Why Are Women at Higher Risk of Visual Impairment?

Over the last two decades, there has been increasing evidence that women are affected by blindness and visual impairment more commonly than men. We now know that being a woman is a significant risk factor for sight-threatening, age-related eye diseases and vision loss.

According to the first World report on vision issued by the World Health Organization (WHO), at least 2.2 billion people worldwide have a vision impairment or blindness, of whom at least 1 billion have a vision impairment that could have been prevented or has yet to be addressed. The WHO estimates that women comprise nearly two-thirds (64.5%) of all visually impaired people worldwide.

Why Are Women at a Higher Risk of Visual Impairment Than Men?

There are many factors and differences between men and women which put women at greater risk of eye-related health issues. Some of these factors are intrinsically more common in women and some are exacerbated by socioeconomic and cultural barriers, access to healthcare, and lifestyle choices. Here are ten factors thought to contribute to gender inequality in visual impairment:

+ Longer Life Expectancy

Women statistically live longer than men by six to eight years on average – and therefore, are more likely to develop age-related eye diseases, such as macular degeneration and cataracts.

+ Hormones

Hormonal changes related to pregnancy, the use of birth control pills, hormone replacement therapy (HRT), and peri-/menopause all affect a woman’s overall eye health. Pregnant women may experience high blood pressure, dry eye syndrome, eye migraines, refractive changes, and light sensitivity. A majority of perimenopausal and menopausal women suffer from dry eyes due to a drop in estrogen levels, which disrupts the oil glands of the eyelids and can lead to dryness.

+ Medications

Various studies on drug use found that women take more prescription and non-prescription drugs than men. Many of these drugs can have serious side effects on the eyes. Several of these drug classes that are specific to women (e.g., hormone replacement therapy) and/or are used significantly more by women than by men (e.g., antihistamines, anxiolytics, antidepressants, and antipsychotics) are associated with an increased risk of dry eye syndrome.

+ Diabetes

About 15 million adult women in the United States have diabetes (about 1 in every 9). Diabetes increases the risk of several eye diseases, notably diabetic retinopathy and early cataract formation. Women are also at risk of developing gestational diabetes during pregnancy.

+ Autoimmune Disease

Women are also more likely to have autoimmune conditions, which often come with ocular and visual side effects. These conditions, which include Sjögren's syndrome, systemic lupus erythematosus (SLE), rheumatoid arthritis, and thyroid diseases, cause inflammation that can lead to the development of dry eye syndrome.

Related Post: Top 5 Women's Eye Health Concerns + Tips

+ Lifestyle Choices

Obesity, eating an unhealthy diet, and a lack of exercise are all risk factors for systemic and eye disease. The prevalence of obesity in the U.S. is high and projected to continue to increase. According to the National Health and Nutrition Examination Study by the CDC, the prevalence of obesity among women was 39.7% among those aged 20–39 and 43.3% among those aged 40 and over.

+ Smoking

Smoking significantly increases one's risk of developing age-related macular degeneration and cataracts. Some studies suggest that women may have a more difficult time quitting smoking than men because women's brains respond differently to nicotine.

+ Cosmetic Use + Tattooing

Permanent eye cosmetics, such as tattooed eyeliner, cause destruction of the meibomian glands, the tiny oil-producing glands of the eyelids. Loss of the meibomian glands reduces the lipid layer of the tear film and can lead to evaporative dry eye. Harmful ingredients found in topical cosmetics, especially mascara and eyeliner, as well as eye/facial creams can increase debris and destabilize the tear film. Make a habit of removing your eye makeup nightly to prevent further damage and lessen the risk of developing an eye infection or stye.

+ Caregiver Role

Women live very busy lives, juggling the demands of working, caring for children, and managing households. On top of that, women often make the majority of their family's health care decisions and play the caregiver role to the extent of neglecting their own self-care. To put it into perspective: When was the last time you took your child or aging parent to the eye doctor? When was the last time YOU had an eye exam yourself? It is important to make your own eye health and vision a priority.

+ Lack of Access to Eye Care Services

Globally, in both low- and middle-income countries, the prevalence of blindness and visual impairment is higher among women. The social, cultural, and economic differences which exist between men and women also lead to reduced access to services for women. In many areas, men are twice as likely as women to be able to access eye care.

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