Hormones play an essential role in many of the body’s functions. They influence sleep, mood, body temperature and metabolism—but did you know they can also affect the eyes and the quality of vision?
From the menstrual cycle and pregnancy to menopause and certain thyroid disorders, hormonal fluctuations can alter tear production, the shape of the cornea and contact lens comfort. Although these changes are often temporary, some symptoms deserve special attention.
Why can hormones affect the eyes?
Several structures in the eye have receptors that are sensitive to hormones, including estrogen, progesterone and androgens. Variations in these hormones can affect the glands responsible for producing the components of the tear film—the thin layer of tears that hydrates and protects the eye’s surface.
Hormonal changes may also slightly alter the thickness, curvature or sensitivity of the cornea. This can cause temporarily blurred or fluctuating vision, dryness and reduced contact lens comfort.
The menstrual cycle and vision
Estrogen and progesterone levels rise and fall throughout the menstrual cycle. Some people may notice subtle variations in visual comfort, such as drier eyes, increased sensitivity to light, slightly fluctuating vision or discomfort while wearing contact lenses.
Hormonal changes can also contribute to migraines. For some people, these are accompanied by a visual aura, which may appear as flashing lights, shimmering lines or a temporarily blurred area in the field of vision.
However, a visual aura that is new, unusual, persistent or limited to one eye should be evaluated promptly to determine its cause.
Pregnancy: usually temporary changes
During pregnancy, hormonal fluctuations and fluid retention can slightly alter the cornea. As a result, an eyeglass or contact lens prescription may seem less accurate, even if it was previously a perfect fit.
Dry eye is also common during pregnancy. The eyes may feel more sensitive, irritated or tired, and contact lenses may become less comfortable. These changes generally improve after delivery or breastfeeding. Unless there is a specific need, it may be best to wait until vision has stabilized before making a major permanent change to a prescription.
A sudden vision change during pregnancy or after delivery should not automatically be blamed on hormones. Sudden blurred vision, flashes of light, spots in the field of vision or a severe headache may be associated with preeclampsia and require immediate medical attention.
Perimenopause and menopause
As menopause approaches, fluctuating and declining hormone levels can disrupt the balance of the tear film. Dry eye symptoms may therefore become more frequent.
Possible symptoms include:
- A gritty or burning sensation;
- Red or tired eyes;
- Excessive tearing;
- Sensitivity to light;
- Temporarily blurred vision;
- Increased contact lens discomfort.
It may seem contradictory, but dry eyes can also water excessively. This is often a reflex response: the eyes attempt to compensate for irritation, but these tears may not have the right composition to provide lasting hydration.
Dry eye should not be viewed as an unavoidable discomfort that must simply be tolerated. An optometrist can assess the quality of the tear film and recommend solutions based on the cause and severity of the symptoms.
The thyroid and the eyes
Thyroid disorders can also affect the eyes. Thyroid eye disease, which is primarily associated with Graves’ disease, is an autoimmune condition that causes inflammation in the tissues surrounding the eyes.
It may cause dryness, redness, light sensitivity, a feeling of pressure, swollen eyelids, bulging eyes or double vision. The condition can sometimes occur even when thyroid hormone levels are normal.
Anyone with a thyroid disorder who notices changes in their eyes should discuss them with both their physician and eye care professional.
How can visual comfort be improved?
A few simple habits may help reduce discomfort:
- Take regular breaks during screen use;
- Make a conscious effort to blink;
- Avoid directing fans or heating vents toward the face;
- Wear sunglasses outdoors;
- Stay well hydrated;
- Temporarily reduce contact lens wear if discomfort develops;
- Avoid using eye drops without first asking an eye care professional for guidance.
Not all artificial tears are the same. An optometrist can recommend an appropriate product based on the type of dry eye and determine whether another condition may be contributing to the symptoms.
When should you seek prompt care?
Prompt evaluation is recommended for:
- Sudden vision loss;
- New double vision;
- Flashes of light or a sudden increase in floaters;
- A curtain, shadow or veil in the field of vision;
- Significant eye pain;
- A red eye accompanied by reduced vision;
- A sudden change in vision during pregnancy or after delivery.
Vision changes as the body changes
Hormonal fluctuations can have a genuine effect on eye comfort and the stability of vision. These changes are often mild and temporary, but they should not be ignored when they persist or interfere with daily activities.
A comprehensive eye examination can help distinguish a temporary hormonal variation from dry eye or a condition requiring closer follow-up. Caring for your eyes also means paying attention to changes taking place throughout your body.
