As women enter perimenopause and menopause, there are certain changes and symptoms they expect, such as hot flashes, fatigue, mood swings, and digestive problems. But what about eyesight? Could the hormone changes associated with perimenopause and menopause have an impact on your eyesight, and if so, what can you do about it?

Hormones, menopause, and your eyesight

Changes in estrogen and progesterone levels that occur in perimenopause and menopause can have a variety of effects on your eye health and eyesight. For example:

• Estrogen has an effect on the elasticity of the cornea. As estrogen levels decline, the cornea can become stiffer, which affects its ability to focus light. That’s one reason why it’s a good idea to have your eyes checked by a professional every year or two in the perimenopause and menopause years.
• Both estrogen and progesterone are involved in regulating the oil glands in the eyes. The oil is important for keeping the eyes well lubricated and not becoming too dry and developing into dry eye.
• Declining testosterone levels also can impact menopausal eyes. As levels of this hormone decrease, the Meibomian and tear glands are affected and become blocked, resulting in inflamed eyelids, reduced tear production, and dry eyes. The name for this condition is Meibomian gland dysfunction.

Read about menopause and Meibomian gland dysfunction

• Fluctuating hormones can also impact eye pressure, which can make it more difficult to see distances and to focus at night. If you wear contacts, increased eye pressure can make wearing the lenses uncomfortable and cause you to need new ones. 
• Rising eye pressure (intraocular pressure) in menopause may also result in glaucoma. Regular eye exams can help detect and monitor any pressure increases. 
• The hormone insulin regulates blood sugar levels, and changes in those levels can impact the retina. Therefore, fluctuating blood sugar levels, pre-diabetes, and diabetes—which are common in the menopause years—can damage the retina and result in vision problems, including diabetic retinopathy.
• Changes in thyroid hormone levels are also not uncommon in menopause. Thyroid hormone imbalance can contribute to double vision, weakened muscles that support eye movement, and swelling of the eyes. 

Caring for your eyes in menopause

Taking care of your eye health and eyesight in perimenopause and menopause involves adopting a number of lifestyle practices.

• See your eye doctor regularly. The American Optometric Association recommends that individuals ages 40 to 64 see their optometrist or ophthalmologist at least every two years and those age 65 and older should do so annually. 
• Follow a nutritious diet. A wholesome, balanced diet is essential for eye health. The American Academy of Ophthalmology recommends foods rich in vitamin A (e.g., carrots, cantaloupe, sweet potatoes) to support the retina; citrus fruits and other foods that provide the antioxidant vitamin C (red bell peppers, strawberries) to help prevent cataracts and age-related macular degeneration; vitamin E found in almonds, seeds, and avocados to keep cells healthy; omega-3 fatty acids from cold water fish to support tear function; the antioxidants lutein and zeaxanthin, which are found in leafy green veggies and protect the macula; and zinc and copper, which are found in all kinds of beans and help protect the retina and damage from light.
• Consider DIM supplements. DIM, or diindolylmethane, is a compound that may help balance estrogen levels. This substance is found commonly in cruciferous vegetables, but taking a high-quality DIM supplement is a more effective way to get this nutrient. In addition to helping adjust estrogen levels, DIM also has anti-inflammatory properties. 
• Consider berberine supplements. Berberine is a compound found in various plants and is known for its ability to help balance blood sugar levels. In a review and meta-analysis of 46 trials, the reviewers found that berberine significantly reduced 2-hour post-meal blood glucose levels. Better control of blood sugar levels can mean better eye health. Consider taking a high-quality berberine supplement.
• Get restful sleep. Research shows that dry eye is associated with poor sleep. Take steps to improve your sleep quality and quantity. Try Sleepus for a better night's sleep.
• Exercise regularly. A growing number of studies are looking at the impact of exercise on eye health. In a review, experts noted that physical exercise provides some neuroprotective effect and may help protect the retina. 
• Wear sunglasses. At the very least, wear sunglasses outdoors year round and with lenses that provide 100 percent ultraviolet (UV) protection, as UV exposure contributes to cataracts, macular degeneration, and other eye diseases. Glasses with large lenses and that are polarized are recommended since they provide added protection for the eyes. 

Read about menopause and dry eyes

• Lubricate your eyes. Dry eyes is common in perimenopause and menopause, so be sure to keep your eyes lubricated. You can use over-the-counter tear drops and also apply warm eye compresses in the morning to help release oil from your eyelid glands. 

Bottom line

Hormone changes characteristic of perimenopause and menopause can have an effect on your eyesight and eye health. Be sure to take steps to ensure the vitality and health of your vision during this time of your life.