title: Sex hormones and the dry eye.
abstract: The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. This review aims to present evidence for how sex hormones may affect the ocular structures involved in the production, regulation and maintenance of the normal tear film. It is hypothesised that hormone changes alter the homeostasis of the ocular surface and contribute to dry eye. Androgens impact on the structure and function of the meibomian and lacrimal glands and therefore androgen deficiency is, at least in part, associated with the aetiology of dry eye. In contrast, reports of the effects of oestrogen and progesterone on these ocular structures and on the conjunctiva are contradictory and the mechanisms of action of these female-specific sex hormones in the eye are not well understood. The uncertainty of the effects of oestrogen and progesterone on dry eye symptoms is reflected in the controversial relationship between hormone replacement therapy and the signs and symptoms of dry eye. Current understanding of sex hormone influences on the immune system suggests that oestrogen may modulate a cascade of inflammatory events, which underlie dry eye.
authors.affiliation: The University of New South Wales, Kensington, New South Wales, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Truong
authors.forename: Nerida
authors.initials: N
authors.lastname: Cole
authors.forename: Fiona
authors.initials: F
authors.lastname: Stapleton
authors.forename: Blanka
authors.initials: B
authors.lastname: Golebiowski
mesh_terms: D015352:Dry Eye Syndromes / Q000378:metabolism* / Q000628:therapy; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D013666:Tears / Q000737:chemistry*
chemical_list: D012739:Gonadal Steroid Hormones
keywords: androgen; dry eye; dry eye treatment; lacrimal gland; meibomian gland; ocular surface; oestrogen; progesterone; sex hormones; sex steroids; testosterone