More women have age-related macular degeneration, cataracts, and glaucoma, making up most of the 12 million Americans age 40 and older who are visually impaired.
One main reason may be the cost of exams. One in four women do not have regular eye exams. The figures are the same among those who don’t have vision insurance.
Besides the impact of cost, dry eye disease and autoimmune diseases that impact your eyes are, by nature, more prevalent in women than in men.
In addition, children carry some diseases, such as trachoma, that are easily passed on to others. Trachoma is a type of conjunctivitis that is quite common in children. Transmission isn’t limited to women, but since it’s transmitted by direct contact and more women 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 be at risk.
Genetics also make a difference. Birth control pills cause women to become more susceptible to eye diseases such as glaucoma because they reduce the level of estrogen in their bodies. Estrogen is widely believed to be one way of keeping optic nerves healthy, and glaucoma directly influences the functioning of optic nerves.
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 nearly twice as many women over the age of 85 than men. That makes women naturally more likely to develop diseases 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. Refractive errors can cause significant vision loss but are easily treated with glasses, contacts, or laser procedures such as Lasik.
As the lens of the eye changes shape, it hardens and becomes more opaque. This change, a cataract, grows as a person ages. 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 studies show that it can 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. Accessories from mascara to fake eyelashes can create vision problems, such as infections, when used improperly and without proper hygiene.
July 10, 2023
Christopher Nystuen, MD, MBA