Hormone Therapies and Eye Health—Here’s What to Know

Published 06/28/2024
by buildcreate

Hormone therapies are an important treatment option for a wide range of conditions. They can also impact your vision.

The health of every part of your body is interconnected. What happens to one part, whether an illness, a normal change, or a treatment, has effects on every other part. In the case of your eyes, that can often mean that whole-body illnesses or conditions show symptoms that are detectable at your regular eye exam—which is why we encourage our members to take full advantage of them!

But if non-eye illnesses can show symptoms in the eye, then the same is true for treatments. Doctors use hormone therapies to address many different illnesses and conditions—and because hormones impact the entire body, they can have noticeable effects on the eyes, too. Usually, these side effects are simple to manage with help from your doctor. But it’s useful to know what to look out for, so that you can address any issues early.

There are many reasons you might be taking hormone therapy, from hypothyroidism to gender affirmation. If you’re beginning one of these common hormone therapies, here are a few potential eye health side effects to be aware of.

Feminizing or masculinizing hormones

Estrogen, testosterone, and other sex hormones are some of the most common components of hormone therapy. They’re used in many different kinds of treatments:

  • Hormonal replacement or supplement to help with:
    • Menopause symptoms
    • Decrease in testosterone due to age
    • Low hormone levels in young people
    • Osteoporosis and muscle loss
    • Intersex conditions
  • Contraceptive uses
  • Gender-affirming therapy for transgender people
  • Treating certain cancers, such as breast or prostate cancer

Feminizing and masculinizing hormones play a role in the health of your eyes, too. Both types of hormones play a role in tear production, affecting the balance of oils and fluids produced by your tear glands. Changes to the balance of your hormones can cause dry eyes until your levels stabilize.

Consistently high levels of estrogen can cause blurry vision, watery eyes, and trouble focusing. Greater flexibility in the lens of the eye, along with water retention and changes in blood flow, may mean that your contacts fit differently or feel uncomfortable. Testosterone, on the other hand, can make dry eye symptoms linger or worsen, especially in people assigned female at birth (AFAB).

In general, patients on testosterone can expect fewer vision-related side effects than those on estrogen or progesterone. But in either case, it’s important to let your care provider know about any symptoms you’re experiencing, to avoid lasting damage.

Growth hormone

Human growth hormone (HGH) prompts children’s bodies to grow, and can promote muscle development in adults. It’s usually prescribed for children who don’t produce enough HGH on their own and/or are unusually small for their age, or for adults with a muscle wasting condition.

HGH doesn’t typically affect vision a great deal, although it can mimic the effects of a growth spurt for children. For nearsighted kids, this often means that their nearsightedness will get worse faster. Nearsightedness, or myopia, is an incredibly common issue, and your child’s doctor will be able to help you manage it.

Thyroid hormones

Hypothyroidism, the abnormally low production of thyroid hormones, has a minimal effect on the eyes. But it has a wide range of other health effects, which is why it’s usually important to receive thyroid hormones to bring your levels back up.

Your doctor will manage your thyroid hormone levels with you, and side effects are usually mild. But in very rare cases, too much thyroid medication or an uncommon interaction can make thyroid hormone levels spike above normal (hyperthyroidism).

Some types of hyperthyroidism can cause thyroid eye disease, which makes the eyes and surrounding tissue bulge and swell. Thyroid eye disease results in dry eyes, damage to the surface of the eyes, and in severe cases, vision loss—so it’s important to check in with your doctor regularly, and take your thyroid medication as directed.

Insulin

Insulin is essential for patients with diabetes to manage their blood sugar levels. Diabetes itself can have serious impacts on eye health, with diabetic retinopathy being a leading cause of blindness around the world.

When you begin taking insulin, it can cause your blood sugar levels to fluctuate rapidly as your hormone levels change. It’s common to experience blurry vision during this time, and more generally as a symptom of high blood sugar. Because diabetes can cause so many eye conditions, it’s always important to consult your doctor if you experience blurry vision—but it’s not an immediate cause for worry.

Corticosteroids

These hormones are produced in the adrenal gland, and they affect the way your body processes nutrients and electrolytes (among many other functions). They’re also used for an impressive array of medical treatments: allergies, autoimmune conditions, cancers, chronic endocrine conditions like Addison’s disease, and lots more.

Eye health effects from corticosteroids typically happen during long-term use—so there’s no cause for concern from, say, a nasal spray during allergy season. For patients taking them regularly, though, they can raise the risk of common eye conditions—specifically, glaucoma and cataracts—and influence the way wounds heal.

Injuries to the cornea—the outer surface of the eye—can become infected and develop into ulcers. Corticosteroids can delay the natural healing process for these injuries and potentially cause them to worsen. But, on the other hand, corticosteroids reduce inflammation and can help prevent scarring. That’s why it’s crucial to let your care provider know which medications you are taking. That way, they can balance the drawbacks and benefits to ensure the best outcome for you.

Manage your whole body health with regular eye exams.

Hormone therapies are a key tool for achieving your best quality of life, whether treating a disease, managing a life change, or living as your most genuine self. When you stay informed about your options, through regular consultation with your doctor and your vision care provider, you’ll be equipped to make confident decisions about your health—and we believe that’s what everyone deserves.

Contact Heritage today to learn more about how we can help you access high quality vision care.