Safiye Yilmaz, Ebru Aydemir, Ahmet Maden
Department of Ophthalmology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey

Aim: To evaluate the effect of hormone replacement therapy on development of dry eye in postmenopausal women.
Methods: In this prospective comparative case series, 120 eyes of 60 postmenopausal women who were taking hormone replacement therapy (group 1) and 168 eyes of 84 postmenopausal women who were not taking hormone replacement therapy (group 2) were compared. The tear function was examined using Schirmer’s test, tear film break-up time, and fluorescein and rose bengal corneal staining. Patients’ symptoms were noted and scored according to the ocular surface disease index. Students t test was used for statistical analysis and Pearson correlation test was used to assess the correlation.
Results: The average duration of hormone replacement therapy was 39.80 months (SD, 9.51 months). The average Schirmer’s test result was 12.71 mm (SD, 2.51 mm) and 12.35 mm (SD, 5.29 mm) for groups 1 and 2, respectively. The average tear film break-up time was 13.53 seconds (SD, 3.48 seconds) and 9.45 seconds (SD, 4.51 seconds) for groups 1 and 2, respectively (p < 0.05). One patient (6%) in group 1 and 4 patients (19.04%) in group 2 had grade 4 and 5 disease based on corneal staining. The average blood oestradiol levels were 139.00 pmol/L (SD, 123.31 pmol/L) and 134.53 pmol/L (SD, 145.75 pmol/L) in groups 1 and 2, respectively. The ocular surface disease index scores were 69.4 (SD, 12.5) and 83.3 (SD, 11.4) in groups 1 and 2, respectively (p < 0.05).
Conclusion: These data suggest that postmenopausal women who have never used hormone replacement therapy are at an increased risk for dry eye compared with postmenopausal women who are taking hormone replacement therapy.

Key words: Dry eye syndromes, Estrogens, Hormone replacement therapy, Menopause

Asian J Ophthalmol. 2007;9:171-174.