Dry Eye Rates in Men and Women

By Dr. Abdalrahman Alabsi – Ophthalmologist | Last reviewed: October 2026

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Women are affected by dry eye disease (DED) at much higher rates than men. This difference is due to many variations in anatomy, gene expression, and the hormonal regulation of the lacrimal gland, the meibomian glands, the cornea, and the eyelids.

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Sex differences in the lacrimal gland:

Studies show that age-related degenerative changes are greater in women, including glandular atrophy and periglandular and periductal damage, with the exception of ductal dilation, which is more common in male glands. The higher rate of degenerative changes in women's lacrimal glands is attributed to hormonal influences or lower estrogen levels, which is consistent with the higher prevalence of dry eye among older women.

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Hormonal regulation:

Androgens are hormones that play a protective role in ocular surface homeostasis, and androgen deficiency is a possible cause of both types of dry eye disease: aqueous-deficient dry eye and evaporative dry eye caused by a deficient lipid layer.

The role of estrogen is less clear, while progesterone-based therapy has shown clinical benefit in relieving ocular discomfort.

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Thyroid hormone disorders and their effect on ocular surface disease:

The link between thyroid eye disease (TED) and dry eye disease is related to anatomical changes in the orbit that cause proptosis and corneal exposure to ulceration, inflammation of the lacrimal gland and eyelids, and incomplete blinking. In addition, reduced lacrimal gland volume correlates with the severity of clinical signs of thyroid eye disease and elevated inflammatory markers.

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Clinical implications:

Androgen levels, predisposition to autoimmune disease, and thyroid dysfunction are the most clinically relevant sex-related factors when assessing the risk of dry eye disease.

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Note: Dry eye rates in women may also be higher due to other external factors that affect the function of the tear-secreting oil glands, such as using cosmetics around the eyes and wearing contact lenses.