Features of dry eye disease in women with menopausal syndrome

Abstract

Aim - to study the peculiarities of clinical manifestations of dry eye disease (DED) in women with menopausal syndrome.

Materials and methods. We examined 53 women. All patients were divided into 2 groups: The main group included 32 women aged 44 to 57 years with menopausal syndrome. The control group included 21 women aged 35 to 46 years with a normal menstrual cycle. The severity of the clinical course of menopausal syndrome was determined by a gynaecologist. The examination of women included: a test questionnaire for determining the ocular surface disease index, biomicroscopy of the cornea and conjunctiva, and diagnostic tests by Schirmer, Johnson, and Norn.

Results. Mild DED was diagnosed in 27 (84.4%) women of the main group, moderate in 5 (15.6%), and severe DED was not observed. Women in the control group were not diagnosed with DED. The most frequent complaints of women were: a feeling of ‘dryness’ in the eyes, which usually increased in the evening; painful reaction to instillation of indifferent eye drops into the conjunctival cavity; poor tolerance to wind, air-conditioned air, smoke; sand, foreign body under the eyelids, burning, and stinging in the eyes. The following objective clinical signs of DED were most often observed: reduced or absent lacrimal menisci at the eyelid margins; slow ‘unraveling’ of the eyelid conjunctiva and eyeball when the lower eyelid is pulled back; local edema of the eyeball conjunctiva with ‘creeping’ to the free edge of the lower eyelid; ‘sluggish’ hyperaemia of the eyelid conjunctiva. In the study of total tear production by Schirmer and basic tear production by Jones, a slight deficit was noted in women with mild DED, and in women with moderate DED, a pronounced deficit of tear fluid was noted. When assessing the stability of the tear film according to Norn, a slight decrease was noted.

Conclusions. The women with menopausal syndrome we examined had a deficit in total and basic tear production, decreased tear film stability, and developed subjective and objective clinical signs of mild to moderate DED. Clinical manifestations of DED, along with other menopausal disorders, can affect the quality of life of women. When determining the algorithm for the examination and treatment of these patients, it is advisable for gynaecologists to consider the peculiarities of the clinical course of DED, which may occur in the setting of menopausal syndrome.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.