How Do Hormones Affect Eye Health?

Published 07/25/2023
by Heritage Vision Plans

Hormones affect our bodies in many ways, including our vision. Here’s what to look out for.

We’re all aware of the important role hormones play in our bodies. Hormones are how our body sends signals from one organ to another, triggering complex reactions that affect our physiology. Hormones stimulate and inhibit growth, moderate our immune system, control the reproductive system, trigger our flight or fight reflex, and affect how we bond with others.

Given how many ways they affect our bodies, it should come as no surprise that they can impact our vision as well. However, these changes can still be surprising, and knowing what to expect can help you be prepared if your vision begins to shift without warning. In this article, we’re going to cover the main hormones that can impact eye health, as well as different life events that can trigger these changes.


As children enter puberty, the hormones causing growth spurts and other bodily changes can also cause the eyes to change shape. Most often, this leads to myopia, or nearsightedness, due to a lengthening of the eyeball. New vision technologies under development can help prevent or reduce myopia in adolescents. Post puberty, laser eye surgery is an effective treatment for myopia.

Estrogen and progesterone.

The female sex hormones estrogen and progesterone have stronger effects on eye health than male sex hormones, and changes in hormone levels during menstruation, pregnancy, breastfeeding, perimenopause, menopause, and while on birth control pills can all lead to vision changes.

The most common symptom is dry eye, which can result if low levels of estrogen affect the oil glands in the eyes. On the other hand, a rise in estrogen levels can lead to watery eyes, blurred vision, and difficulty focusing.

Hormone changes, especially during pregnancy, can also lead to fluid retention resulting in light sensitivity, blurred vision, and even headaches. While these conditions usually go away post-pregnancy, women should not wait to talk to a doctor as they can also indicate other health conditions including diabetes and hypertension.

Post-menopause, women are more likely to experience dry eyes, and decreased water retention can mean their nearsightedness changes as well. If you suddenly find yourself struggling to read fine print or to focus on close objects, your hormones may be the cause.

Androgen and testosterone.

Androgens boost both the meibomian and lacrimal glands, two of the glands responsible for producing tears. The lacrimal gland is responsible for the layer of water and electrolytes that we mostly think of when we think of tears, while the meibomian gland produces an oily layer on the surface of the eye that both lubricates the cornea and prevents our tears from evaporating too fast. A drop in androgens can affect one or both of these glands, leading to dry eyes. In women with polycystic ovary syndrome, an excess of androgens can also lead to dry eye symptoms.

Testosterone has fewer effects than other hormones, and is mostly related to aging. As testosterone levels lower, changes in the tear ducts may lead to dry eyes and blurry vision, similar to the effects of lower estrogen in post-menopausal women.

Hormone replacement therapy.

By now it should come as no surprise to learn that HRT can have vision-related side effects. These are especially common in those taking feminizing HRT treatments, as the hormones involved are those most likely to impact vision.

Feminizing HRT can lead to a drop in androgen levels, which can disrupt tear glands and lead to dry eyes. Low androgen levels also affect how well the cornea can heal after an injury. This can be offset by the increased levels of estrogen, which can improve meibomian gland production.

HRT patients receiving testosterone generally experience fewer vision-related symptoms. However, it is possible that testosterone binding with androgen receptors can disrupt meibomian gland production, leading to dry eye symptoms.

Either way, patients receiving HRT treatments should pay attention to vision changes and speak to their doctor if dry eye symptoms occur, as early treatment can prevent long-term damage.

Thyroid hormone.

Several autoimmune diseases including Graves’ disease and Hashimoto’s disease interrupt the thyroid gland’s normal functioning. Graves’ disease causes the thyroid to over-produce the hormones triiodothyronine and thyroxine, leading to bulging eyes or puffy eyelids. As a result, the eyelids can’t close all the way, causing eyes to dry out. Apart from discomfort, this can also lead to damage of the cornea. Because Hashimoto’s disease results in an underproduction of thyroid hormones, it can affect the tear ducts, which also leads to dry eyes.

Imbalances in thyroid hormone levels have also been linked to higher rates of age-related macular degeneration and issues with the development and regulation of the eye cells responsible for color vision.

To manage your hormones and the impact they have on your eye health, maintain a healthy diet and see your eye doctor.

Long-term, the best way to protect your vision is by maintaining a healthy diet that is rich in fruits, vegetables, and omega-3 fatty acids. Under certain conditions, a supplement may be advisable if you suspect you aren’t getting enough of these nutrients through natural sources.

If you’re undergoing a major bodily change related to fluctuating hormones, it’s natural to notice changes in your eyesight as well. However, any time your vision changes, you should talk to your doctor. After all, a vision change can also be caused by other factors that may or may not be related to whatever change you’re currently experiencing.

Even if you aren’t noticing symptoms now, annual eye exams are an important checkpoint for early detection of a range of health concerns. If you haven’t had an eye exam within the past year, schedule one today, or reach out to your vision carrier to find an optometrist in your area.