Survey reveals most women don't recognize dry eye as a symptom of perimenopause or menopause.
A newly released industry-sponsored survey indicates that
"Dry eye symptoms can have a meaningful impact on everyday activities and quality of life, yet they are often not associated with perimenopause and menopause," said Mayssa Attar, PhD, senior vice president of Consumer and Pharmaceutical Research & Development at Bausch + Lomb. "The survey findings highlight an opportunity to increase understanding of how eye health can be affected during these stages of life and encourage women experiencing symptoms to speak with an eye care professional."1
"It goes unrecognized because other symptoms, such as hot flashes, are visible, but dry eye may not be visible, and OB-GYNs don't routinely ask about these symptoms," said Giacomina Massaro-Giordano, MD, an ophthalmologist at NYU Langone Eye Center. "Symptoms can also be nonspecific and mimic allergies."
The 2026 Bausch + Lomb (Peri)Menopause Survey was conducted via the Suzy online platform among 402 women aged 30 to 80 years or older who self-identified as perimenopausal, menopausal, or postmenopausal. The survey was funded by Bausch + Lomb; no independent methodological validation or peer review has been reported, and the findings should be interpreted with those limitations in mind.1
According to the press release, only 14% of respondents recognized dry eye as a menopause-related symptom, compared with 79% who recognized hot flashes. Notably, 78% of all respondents and 80% of those who reported experiencing dry eye symptoms during the perimenopausal, menopausal, or postmenopausal period said the association came as a surprise.1
Among women in these hormonal stages who reported dry eye symptoms, the survey identified substantial functional impact: 58% reported difficulty reading, 53% reported difficulty with screen use, 26% reported difficulty driving, and 17% reported reduced workplace productivity. More than 43% of all respondents described managing their perimenopausal or menopausal symptoms overall as overwhelming, and more than 40% reported uncertainty about where to seek guidance.1
The hormonal fluctuations accompanying perimenopause and menopause, most notably declining estrogen and androgen levels, are understood to influence lacrimal gland and meibomian gland function, altering tear production, composition, and evaporation rates.4 These changes can precipitate or exacerbate dry eye disease, a condition characterized by tear film instability and ocular surface inflammation that produces symptoms including burning, irritation, photophobia, fluctuating vision, and foreign body sensation.2
• Drug/product class: OTC and Rx dry eye portfolio (Bausch + Lomb)
• Indication: Dry eye disease in peri-/menopausal women
• Data source: Industry-sponsored online survey, n = 402
• Key finding: Only 14% recognized dry eye as menopause-related
• Key finding: 78% surprised to learn of the association
• Functional impact: 58% reported reading difficulty
• Geography: United States/Canada (Bausch + Lomb, Ontario)
"During menopause, androgens can decrease, and androgens support the function of meibomian glands," Massaro-Giordano said. "Malfunctioning glands can lead to evaporative dry eye. Estrogen and progesterone also play a role in dry eye. Levels fluctuate, and the balance is important."
Dry eye disease is among the most prevalent ocular conditions globally and disproportionately affects women, particularly those of postmenopausal age.3 A 2017 review in the Journal of Mid-Life Health identified sex hormones, estrogens and androgens, as key regulators of tear film composition via lacrimal and meibomian gland activity, supporting the biologic plausibility of the menopausal-dry eye link.4 Despite this established mechanistic link, the survey data suggest the connection remains poorly communicated in clinical practice and public health messaging.
Neda Gioia, OD, CNS, IFMCP, FOWNS, founder of Integrative Vision in Shrewsbury, New Jersey, noted in the press release: "Recognizing symptoms early can help women seek appropriate care and explore management options that may improve comfort and quality of life."1
"If a patient experiences persistent redness, foreign body sensation, and fluctuating vision, especially if it has worsened during perimenopause, they should get in to see an eye doctor," Massaro-Giordano said.
On management, she noted: "Hormonal balance, possible systemic hormone replacement therapy, and prescription eye drops that address the underlying inflammation" are options to consider, "and of course, lid hygiene, such as warm compresses, to help support the meibomian glands."
The survey carries several limitations that warrant caution in interpreting its findings. The sample of 402 respondents was recruited through an online panel and was not probability-based, raising questions about representativeness. Self-identification of menopausal status, rather than clinical or hormonal confirmation, introduces potential misclassification. As a sponsor-commissioned survey with no disclosed independent oversight, results may be subject to framing and selection effects.
The survey did not assess healthcare-seeking behavior, clinical dry eye diagnoses, prior ophthalmologic care, or use of prescription versus over-the-counter therapies. The data cannot establish the prevalence of clinically confirmed dry eye disease in this population, nor can they quantify the proportion of women whose symptoms went unmanaged as a result of the described awareness gap.
The findings are consistent with broader evidence that dry eye in women of perimenopausal and postmenopausal age is underdiagnosed and undertreated.1 For ophthalmologists, the data reinforce the potential value of proactively querying patients about hormonal status during dry eye evaluations and of integrating ocular surface health into interdisciplinary menopause care discussions.
