Gland Problems Common in Postmenopausal Women With Dry Eye

Megan Brooks

November 15, 2013

Gland dysfunction is a common contributor to dry eye in postmenopausal women, according to the results of a new study. Whether gland changes occur as part of the dry eye disease process or as a normal part of aging is unclear, researchers say.

Healthcare providers should be aware that older women with dry eye are "highly likely to be suffering from some kind of meibomian gland dysfunction as opposed to aqueous-deficient dry eye, although it is important to assess all types of dry eye in clinical practice," Lisa Jones-Jordan, PhD, from Ohio State University College of Optometry in Columbus, told Medscape Medical News.

She presented the findings at the American Academy of Optometry 2013 Annual Meeting in Seattle, Washington.

Dry eye disease occurs more often in women than in men and increases with age.

"Recent studies have begun trying to determine the prevalence of the different dry eye types," said Dr. Jones-Jordan. "Doing this will better direct treatments by selecting options appropriate to each group."

Dr. Jones-Jordan and her colleague Kelly Nichols, PhD, from the University of Houston in Texas, investigated the prevalence and types of dry eye in 939 postmenopausal women. All women underwent standard diagnostic testing and completed the Dry Eye Questionnaire. According to these criteria, 62.5% met 1 of 3 dry eye categories.

For those with dry eye, the different types were first categorized by Schirmer scores and meibomian gland status. When symptoms were added to the classification criteria, researchers found that fewer women were classified as having the disease, which they say demonstrates the variability in symptom reporting, combined with diagnostic testing.

Table. Dry Eye Classifications

Types of Dry Eye Patients Classified by Schirmer Scores and Meibomian Gland Status (%) Patients with Symptoms Included (%)
Aqueous-deficient dry eye 6.3 9.2
Mixed dry eye 47.9 44.0
Evaporative-only dry eye 45.8 46.8


Overall, dry eye increased in prevalence across age groups, and 90.8% of this sample of postmenopausal women had mixed dry eye or evaporative-only dry eye.

"In postmenopausal women, dry eye categories seem to be less distinct and more of a continuum of disease, and meibomian gland dysfunction is the most common contributor to dry eye disease," said Dr. Jones-Jordan.

Asked by Medscape Medical News to comment on the findings, Glenda Secor, OD, communications chair of the American Academy of Optometry, said differentiating between types of dry eye disease is part of disease management. "This research will help direct the treatment plan that practitioners use for symptomatic patients," she said.

This study was supported by grants from the National Institutes of Health and the National Eye Institute. Dr. Jones-Jordan and Dr. Secor have disclosed no relevant financial relationships.

American Academy of Optometry 2013 Annual Meeting. Abstract #130240. Presented October 24, 2013.


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