BACKGROUND Due to the higher prevalence of dry eye disease (DED) in postmenopausal women, it is essential to understand the effects of sex hormones on the ocular surface. This study was done to identify the association between serum concentration of 17 beta estradiol E2 and DED in postmenopausal women. METHODS Our study population comprised of 100 postmenopausal women who were segregated into two groups – 50 symptomatic participants in dry eye group and 50 asymptomatic participants in normal eye group (NEG), based on the dry eye questionnaire assessment. Other preliminary tests to detect DED and meibomian gland dysfunction (MGD) such as tear break up time (TBUT), meibum evaluation, ocular staining score (OSS) and Schirmer’s test were performed. All participants underwent venous sampling for measurement of serum concentration of 17 beta estradiol E2. RESULTS 82 % of participants of DEG belonged to older age group (> 60 years) on comparison with NEG (32 %). A shorter TBUT of 5.78 and 5.96 in DEG as compared to 13.44 and 13.08 in NEG were documented in right and left eyes respectively. Mean serum estradiol was significantly higher in DEG (30.90 pg/ml) than in NEG (16.02 pg/ml). With an increase in the severity of MGD stage, an analogous increase in serum estradiol was noted, which was statistically significant (P < 0.001). CONCLUSIONS Higher levels of serum estradiol correspond with higher stages of MGD, suggesting that sex hormone induced alteration of meibomian gland morphology and function plays an important role in postmenopausal DED. KEY WORDS Dry Eye Disease, Meibomian Gland Dysfunction, 17 Beta Estradiol E2, Postmenopausal Women
Effect of dry eye diseases on the level of Protein and Lipids in Tears of Postmenopausal Women.