages, when they are typically most treatable. Even though many women bear the responsibility of organizing healthcare checkups for their entire families, it is not uncommon for these caregivers to let their own health needs come second. Many people also believe eye care is not as important as other types of health care, and may wait until their symptoms worsen to schedule an appointment with an ophthalmologist. Either case is a mistake — everyone should receive regular check-ups with an ophthalmologist.
Women who are interested in finding a qualified eye doctor can follow these guidelines on finding an eye care professional from the National Eye Institute at the National Institutes of Health.