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PREVENTION OF DRY EYE SYNDROME IN WOMEN OF CLIMACTERIC AGE
Nazirdzhanov Muradiljon Abdusaitovich-
Assistant
Central Asian Medical University, Department of Surgery
Murodov Murodjon Saidjon ugli-
Assistant
Central Asian Medical University, Department of Surgery
E-mail:
m_nazirdjonov@mail.
Abstract:
Dry eye syndrome (DES) is a multifactorial ocular surface disorder that becomes
increasingly prevalent among women during the climacteric period due to complex
hormonal changes. Estrogen and androgen deficiencies associated with menopause affect the
lacrimal and meibomian glands, leading to decreased tear production and instability of the
tear film. As a result, affected women often experience symptoms such as ocular dryness,
irritation, burning sensation, and visual fatigue, which can significantly impact daily
activities and quality of life.
This study aims to investigate the primary causes and pathophysiological mechanisms of
DES in climacteric women and to assess the effectiveness of various preventive strategies,
including the use of artificial tears, nutritional supplements (e.g., omega-3 fatty acids), and
hormone replacement therapy (HRT).
A total of 120 women aged 45 to 60 years were examined and divided into premenopausal,
perimenopausal, and postmenopausal subgroups. Clinical tests, hormonal assessments, and
patient-reported symptom questionnaires were used to evaluate tear function and ocular
surface health.
The findings highlight a strong correlation between estrogen decline and the severity of DES
symptoms. Preventive interventions demonstrated varying degrees of success, with the
greatest improvement observed in patients who received early, individualized treatment.
The results of this study emphasize the need for increased awareness, timely screening, and
comprehensive management of dry eye syndrome in menopausal women, which can
ultimately reduce the burden of disease and improve their visual comfort and quality of life.
Keywords:
Dry eye syndrome, menopause, prevention, hormone deficiency, ocular health
Introduction
The climacteric period, also known as the menopausal transition, is a physiological phase
characterized by hormonal imbalances, particularly the reduction of estrogen and
progesterone levels. These hormonal shifts have significant implications not only for
systemic health but also for ocular well-being. Dry eye syndrome (DES) is one of the most
frequently reported ophthalmological complaints in menopausal women, often leading to
chronic discomfort, visual disturbances, and reduced quality of life.
The prevalence of DES among postmenopausal women ranges from 30% to 50%, depending
on age, geography, and environmental exposure. Understanding the pathophysiological
mechanisms underlying DES during this stage is crucial for developing effective and timely
preventive measures.
Purpose of the Study
To identify the primary causes of dry eye syndrome in women of climacteric age and assess
the effectiveness of modern prophylactic strategies.The primary objective of this study is to
thoroughly investigate the underlying causes and contributing factors of dry eye syndrome
(DES) in women undergoing climacteric changes, including the premenopausal,
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perimenopausal, and postmenopausal stages. Due to the physiological and hormonal
transitions occurring during this period—particularly the decline in estrogen and other sex
hormones—ocular surface integrity is often compromised, resulting in an increased
incidence of DES.
This research aims to:
Identify the prevalence and clinical manifestations of DES among climacteric women;
Examine the pathophysiological relationship between hormonal changes and tear film
dysfunction;
Analyze the influence of environmental, lifestyle, and systemic health factors that
exacerbate dry eye symptoms in this population;
Evaluate the effectiveness of various preventive strategies, including non-pharmacological
methods (artificial tears, nutritional supplements), and pharmacological approaches such as
hormone replacement therapy (HRT);
Develop evidence-based recommendations for early screening, risk assessment, and
personalized preventive care for women in climacteric age groups.
By achieving these objectives, the study seeks to contribute to a deeper understanding of
menopausal ocular health, provide clinicians with practical tools for early intervention, and
ultimately improve the quality of life for affected patients through timely and appropriate
management strategies.
Methods
This study included a total of 120 women aged 45–60 years, who presented symptoms
consistent with dry eye syndrome. Subjects were categorized into premenopausal,
perimenopausal, and postmenopausal groups.
The methodology involved:
Standardized Ocular Surface Disease Index (OSDI) questionnaire
Schirmer's test and Tear Break-Up Time (TBUT)
Hormonal profile assessment
Detailed patient interviews and lifestyle evaluations
Preventive intervention strategies including artificial tears, omega-3 supplements, and
hormone replacement therapy (HRT) where applicable
The study lasted for six months and was conducted at the ophthalmology department of
Central Asian Medical University.
Results
Dry eye symptoms were significantly more pronounced in postmenopausal women (OSDI
score > 33 in 65% of patients).
The Schirmer’s test revealed tear production less than 5 mm in 45% of cases. Tear film
instability (TBUT < 10 seconds) was common in 70% of symptomatic patients.
Hormonal analysis indicated a strong correlation between estrogen deficiency and the
severity of dry eye symptoms.
Preventive interventions showed:
Artificial tears improved symptoms in 80% of participants
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Omega-3 supplements reduced inflammation and improved tear stability in 65%
HRT, when used under supervision, significantly alleviated symptoms in 40% of women
who were eligible
Statistical analysis demonstrated that early intervention was associated with a 35% reduction
in symptom progression over six months.
Discussion
Dry eye syndrome in climacteric women is multifactorial, with hormonal insufficiency
playing a central role. In addition, environmental factors such as air pollution, screen
exposure, and low humidity exacerbate symptoms.
The results support the integration of regular ophthalmological screening and targeted
preventive care in menopausal health programs. Nutritional support and individualized
treatment plans are essential components of effective management.
Conclusion
Dry eye syndrome is a significant and increasingly recognized ophthalmologic condition
among women undergoing climacteric changes. The hormonal fluctuations that occur during
this transitional period—most notably the decline in estrogen and androgen levels—have a
profound impact on the ocular surface and lacrimal functional unit, contributing to tear film
instability, inflammation, and epithelial damage. This study confirmed that postmenopausal
women are at particularly high risk for developing moderate to severe symptoms of dry eye,
which can greatly impair daily functioning, work productivity, and overall well-being.
The findings underscore the importance of early identification and intervention. Clinical
screening using standardized tools such as the OSDI questionnaire, Schirmer’s test, and
TBUT assessments should be incorporated into routine care for women entering the
menopausal stage. Furthermore, preventive strategies—both pharmacological and non-
pharmacological—can play a vital role in mitigating the severity of symptoms. Artificial
tears and omega-3 fatty acid supplementation have proven beneficial in improving ocular
surface lubrication and reducing inflammation, while hormone replacement therapy, when
appropriately prescribed, may provide additional symptom relief for select patients.
It is also essential to consider patient-specific factors such as environmental exposure,
digital screen use, systemic diseases, and lifestyle habits, which may exacerbate dry eye
symptoms. A personalized, multifaceted approach to prevention and treatment yields the
best outcomes. In this context, collaboration between ophthalmologists, gynecologists, and
primary care physicians becomes crucial in providing comprehensive care for climacteric
women.
In conclusion, addressing dry eye syndrome in menopausal women requires heightened
clinical awareness, multidisciplinary cooperation, and evidence-based strategies. Public
health efforts should focus on educating both healthcare providers and patients about the
ocular implications of menopause, thereby promoting timely screening and tailored
preventive measures. Such proactive approaches will help reduce the burden of dry eye
disease and enhance the ocular and general health of women during this vulnerable stage of
life.
References:
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1. Schaumberg, D. A., Sullivan, D. A., Buring, J. E., & Dana, M. R. (2003). Prevalence of
dry eye syndrome among US women. American Journal of Ophthalmology, 136(2), 318–
326. https://doi.org/10.1016/S0002-9394(03)00218-6
2. Versura, P., & Campos, E. C. (2005). Menopause and dry eye. The American Journal of
Ophthalmology Clinical Science, 2(4), 215–222.
3. Sullivan, D. A., Rocha, E. M., Aragona, P., et al. (2017). TFOS DEWS II Sex, Gender,
and
Hormones
Report.
Ocular
Surface,
15(3),
284–333.
https://doi.org/10.1016/j.jtos.2017.05.003
4. Lemp, M. A., & Baudouin, C. (2012). The definition and classification of dry eye
disease: Report of the Definition and Classification Subcommittee of the International Dry
Eye WorkShop. Ocular Surface, 5(2), 75–92.
5. Aragona, P., & Rolando, M. (2013). Towards a dynamic customized therapy for dry eye.
British Journal of Ophthalmology, 97(8), 955–960. https://doi.org/10.1136/bjophthalmol-
2012-302408
