Is Perimenopause Messing With Your Eyesight? The Vision Changes Nobody Talks About

You’ve found your first grey hairs. Your periods have developed a mind of their own. You’ve started walking into rooms and forgetting why you’re there.

But your eyesight?

Surely perimenopause can’t be responsible for that too?

Actually… it might be.

Changes to our eyes and vision are one of the lesser-talked-about things that can happen around perimenopause and menopause. Hormonal fluctuations can affect the surface of the eye, our tear film and potentially even how comfortable our contact lenses feel.

So if you’ve recently found yourself blinking at your laptop, reaching for your reading glasses more often or wondering why your eyes suddenly feel like they’ve been lightly sandpapered, you’re definitely not imagining the symptoms.

Why can perimenopause affect your eyes?

As oestrogen and other sex hormones fluctuate during perimenopause, their effects aren't limited to periods, temperature and mood.

Hormone receptors are found in tissues throughout the body, including structures involved in eye and tear-film health.

Changes during menopause can affect the quantity and quality of tears, which is one reason dry eye becomes particularly common in women around this stage of life.

And dry eye doesn't necessarily mean your eyes actually feel dry.

You might notice:

• blurred or fluctuating vision

• gritty or scratchy eyes

• burning or stinging

• tired or heavy eyes

• sensitivity to light

• redness

• difficulty wearing contact lenses

• strangely watery eyes

Yes, watery eyes can actually be a symptom of dry eye. If the tear film isn't doing its job properly, the eye can respond by producing lots of watery reflex tears.

Because apparently perimenopause enjoys keeping us guessing.

“My vision keeps going blurry”

One particularly confusing symptom is vision that seems fine one minute and slightly blurry the next.

Dry eye can cause intermittent blurred vision because your tear film helps create a smooth optical surface at the front of your eye.

One useful clue is blinking.

If things briefly become clearer after you blink, a disrupted tear film could be contributing to the problem.

But don't automatically assume new blurred vision is hormonal. Any persistent or significant change in your eyesight deserves a proper eye examination.

Why do my contact lenses suddenly feel uncomfortable?

This can be another midlife surprise.

You may have happily worn contact lenses for 20 years and suddenly find that by mid-afternoon you desperately want to take them out.

Dryness and changes to the surface of the eye can make lenses feel less comfortable. Hormonal changes may also cause subtle alterations to the cornea, which can potentially affect vision and lens comfort.

It doesn't necessarily mean you have to abandon contact lenses.

An optometrist can check your eyes and may suggest a different lens material, wearing schedule or lubricating product depending on what's causing the problem.

Potential affiliate link: Contact lenses, contact-lens-friendly eye drops or eye-care products from an online optical retailer.

And why can I suddenly not read a menu?

This one has an important caveat.

If you're in your 40s and suddenly holding your phone further and further away from your face, that's probably not just perimenopause.

It's very likely presbyopia.

Presbyopia is the normal age-related loss of the eye's ability to focus on things close up, and it typically starts becoming noticeable in our 40s.

Unfortunately, that means it arrives at roughly the same time as perimenopause.

Typical signs include:

• holding your phone further away

• struggling with small print

• needing brighter light to read

• headaches or tired eyes after close-up work

• taking your glasses off to read

• discovering that restaurant menus have apparently started using 4-point type

Reading glasses may help, but it's worth having an eye test rather than simply buying increasingly strong readers, particularly if you haven't had your eyes checked recently.

Potential affiliate link: Stylish reading glasses or blue-light/screen glasses — but I'd position these as a convenience/fashion purchase rather than claiming blue-light glasses treat menopause symptoms.

Dry eyes might be the biggest menopause eye issue

Dry eye is particularly worth knowing about.

Our tears aren't simply water. They contain different layers, including an oily outer layer produced largely by tiny meibomian glands in the eyelids.

That oil helps stop tears evaporating too quickly.

Hormonal changes and ageing can affect these glands and the tear film, leaving the surface of the eye irritated and uncomfortable.

The result can be that annoying combination of:

dry + gritty + blurry + watery + tired.

Very glamorous.

What can actually help?

The right treatment depends on what's causing your symptoms, so persistent dry eye is worth discussing with an optometrist.

But there are some simple measures commonly recommended for dry-eye symptoms.

Lubricating eye drops

Artificial tears or lubricating drops can help relieve dryness and irritation.

If you're using drops frequently, ask your pharmacist or optometrist whether preservative-free drops would be more suitable.

And if you wear contact lenses, make sure the drops you're buying are suitable for use with your particular lenses.

Potential affiliate link: Preservative-free lubricating eye drops.

A warm eye compress

This is one of those wonderfully simple things that can feel disproportionately lovely at the end of a screen-heavy day.

Warm compresses can be used as part of eyelid care, particularly where the oil-producing meibomian glands are involved.

You can use a clean warm flannel, although reusable microwaveable eye masks are much easier to keep warm for the required time.

Potential affiliate link: Reusable heated/microwaveable dry-eye mask.

Eyelid wipes and cleansers

If you also have crusting around your lashes, irritated eyelids or blepharitis, an optometrist may recommend regular eyelid hygiene.

There are specialist eyelid wipes and cleansing products designed for this.

Potential affiliate link: Eyelid cleansing wipes or foam.

Give your eyes a screen break

Staring at a screen reduces how often we blink.

Less blinking means your tears aren't being spread across your eyes as effectively, which can make dryness worse.

Try the 20-20-20 rule:

Every 20 minutes, look at something approximately 20 feet away for at least 20 seconds.

And actually blink.

Yes, we've reached an age where we apparently need reminding how to blink.

Protect your eyes outside

Wind and bright sunlight can make dry or sensitive eyes feel worse.

A decent pair of sunglasses — preferably ones offering proper UV protection and enough coverage around the eyes — can make a surprisingly big difference.

Potential affiliate link: UV-protective sunglasses.

What about supplements for eye health?

You'll see plenty of supplements marketed for eye health containing ingredients such as omega-3 fatty acids, lutein, zeaxanthin and various vitamins.

This is an area where I'd be cautious about big claims.

A supplement shouldn't be presented as a treatment for menopause-related eyesight changes or dry-eye disease unless there is appropriate evidence for that specific claim.

A balanced diet containing oily fish, colourful fruit and vegetables, leafy greens, nuts and seeds provides many nutrients associated with general eye health.

If you're considering supplements — particularly if you take medication or have a medical condition — it's sensible to speak to a pharmacist, optometrist or healthcare professional.

Potential affiliate link: General eye-health or omega-3 supplements, provided the product and wording comply with UK health-claim rules.

Should I mention eyesight changes at my eye test?

Absolutely.

If you're experiencing new symptoms, tell your optometrist that you're perimenopausal or menopausal.

It's useful context.

Regular eye examinations become increasingly important in midlife anyway, because an eye test isn't simply about whether you need stronger glasses. Optometrists can look for signs of eye conditions that may initially have very few noticeable symptoms.

When eyesight changes are NOT something to blame on menopause

This bit is important.

Perimenopause can coincide with eye and vision changes, but don't assume every new visual symptom is hormonal.

Seek urgent medical or eye-care advice for symptoms such as:

• sudden loss of vision

• a dark curtain or shadow moving across your vision

• sudden new flashes or a significant increase in floaters

• severe eye pain

• a very red, painful eye

• sudden double vision

• sudden significant distortion or blurring

• visual symptoms accompanied by neurological symptoms such as weakness, difficulty speaking or facial drooping

And if your vision is simply changing gradually or your eyes remain uncomfortable despite self-care, book an appointment with an optometrist.

Another one for the perimenopause list…

Hot flushes? Yep.

Brain fog? Yep.

3am wake-ups? Naturally.

Suddenly dry, gritty eyes and contact lenses that you want to rip out by lunchtime?

Potentially, yes.

The frustrating thing about perimenopause is just how many different parts of the body can seem to change at once. Knowing that your eyes can be affected means you can stop quietly wondering what's going on and actually do something about it.

Start with an eye test if things have changed, and don't be afraid to tell your optometrist you're going through perimenopause.

Because sometimes “Is this another bloody perimenopause thing?” really does have the answer:

Possibly.