Vision health is an understated, yet important, component of women’s overall health. Women are disproportionately affected by eye disease, which can disrupt both their physical and mental health.* Since women of all ages experience vision disorders, the Society for Women’s Health Research (SWHR) sought to find the gaps in women’s eye vision.

The SWHR convened women’s health experts for an event that focused on better understanding the following areas of interest:

• Thyroid eye disease
• Dry eye
• Retinal diseases
• Neuro-ophthalmological disorders in pregnancy
• Migraine-related eye disorders

“What do we have to give up in order to bring better vision to all people, women and girls especially?” asked Panelist Janine Austin Clayton, MD, an ophthalmologist and director of the National Institutes of Health (NIH) Office of Research on Women’s Health (ORWH). “What unquestioned assumptions, beliefs, standard operating procedures, or accepted norms must we give up in order to make greater strides to bring good eye health to women and men around the world?” she asked.

Thyroid eye disease

Thyroid eye disease (TED) is considered a rare autoimmune disease that presents with inflammation and swelling in the muscles and tissues that surround the eyes. More than 85% of women make up all diagnoses of TED.

The condition is associated with Graves’ disease, a severe thyroid condition, but people without Graves’ may also suffer from TED. It’s also important to note that smokers with Graves’ disease are almost eight times more likely to develop TED.

Symptoms common with TED include:

• Dry or irritated eyes
• Eyelid retraction
• Bulging eyes

Although treatment options are limited, in early 2020, the Food and Drug Administration (FDA) approved the first treatment for TED. “It will allow for earlier intervention and brings hope that severely affected patients can improve dramatically,” according to Erin Shriver, MD, a clinical professor of ophthalmology at the University of Iowa.

Despite the emergence of the new treatment, more research is needed to understand thyroid disorders in an effort to identify and prevent the underlying causes of TED.

Dry eye disease

Dry eye disease (DED) is over two (2) times more common in women than in men and presents with malfunctioning or too little tear production. Women are diagnosed earlier in life and can sometimes experience severe symptoms. 

“The loss of testosterone—not estrogen or progesterone—that occurs during menopause is linked to increased risk of DED in older women,” explained Laura M. Periman, MD, founder and director of Dry Eye Services and Clinical Research at the Periman Eye Institute in Seattle. “Women are also more likely to use contact lenses, wear makeup, and have certain elective eye surgeries compared to men, all of which elevate risk for DED.”

Moreover, the prevalence of computer use in modern life, especially during the recent transition to virtual work, coupled with worsened air quality, could continue to increase the prevalence of DED diagnoses. 

Treatment for dry eye disease is currently very expensive, creating a barrier to access to care. There is an urgent need to find less expensive treatment through new research to mitigate the long-term impact of these risk factors.

Pregnancy and vision

Pregnancy can exacerbate or lead to retinal eye diseases, like diabetic retinopathy, which is considered to be the fifth leading cause of blindness in the world. 

In addition to pregnancy, pre-existing conditions, like obesity, also increase the risk of eye conditions, like diabetic retinopathy or idiopathic intracranial hypertension (IIH), an eye condition that can cause intense headaches. 

To better understand the connection between vision health and pregnancy, pregnant women should be included in future research. Currently, there are no approved treatments for women who suffer from eye diseases, like IIH, but through an emphasis on regular screening and healthy living education, these conditions can be predicted and prevented in pregnant women.

Migraines and vision

Migraines are extremely common in all Americans, but they are three times more common in women than men. They can have an impact on light sensitivity and cause severe eye pain. In some women, it causes aura, in which migraine sufferers may see sparks, bright spots, or other disturbances in their vision. 

“Migraine affects visual quality of life to the same degree as Graves’ disease, optic neuritis, and other severe vision conditions, but we just don’t study the links between migraine and vision,” said Kathleen Digre, MD, a professor of neurology and ophthalmology at University of Utah School of Medicine. “Why aren’t we paying attention to chronic migraine in women’s vision health?

Although more research is needed as to why women suffer from migraines more than men, many treatments are currently available. SWHR also offers patient toolkits to help migraine sufferers find relief.

A need for more women-centered research

There is much to explore and further understand in regards to women’s health and its connection to eye disease. One such example is what the gender differences are in disease prevalence, severity, diagnosis, and treatment.

“We know that vision disorders impact a significant proportion of the population, and we know that there are significant disparities relating to gender,” explained Kira Baldonado, vice president of public health and policy at Prevent Blindness. “Vision disorders are just as common as other chronic disorders, and they need to be given that same level of urgency at the population level to improve women’s vision and eye health.”

Learn more about eye disease in women and methods to reduce vision loss by visiting the Women’s Eye Health website, created by the National Eye Health Education Program and Women in Ophthalmology.

*Hay, L. (2020, Dec. 1). A Call to Improve Women’s Eye Health Through Research, Access, and Education. Society for Women’s Health Research. https://swhr.org/a-call-to-improve-womens-eye-health-through-research-access-and-education/

Any sources from outside of Prevent Blindness do not imply an endorsement from Prevent Blindness. The contents of the material used are the responsibility of the authoring organization, Responsum Health.