Eye Health Across a Woman’s Life is Not a Straight Line

Women are often given the same eye health advice year after year: a nutritious diet, ocular protection, makeup hygiene, and routine eye examinations. While these recommendations remain fundamental, they risk reflecting a “one size fits all” approach. In reality, a woman’s ocular health is dynamic. It shifts in response to hormonal fluctuations, systemic conditions, life transitions, and environmental exposures.  

During childhood, adolescence, and early adulthood, clinical attention often focuses on refractive correction with glasses and contact lenses, as well as on managing digital eyestrain. US national data indicate that the prevalence of glasses and/or contact lens use is higher among girls than boys between the ages of 6 and 17 years. Contact lens use alone is comparable between sexes up to age 17, with girls exceeding boys by only 4.6%, but this gap significantly widens among contact lens wearers aged 18–24, with 69.3% female compared to 30.7% male². Given the established association between contact lens wear and dry eye, as well as broader ocular surface health, this developmental stage in females may warrant particular clinical attention. 

Pregnancy and the postpartum period, associated with hormonal and physiological changes, can present with important ocular challenges. A recent report suggests that dry eye can affect up to 50% of pregnant women. Reduced tear production, altered corneal biomechanics, and increased corneal sensitivity are among the changes observed during this period. Symptoms such as dryness, fluctuating vision, or photophobia are frequently considered transient or mild, yet in many cases, they persist beyond pregnancy, highlighting the need for proactive monitoring and tailored management strategies³. 

Perimenopause and menopause are critical turning points for ocular surface disorders. Declining estrogen and androgen levels contribute to tear film instability and increased inflammatory responses, while female lacrimal glands may be more susceptible to degeneration due to hormonal fluctuations or genetic predisposition. These factors play a significant role in the higher prevalence of DED in women.  

Certain systemic co-morbidities, including autoimmune, endocrine, and psychological disorders, are more frequent among women, further predisposing them to ocular surface disease across their lifespan. Clinicians should remain vigilant to these risk factors when evaluating symptoms that might otherwise appear nonspecific.  

Societal pressures around appearance amplify the challenge. Extensive use of makeup, cosmetic procedures, and dermatologic products and treatments, including retinoid-based anti-aging or anti-acne medications, can inadvertently affect ocular surface homeostasis. Retinoids, for example, are secreted into the tear film via the lacrimal gland, contributing to tear film instability and meibomian gland dysfunction, thereby initiating or exacerbating symptoms^4. 

Time constraints further limit self-care. According to Statistics Canada, 52% of women aged 15 and older provide some form of care to children and care-dependents adults⁵. In this context, ocular discomfort is easily deprioritized, symptoms are normalized, and relief becomes optional rather than essential.  

Recognizing that women’s eye health is non-linear allows clinicians to anticipate periods of vulnerability, interpret subtle symptoms, and implement timely, individualized and evidence-based treatments. Today, eye care is not only a matter of vision preservation, but also an essential aspect of holistic, patient-centered care. 

References: 

1. National Center for Health Statistics, National Health Interview Survey, 2019; https://www.cdc.gov/nchs/nhis.htm).
2. https://www.statista.com/statistics/743488
3. Jaruchowska, M.; Przybek-Skrzypecka, J.; Skrzypecki, J. Pregnancy and Dry Eye Syndrome: A Review for Clinical Practice. Int. J. Mol. Sci. 2025, 26, 9990. https://doi.org/10.3390/ijms26209990
4. TFOS DEWS III: Digest. Stapleton, Fiona et al. American Journal of Ophthalmology, Volume 279, 451 – 553
5. https://www.statcan.gc.ca/o1/en/plus/2649-more-half-women-canada-are-caregivers

Eris Ligu, MD (EU), is the scientific and clinical advisor at Labtician Ophthalmics, with over 12 years of experience in eye care.

Throughout this time, she has engaged with national and international optometrists, ophthalmologists, and technology innovators, whose depth of expertise has helped shape her perspective on the field. Guided by the belief that medicine is defined as much by unanswered questions as by established knowledge, Eris remains deeply engaged in discovery, methodically analyzing emerging literature and tracking shifts in scientific consensus. A physician with postgraduate studies in public health, she has previously worked in preventive medicine, focusing on children’s and women’s health. Eris speaks four languages and enjoys reading, travelling, and time with her family.