I found this on the internet...soem of which seems logical, but I also called my Eye Dr. yesterday...I had just had it with the constant watering eyes, which seems much worse when I'm on Xeloda....I couldn't even go outside without tears running down my face, and wind or a breeze makes it unbearable...glasses don't help...my eyes were so sore at the corners from wiping them....last year I had little collagen stints put in my tearducts, but that only helped a few days...well now its Restasis....very expensive, but after 2 doses (a.m. & p.m.), I haven't wiped my eyes all morning ...it is by prescription only, but nothing over the counter seemed to work...so I will let you know how long this new treatment lasts. It seems the excessive tearing is due to dry eye syndrome, where the body cannot produce enough lubricant for the eyes and therefore goes into hyperactive mode trying to keep the eyes moist. I thought I had too many tears, seemed that was because I didn't have enough.
Hope this helps someone who is suffering.
Seeing clearly about dry eyes and menopause
by Marcelle Pick, OB/GYN NP 
What symptoms do you think of when it comes to menopause? Hot flashes, insomnia, vaginal dryness, mood swings, fatigue, headaches — all the usual suspects, right? Yet one symptom affects more than 60% of women and they don’t even know it’s connected to menopause: dry eyes. And more often than not, other imbalances that affect the eye are also at work but only become evident when hormones begin to fluctuate.
Eyes are the windows of the soul, it’s said. But in my experience they are also windows into your physiology and can turn dry, itchy, red, and irritated in, literally, the blink of an eye. Symptoms of dry eye are an invaluable warning that something deeper is brewing in your system and needs to be looked at — a truth many Eastern practitioners have known for millennia.
Yet conventional medicine continues to tell us that dry eye is an isolated condition, one that is best served by covering up the symptoms with drops or blocking the eye’s tear drainage system. At Women to Women, we’ve had tremendous success treating dry eye from the inside out. So let’s take an up-close look at dry eye because it can affect so many of us and learn how to restore balance to the body and the eyes.
Symptoms of dry eye
Temporary mild symptoms of tired, itchy, or red eyes that abate with sleep, a change in environment, or taking your contact lenses out can be chalked up to obvious culprits. But worsening or persistent symptoms should be taken seriously. They include:
- itchiness
- a scratchy or gritty feeling
- tears running down the cheeks
- increasingly tired eyes during the day
- irritation from smoke, wind, or air movement
- stringy mucus
- sensitivity to light
- blurriness
- problems wearing contact lenses
If dry eye is left untreated, the cornea can become scarred or develop ulcers. Infection can also become more common because eye fluids help carry away debris. Vision can be affected, and you may feel chronic eye pain. But getting to the real cause of the condition can take some sleuthing.
What causes dry eyes?
Dry eyes can develop for two reasons: insufficient oil production by the meibomian glands (found in the inner eyelids) or too much evaporation of the eye’s watery tears. Most people with dry eyes are affected by both low oil and high evaporation. Symptoms of dry eye are also common with certain auto-immune disorders, like diabetes, arthritis, lupus, and Sjögren’s syndrome.
If you think you may have dry eye, call your healthcare practitioner and schedule a medical evaluation of your eyes. You will also be asked a number of questions about your lifestyle and habits. Lifestyle factors that contribute to dry eyes include:
- Looking at computers or reading without blinking often enough to redistribute eye fluid
- Living and working in dry places
- Wearing contact lenses that absorb eye fluids
- Having LASIK surgery, which cuts eye nerves, reducing impulses for blinking
- Taking medications like allergy pills, diuretics, beta-blockers, birth control pills or other drugs that dry out the body
- Diets that don’t provide sufficient essential fatty acids or anti-inflammatory foods
- Droopy eyelids or certain health conditions, particularly autoimmune disorders like diabetes, arthritis, lupus, and Sjögren’s syndrome, which also causes dryness in the mouth.
Conventional medicine generally stops here when it comes to identifying the cause of dry eye, but the root imbalances that lead to many cases of dry eye extend much deeper, particularly for women in perimenopause and menopause. Often it’s just the tip of the iceberg. That’s because hormones play an important role in tear production and lubrication.
Hormonal changes and dry eyes
The degree to which your hormones affect your eye health depends largely on your individual blueprint and lifestyle. However, studies have linked androgen (testosterone) and estrogen receptors on the cornea of the eye and on the meibomian gland. This indicates a correlation between the production of tears and our sex hormones.
Before menopause, the more testosterone you have, the fewer tears you produce, while an increase in estrogen means more tear production. However, this equation reverses during menopause — more testosterone means more tear production, while more estrogen means less tear production. And while we still need to learn more about how this mechanism works, it’s clear that hormones play a significant role in lubricating our eyes. It makes sense that dry eyes may result from estrogen deficiency, progesterone deficiency, testosterone deficiency or possibly from an imbalance of any of the three.
When your eyes stay dry for too long, the result is localized inflammation. This immune response releases all kinds of inflammatory substances which make your eyes red, itchy, and swollen. The appearance of dry eyes often coincides with other signs of “drying” in menopause, like sore joints and dry vaginal tissues. Restoring a natural internal balance between estrogen, progesterone and testosterone is an important remedy for dry eyes. Though this is something we rarely hear about in a conventional eye doctor’s office, or other imbalances that may be contributing to the condition. For a more profound look at dry eye, you need to look East.
An alternative view of dry eyes
In many Eastern healing traditions, the eyes are crucial diagnostic tools. During an exam, practitioners peer intently into a patient’s eyes to gain insight into the root of their health concerns. In Traditional Chinese Medicine (TCM), the eyes are the organs through which your purest energy flows. When you are healthy and balanced, your eyes emanate a clarity or awareness that is immediately visible to the practitioner. And when you are imbalanced, it also shows in your eyes. Why? Because the organ that rules the eye in TCM is the liver: the organ of detoxification.
As a holistic, functional medicine practitioner, I agree that symptoms of dry eye can be an important warning sign that your body’s detox capabilities are on overload. And what happens when you aren’t detoxifying efficiently?
Inflammation. While no clinically controlled study as of yet has linked the localized inflammation of dry eye to systemic low-grade inflammation, my experience with thousands of patients over the past 20 years has shown me that they are branches off the same tree. An inner physiology that’s weighted toward fire will (figuratively) drink up any available lubricants — including your eye fluid.
Moreover, the inflammation connection is being supported by the growing trend among conventional eye doctors to add omega-3 supplements or fish oil to their standard dry eye treatment protocol. A recent study reported that women with a diet rich in omega-3 fatty acids reduced their risk of dry eye by 20% compared to women with low levels of omega–3.
Increasing your intake of omega-3 fatty acids — either in supplements or by eating fish like mackerel, tuna, or wild salmon or certain nuts and seeds — does several things that benefit the eye by benefiting your entire body. For one, they have been shown to naturally moderate inflammation. They also aid in the stimulation of tear secretion and increase the oils in that secretion. Additionally, they may moderate excess estrogen production. And all of these benefits get at the root of dry eyes by providing natural lubrication rather than temporary “artificial” relief.
Conventional
dry eye treatments and “artificial tears”
The most common conventional treatment for dry eye is drops or “artificial tears” that temporary relieve symptoms by restoring fluid to the eye. These drops can be invaluable in the short term for many people with dry eyes by making it comfortable to blink. The unfortunate side of drops, though, is that they offer only temporary relief of dry eye symptoms, not a systemic response that helps prevent recurrences.
If your symptoms of dry eye are really bothering you, it’s worth finding some soothing drops to use while you pursue other long-term approaches that may take more time to kick in. The ingredients and viscosity of drops vary a lot, so you may need to try a few; be sure to ask your practitioner for samples. When buying, remember that preservatives irritate some eyes, and drops designed to “get the red out” are not designed for dry eyes.
Keep in mind that using drops is like pouring water into a dry well instead of looking for a new spring — to find permanent relief you need to start digging.
Relief for dry eyes: the Women to Women approach
At Women to Women, we’ve helped many women recover and prevent dry eyes by building up their core foundation of nutrition and restoring their hormonal balance.
Every body is unique so you may need to experiment to find a combination of changes that work for you. My experience at the practice has led me to believe that supplemental essential fatty acids, in addition to a highly nutritious diet, are helpful for women of all ages with dry eyes. So let’s start here:
Optimize your nutrition. Eat three balanced meals a day, consisting of whole foods (for more information, see our
nutrition and lifestyle guidelines). Fill in any nutritional gaps with a daily multivitamin. Choose a formulation like the one in our Personal Program that has a good balance of essential fatty acids, including EPA and DHA, plus vitamin E, which helps the omega-3’s do their work. Keep in mind that you need the right balance of omega-3’s, 6’s and 9’s — not more of everything. Be sure your omega-3 supplements are free of lead, mercury, PCB’s and other contaminants.
Balance your hormones. Using progesterone cream, like that in our Personal Program, can help the body generate its natural levels of estrogen, progesterone and testosterone. You may also notices that some simple dietary changes, like eating more whole grains and less sugar and processed foods can help control insulin levels and reduce chronic inflammation. (Take a look at our
anti-inflammatory diet suggestions for ideas.)
Evaluate your medications. If you are on medication, speak with your doctor about the possibility of it contributing to your dry eyes. There may be alternatives that cause fewer side effects.
Avoid excessive pollution and other irritants. Here’s another great reason to quit smoking: smoke aggravates dry eyes. Also, try to avoid rubbing your eyes since it can disturb tear film, remove moisture, and introduce bacteria or irritants into the eye. Try to buy hypoallergenic make-up as well.
Hydrate and humidify. Dehydration can draw fluid from the eyes, so remember to drink plenty of fluids. Non-diuretic drinks like water, pure juices, milk and herbal teas are good choices for hydration. You may also try using a humidifier to reduce tear evaporation, but be sure to clean it daily with soap to avoid introducing more irritants into the air.
Blink! Try to blink at least every five seconds or so, particularly when looking at your computer screen. It may also be helpful to lower your computer monitor a bit so your eyelids cover more of your eyeballs while you look at it.
Practice care with contact lenses. Contacts can sap the eye’s fluid and collect proteins, irritating eyes further with roughness and an environment conducive to growing bacteria. Keep lenses very clean, consider wearing them less, or explore lenses designed for dry eyes. Not all drops can be used with contacts, so check the labels. TheraTears makes a product specifically designed for contact wearers with dry eyes.
Get more sleep! Last but definitely not least: enjoy the anti-inflammatory benefits of regular sleep! Beyond giving your eyes a chance to rest and refresh, good quality sleep reduces stress that can contribute to hormonal imbalances. Our bodies detoxify and attend to much needed cellular repair while we sleep, which helps soothe inflammation in all systems.
Heed the insight of your third eye
In the end, your “third eye” — your intuition — may be one of the best tools in helping you find ways to keep your eyes healthy and comfortable. Start from the inside when looking for solutions. Know that dry eye is extremely common during menopause and that you are not alone. Try to be patient as you wait for improvement and talk with your healthcare practitioner if your condition worsens or doesn’t improve. Eyesight is so much a part of our daily lives that most of us take it for granted until something goes wrong. Consider making some positive changes that will benefit your eyes — and the rest of you — for life.
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