Dry Eyes After 40: Is Perimenopause the Cause?

What can dry eye feel like?

According to the US National Eye Institute, dry eye occurs when the eyes do not make enough tears or when the tears do not work properly.

Symptoms can include:

The NHS also lists itching, soreness and eyes that are more watery than usual. Watery eyes do not necessarily rule out dryness, but symptoms alone still cannot confirm the cause.

• A stinging, burning or gritty feeling
• Red eyes
• Sensitivity to light
• Blurry vision

Is perimenopause the cause?

Do not reach a conclusion from age or menstrual changes alone.

The National Eye Institute lists being female and being over 50 among factors associated with a greater likelihood of dry eye. However, greater likelihood does not mean every eye symptom after 40 is caused by hormones.

Other factors worth considering include:

Do not stop a prescribed medicine on your own, even if you suspect it may be contributing. Take your medicine and supplement list to a doctor, pharmacist or eye-care professional for review.

• Long periods of screen use without breaks
• Contact-lens wear
• Air-conditioned, windy, dry, dusty or smoky environments
• Certain medicines
• Eyelid problems or other health conditions

Track the pattern before buying multiple products

For one or two weeks, note:

This record is not a diagnostic tool. It gives a health professional a clearer picture of the pattern.

• When the symptoms begin and whether one or both eyes are involved.
• What you feel: dryness, stinging, burning, grittiness, itching, redness, watering or light sensitivity.
• Whether your vision becomes blurred and whether blinking or resting changes it.
• Screen time, contact-lens use, air conditioning, smoke, dust and sleep.
• New medicines or supplements and any dose changes.

Sensible first steps

If symptoms are mild and you have none of the warning signs below, environmental and routine changes may reduce irritation:

The National Eye Institute and NHS include screen breaks and reducing exposure to dry air, smoke or wind among reasonable supportive measures.

Do not randomly choose eye drops for persistent symptoms, particularly if you wear contact lenses, have another eye condition or already use eye medicines. A pharmacist, optometrist or doctor can help you decide what is appropriate.

• Take regular screen breaks and look into the distance.
• Move away from direct air-conditioning or fan airflow if it makes symptoms worse.
• Rest your eyes from contact lenses and wear glasses when appropriate.
• Reduce exposure to smoke, dust and very dry air.
• Position your screen slightly below eye level and remember to blink.

When should you arrange an eye check?

Book an assessment with an optometrist, doctor or ophthalmologist if:

Severe dry eye that is not treated can sometimes affect the cornea. An assessment can distinguish dryness from other eye problems that need a different approach.

• Symptoms continue for several weeks despite basic adjustments
• Dryness or blurring interferes with reading, driving or daily work
• Symptoms keep returning or are getting worse
• The shape of your eyelids changes
• You are unsure whether the problem is actually dry eye

Warning signs that need prompt help

Seek prompt assessment if your eye is painful and red, or if you wear contact lenses and develop a red eye.

Use local emergency services immediately if you have:

These signs should not be watched and waited on or treated as an ordinary part of perimenopause.

• Sudden loss of vision or changes such as flashing lights or wavy lines
• Pain when looking at light
• A red eye with a severe headache and nausea
• An eye injury, a pierced eye or something stuck in the eye

One small action today

Set a reminder after 30 to 45 minutes of screen work. Pause, look into the distance, blink deliberately and note whether the dryness or blurring changes.

This is not a self-test. It helps you notice a pattern and gives you more useful information if an eye check is needed.