Dry Eye Disease: Consideration for Women's Health.

Cynthia Matossian,Sarah Maciver,Marguerite Mcdonald,Kendall E Donaldson,Kelly K Nichols,Preeya K Gupta

doi:10.1089/jwh.2018.7041

Abstract

Dry eye disease (DED) is a multifactorial disorder of the ocular surface and tear homeostasis that can result in discomfort, pain, and visual disturbance. Untreated, DED can become chronic, progressive, and significantly affect an individual's quality of life. Women are disproportionately affected by DED, are diagnosed at a younger age, and experience more severe symptoms compared with men. DED is associated with a wide range of comorbid conditions; there is a strong association between DED and autoimmune disorders, especially those that affect women at many times the rate of men. Treatment response questionnaires indicate women respond better to a wellness model of treatment for DED than men. Furthermore, women's health care-seeking behaviors provide opportunities for general practitioners, specialists, and women's health centers to help identify women with DED or at risk for DED for referral to an eye care specialist. This review of the prevalence of DED in women, and gender and sex-specific aspects of DED, highlight a significant opportunity for action. Earlier diagnosis and treatment of this common but burdensome condition could significantly improve a woman's quality of life.

Highlights

We explore the biological sex and hormonal differences in ocular structure, functioning, and health that contribute to the higher Dry eye disease (DED) prevalence in women
We have reviewed sex and gender differences in DED causes, clinical sign presentation, patient experience of symptoms, and—perhaps most relevantly—differences in treatment response and efficacy
While some of these differences are biological, with sex-specific hormones having a great effect on DED etiology, there are comorbidities and gender-based factors that contribute to DED risk in women

Summary

Introduction

Dry eye disease (DED) is an ocular disorder that is often characterized by symptoms of eye dryness, discomfort, and sensitivity to light.[1,2] It is highly prevalent, increases with age and, as is the case with many ocular conditions, disproportionately affects women.[3,4,5,6,7,8,9,10,11] Untreated, DED may become chronic and progressive and can significantly affect one’s quality of life.[7,12,13,14,15,16,17,18]Greater utilization of the health care system by women provides the opportunity for DED to be recognized and diagnosed earlier.[12,19] women’s health care settings, which are designed to offer ‘‘one-stop shopping’’ for medical needs compared with general internal medicine practices, and primarily utilized by younger individuals,[20] may provide additional opportunities to identify, study, educate, and treat women with DED or at risk of developing DED.

Results

Conclusion