In short (TL;DR)
More than one in two women in or after menopause reports dry, burning, or light-sensitive eyes. The cause is usually not the screen, but the tear film itself: Declining estrogen and androgen levels alter its composition and the function of the meibomian glands, which produce the tear film's protective fatty layer.
The best currently available evidence (TFOS DEWS II) confirms hormones as a central factor in dry eye. At the same time, the largest randomized study on omega-3 and dry eye to date (DREAM, NEJM 2018) shows no significant benefit of high-dose fish oil compared to placebo – an important distinction between a plausible mechanism and a proven effect.
The sensible approach is therefore not a single "miracle cure," but a combination of medical evaluation, basic tear film care, and good overall nutritional support.
Important medical note
This article does not replace an eye examination. Persistent, severe, or sudden eye discomfort, visual disturbances, or pain should always be evaluated by an ophthalmologist, as other causes may be involved.
Hormone replacement therapy and prescription eye drops are medical decisions. Dietary supplements are not medications and cannot replace necessary medical treatment.
Dry eyes during menopause are common – and usually not the screen's fault
Those who suddenly suffer from burning, scratching, or light-sensitive eyes during perimenopause or after menopause often look to the screen as the primary culprit. This is understandable, but often only half the story: Digital eye strain caused by screen work – which we have covered in a separate article on Office Eye Syndrome – has a different primary cause than the dry eye associated with the hormonal transition of menopause. Both can overlap, but they are not the same problem.
A recent cross-sectional study of over 3,500 women (mean age 52) presented at the annual congress of The Menopause Society found, using the validated OSDI questionnaire, a dry eye prevalence of 57.38% in postmenopausal versus 53.22% in premenopausal women.
Dr. Stephanie Faubion, Medical Director of The Menopause Society, puts the finding into clinical context: early detection of dry eyes during routine medical check-ups in menopause allows for timely treatment before symptoms become chronic. The Austrian Ophthalmological Society (ÖOG) also confirmed in a November 2025 press release that declining estrogen and androgen levels can alter the composition of the tear film and lead to dry, irritated eyes.
→ Source: Austrian Ophthalmological Society (ÖOG), press release "Menopause and Eyes" (13.11.2025)
Why do eyes dry out during menopause? The role of estrogen and androgens
The tear film is not a simple drop of water, but a three-layered system: an outer lipid layer (from the meibomian glands at the eyelid edge), a middle aqueous layer, and an inner mucous layer (mucin) that keeps the film on the ocular surface. For this film to remain stable and not evaporate too quickly, all three layers must function correctly.
The meibomian glands are hormone-dependent organs. Ophthalmologist Dr. David A. Sullivan of the Schepens Eye Research Institute (Harvard Medical School) demonstrated with his research group that androgens directly influence gene expression in the meibomian glands and support their function. If androgen levels drop – which typically happens during perimenopause and menopause – it can disrupt the glands' oil production. The result is a tear film that evaporates more quickly: so-called evaporative dry eye.
The American Academy of Ophthalmology (AAO) summarizes in a clinical review article that androgen deficiency should be considered in women with therapy-resistant ocular surface disease – especially in cases of premature ovarian insufficiency or long-term estrogen therapy. At the same time, the AAO points out that the ratio of estrogens to androgens is complex: hormone replacement therapy can actually increase the risk of dry eyes in some women rather than decrease it – an indication that "more hormones" does not automatically mean "better eyes."
→ Source: American Academy of Ophthalmology, "Androgen Deficiency in Ocular Surface Disease"
The most comprehensive scientific overview on this topic is provided by the TFOS-DEWS-II report "Sex, Gender, and Hormones" – an international consensus work by tear film and ocular surface experts. The report confirms sex hormones as one of several documented risk factors for dry eye and categorizes menopause, androgen deficiency, and certain hormone therapies as relevant, yet complex, influencing factors – without a simple causal chain.
→ Source: Sullivan D.A. et al., "TFOS DEWS II Sex, Gender, and Hormones Report", The Ocular Surface (2017)
Evidence Filter
Well-supported: Dry eye occurs more frequently in postmenopausal women; androgens are proven to influence the meibomian glands.
Complex, not automatic: The relationship between hormone replacement therapy and eye symptoms is not uniform according to the AAO and TFOS DEWS II – it can alleviate symptoms or, in some cases, worsen them.
Not sufficiently proven: that every woman with dry eyes during menopause automatically has a hormonal imbalance that must be treated.
Does omega-3 help with dry eyes? What the DREAM study actually shows
Omega-3 fatty acids are considered a standard recommendation for dry eyes in many guides – the theory: EPA and DHA have anti-inflammatory properties and could support the lipid layer of the tear film. The most significant study to date on this is the DREAM study (Dry Eye Assessment and Management Study) led by Prof. Penny Asbell, published in the New England Journal of Medicine.
In this randomized, placebo-controlled study, patients with diagnosed dry eye received either 3,000 mg of omega-3 fatty acids daily or a placebo (refined olive oil) over twelve months. The result was clear: there was no significant difference in symptoms (OSDI score) or objective ocular surface measurements between the two groups.
A subsequent DREAM extension study also examined what happens when participants stop taking omega-3 after one year. Here, too, there was no disadvantage to stopping: those who ceased intake did not have significantly worse scores than those who continued taking omega-3 – further evidence that high-dose omega-3 does not provide a proven added benefit specifically for the treatment of already diagnosed dry eye.
This is an important distinction from many older, smaller studies that found positive effects – DREAM remains the largest and most methodologically rigorous randomized investigation on this topic to date. For VEYT, this means: we consciously do not market omega-3 in this context as a remedy for dry eye. Omega-3 fatty acids, like those in the Veyt™ Premium Omega-3 Complex, remain a well-researched building block for the cardiovascular system and the brain – more on this in our Study Check on Omega-3, Heart, and Brain – but based on the current body of evidence, the specific treatment of dry eye is not a proven use case.
Veyt™ Premium Omega-3 Complex
140 capsules with 2,000 mg of omega-3 fatty acids (DHA & EPA) per serving, made in Germany. In the context of this article, categorized as general nutritional support for the heart, brain, and joints – not as a proven treatment for dry eye.
View Veyt™ Premium Omega-3 Complex →Dietary supplements are not a substitute for a balanced diet or medical treatment for dry eye. In the case of existing conditions, pregnancy, breastfeeding, or regular medication intake, supplementation should be discussed individually.
What actually helps against dry eyes according to TFOS DEWS II
The TFOS-DEWS-II management guidelines describe a stepped approach rather than a single miracle cure. Basic care includes: conscious, regular blinking (especially during screen work), warm compresses to support meibomian gland function, eyelid hygiene, a sufficiently humid indoor environment, and – if necessary and upon medical recommendation – preservative-free artificial tears.
Only when these basic measures are insufficient, according to TFOS DEWS II, do further steps come into consideration, such as prescription anti-inflammatory eye drops or procedures for mechanical cleaning of the meibomian glands. Targeted hormonal treatment of the eye – such as with compounded DHEA eye drops – is, according to the AAO, only considered for therapy-resistant cases and after thorough counseling regarding the limited study data and potential side effects (including possible virilization). This is expressly not a self-treatment, but a specialized ophthalmological decision.
| Measure | Purpose | Level of evidence | What does not follow |
|---|---|---|---|
| Preservative-free artificial tears | Basic moistening of the ocular surface | TFOS-DEWS-II base recommendation, extensive clinical experience | Does not eliminate the hormonal cause |
| Warm compresses / eyelid hygiene | Supports meibomian gland function | Recommended as a basic measure in TFOS DEWS II | Does not replace ophthalmological diagnosis |
| Omega-3 supplementation (high-dose) | Originally discussed as anti-inflammatory | DREAM study (NEJM 2018): no significant benefit vs. placebo | No proven remedy specifically for dry eye |
When should you see an ophthalmologist for dry eyes?
An ophthalmological assessment is advisable if symptoms persist for more than a few weeks, worsen despite using artificial tears, are accompanied by severe pain, redness, vision impairment, or sensitivity to light, or if you find yourself increasingly unable to tolerate contact lenses. A general check-up of eye health around menopause is also sensible, as hormonal changes are discussed in connection with other age-related eye conditions, such as cataracts or age-related macular degeneration, according to the ÖOG – a relationship that has been observed but not yet definitively explained in terms of causality. Dry eyes also rarely occur in isolation: we have summarized how hormonal changes as a whole affect nutritional needs and well-being in our study check on nutritional supplements during menopause.
VeyT Daily Checklist for Dry Eyes in Menopause
□ Have persistent symptoms checked by an ophthalmologist
□ Use preservative-free artificial tears as needed
□ Plan for screen breaks and conscious blinking
□ Keep indoor air from becoming too dry; humidify heating air
□ Test warm compresses to support the eyelid margins
□ View Omega-3 as part of an overall balanced diet – not as a targeted eye therapy
What is (not yet) proven regarding dry eyes in menopause
"Omega-3 capsules cure dry eyes"
The DREAM study refutes this common advice for the specific treatment of already diagnosed dry eye disease. This does not exclude a general benefit of Omega-3 for other areas – just not for this specific indication at this dosage.
"Every case of dry eyes in menopause is a hormonal problem"
Dry eyes have many possible contributing factors – screen time, air conditioning, certain medications, autoimmune diseases like Sjögren's syndrome, or wearing contact lenses. Menopause is a documented risk factor, but not automatically the sole explanation. The same applies to dry, itchy skin, as shown in the article Itchy skin in menopause.
"DHEA eye drops are a safe self-help remedy"
According to the AAO, this is a specialized option to be prescribed by a doctor, with limited studies and relevant potential side effects – it is not an over-the-counter home remedy.
Expert Perspectives & Protocol Breakdown
Dr. Stephanie Faubion (The Menopause Society) emphasizes the clinical practice level: dry eyes should be routinely asked about during menopausal symptom consultations so that they can be treated early instead of worsening.
Dr. David A. Sullivan and co-authors (Schepens Eye Research Institute / TFOS DEWS II) provide the mechanistic perspective: androgens are a key regulator of meibomian gland function, and their decline in menopause is a plausible biological explanation for evaporative dry eye.
The American Academy of Ophthalmology adopts the most cautious, clinically practical position: hormonal connections are real, but hormone replacement or hormonal eye drops are not a universal solution and do not work the same for all women – in some cases, they may even have the opposite effect.
Where these perspectives agree: the hormonal connection is scientifically sound. Where they differ: on how aggressively to intervene hormonally, and whether nutritional supplementation (especially Omega-3) plays a proven role at all – here, the randomized study situation (DREAM) is clearly more reserved than many popular health guides suggest.
Conclusion: Taking dry eyes in menopause seriously without overcomplicating them
Dry eyes in perimenopause and menopause are a real, documented, hormonally-influenced phenomenon – not imaginary and not merely a screen-related problem. At the same time, treatment is not a case for a single dietary supplement: basic measures like artificial tears, eyelid hygiene, and a good indoor climate are the best-proven first-line measures, while specific hormonal interventions for the eyes remain a decision for an ophthalmologist. Omega-3 can be a sensible part of a balanced diet but is – based on current studies – not a proven treatment specifically for dry eye. Those who take their symptoms seriously, have them assessed by an ophthalmologist, and consistently implement basic measures are in the best evidence-based position.
Frequently asked questions about dry eyes in menopause
Why do many women get dry eyes in menopause?
Declining estrogen and androgen levels change the composition of the tear film and impair the function of the meibomian glands, which produce the protective lipid layer of the tear film. This favors evaporative dry eye.
How common are dry eyes after menopause really?
A study of over 3,500 women found signs of dry eye based on the OSDI questionnaire in 57.38% of postmenopausal and 53.22% of premenopausal women.
Does Omega-3 help with dry eyes in menopause?
The largest randomized study on this topic (DREAM, NEJM 2018) found no significant difference between high-dose Omega-3 and placebo for diagnosed dry eye. Omega-3 is therefore not a proven treatment for this specific complaint.
According to studies, what actually helps the most?
Preservative-free artificial tears, warm compresses, eyelid hygiene, and a humid indoor climate are considered basic measures with the best evidence and experience base according to TFOS DEWS II.
Can hormone replacement therapy improve dry eyes?
Not consistently. According to the AAO and TFOS DEWS II, hormone replacement therapy can improve eye symptoms in some women, but it can also worsen them in others. This is an individual medical assessment, not a blanket recommendation.
Are DHEA eye drops a solution?
According to the AAO, compounded DHEA eye drops are only considered in therapy-resistant cases and after counseling regarding limited evidence and potential side effects such as virilization – they are not an over-the-counter self-help remedy.
Is dry eye in menopause the same as digital eye strain?
No. Digital eye strain is primarily caused by screen time and reduced blink frequency, while dry eye in menopause is primarily hormonally influenced. Both causes can overlap and occur together.
When should I go to the doctor for dry eyes?
An ophthalmological check-up should be sought for persistent symptoms lasting several weeks, severe pain, redness, vision deterioration, increasing sensitivity to light, or worsening contact lens tolerance.
References & Scientific Citations
- The Menopause Society – Risk of Dry Eye Disease Increases During Menopause Transition (2025)
- Austrian Ophthalmological Society (ÖOG) – Menopause and the Eyes (13.11.2025)
- Sullivan D.A. et al. – Androgen Deficiency, Meibomian Gland Dysfunction, and Evaporative Dry Eye, Ann N Y Acad Sci (2002)
- American Academy of Ophthalmology – Androgen Deficiency in Ocular Surface Disease
- Sullivan D.A. et al. – TFOS DEWS II Sex, Gender, and Hormones Report, The Ocular Surface (2017)
- Asbell P.A. et al. – n−3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease, NEJM (2018)
- Dana R. et al. – The DREAM Extension Study, The Ocular Surface (2019)
Source Transparency: The experts and institutions mentioned are for transparency regarding the sources used and do not constitute an endorsement of VEYT products. Clinical statements are primarily based on professional societies, randomized studies, and peer-reviewed literature. Expert opinion, mechanism, and clinical evidence of efficacy are expressly distinguished in the text.
