Natural hormonal changes and longer lives make the difference.
More women than men have age-related macular degeneration, cataracts, and glaucoma, and they make up the majority of the 4.4 million Americans age 40 and older who are visually impaired.
According to a 2015 Prevent Blindness study, the main reason was cost. One in four women has not received an eye exam within the past two years. The figures were the same among those who had and who didn’t have vision insurance.
Besides the impact of cost, dry eye disease and autoimmune diseases that impact the eyes are by nature more prevalent in women than in men.
In addition, some diseases, such as trachoma, are carried by children and easily passed on to others. Trachoma is a type of conjunctivitis that is quite common in children. It’s transmission isn’t limited to women but since it’s transmitted by direct contact and more women presumably care for children, it’s natural that more women have it. If left untreated, trachoma can lead to blindness.
Even caregivers such as babysitters, daycare workers, and teachers, most of whom are often women, can all be at risk.
Genetics also make a difference. Birth control pills cause women it become more susceptible to eye diseases such as glaucoma because they reduce the level of estrogen in the body, says the Amercian Optometric Association.
Estrogen is widely believed to be one way of keeping optic nerves way healthy, and glaucoma directly influences the functioning of optic nerves. While there is no definitive evidence, birth control may be affecting women’s eye health.
As the population ages, more women than men are likely to have eye disease in general. The number of Americans with age-related eye disease and the vision impairment that results is expected to double within the next three decades, according to Prevent Blindness.
Women also live longer than men in the United States and the difference widens at the population ages. U.S. Census Bureau data shows that there are twice as many women over the age of 85 than men. This makes women naturally more likely to develop disease of the eye related to aging such as age-related macular degeneration.
Women also are more likely to have untreated refractive errors and dry eye syndrome. Refractive errors include near-sightedness (or myopia), far-sightedness (or hyperopia), and astigmatism. These refractive errors can cause significant vision loss but are easily treated with glasses, contacts, or laser procedures such as LASIK.
Also, as the lens of the eye changes shape it hardens and become more opaque. This change, a cataract, grows as a person ages and early cataracts “create much of the untreated refractive errors in the aging female population,” says the American Foundation for the Blind.
Dry eye syndrome, which can reduce vision and cause pain, is particularly connected to menopause and the hormonal imbalances it causes. Hormone replacement therapy was long thought to be a solution, but some newer studies show that it can actually make dry eye syndrome worse
"Dry eye is more common after menopause. Women who experience menopause prematurely are more likely to have eye surface damage from dry eye," according to the National Eye Institute.
Women have one more disadvantage when it comes to their eyes: makeup. All the accessories from mascara to fake eyelashes can create vision problems like infections when used improperly and without proper hygiene.
“I think with makeup, people keep it longer than they should. We recommend that women replace it every six months, and if you suffer an eye infection you should discard all eye makeup," Las Vegas optometrist Alissa Nagel said to the Las Vegas Review Journal.
March 25, 2020
Christopher Nystuen, MD, MBA