Women go blind more often, develop glaucoma or cataracts more often and are more sensitive to contact lenses and medication than men. Differences in anatomy and hormone levels are thought to be the causes. How does this manifest itself in practice and what are the consequences for the treatment of eye diseases in women and men? Ophthalmologists report on the current state of knowledge regarding these gender-specific differences.
The eyes of men and women are not the same. They differ in terms of their structure and their hormonal balance. As a result, women’s eyes suffer from diseases differently than men’s eyes and should actually be treated in a gender-specific manner. This is reflected in a variety of ways in ophthalmology.
Higher risk of disease due to anatomy and hormones
For example, women have a higher risk of going blind or developing other visual impairments than men. For example, women are four to five times more likely than men to suffer from endocrine orbitopathy – a condition in which the eyes bulge out. “This is due to the fact that autoimmune thyroid diseases such as Graves’ disease are much more common in women,” explains ophthalmologist Maya Müller from the Institute for Refractive and Ophthalmic Surgery (IROC) in Zurich. In addition, women worldwide are up to four times more likely to suffer from narrow-angle glaucoma, a form of glaucoma. This causes excessive intraocular pressure, which damages the optic nerve and, if left untreated, can lead to blindness. “This is partly due to anatomical differences, as women often have smaller eyes and narrower anterior chamber angles,” says Müller.
In addition to autoimmune diseases and anatomy, hormones also play an important role in eye health. In many regions of the world, women are up to 1.7 times more likely to develop cataracts, especially after menopause. “The decline in estrogen as a protective factor against oxidative stress in the eye could play a role here,” explains Müller. In addition, the cornea is thinner and more sensitive in women of all ages than in men. This could also be due to hormones, as the female hormone estrogen can affect the nerves in the cornea. This makes the eyes drier and more sensitive: “The increased sensitivity may lead to a greater tendency to dry eyes, a typical eye disease in women, and discomfort that becomes noticeable when wearing contact lenses, for example,” emphasizes Müller.
Women take better care of their eyes
In addition, medications for eye diseases can work differently in women or they may not tolerate them as well. “We know that women are often more sensitive to certain medications or preservatives in eye drops,” says the ophthalmologist. On the other hand, therapies often work better in women because they implement their treatment more consistently than men. “Women use glaucoma drops more regularly and require fewer check-ups for age-related macular degeneration,” explains Müller. They therefore take better care of their eyes in the event of illness than men.
These findings could lead to better treatment strategies for both sexes. But implementation in everyday clinical practice is difficult. “Many ophthalmologists are not sufficiently trained to take gender-specific factors into account,” says Müller. There are currently no clear guidelines for gender-specific therapies, mainly because there are no detailed long-term studies on the subject.
Source: German Ophthalmological Society