Hi purplebee!
Dry eye is a common problem at this stage of life. I have evaporative dry eye due to a deficient tear film lipid layer, which increases tear evaporation. The meibomian glands are the sebaceous glands on the eyelids responsible for producing the oil component of tears that prevents evaporation. Androgens regulate meibomian gland function and androgen deficiency may lead to meibomian gland dysfunction.
It could be, for this reason, that some studies suggest that women who use HRT, particularly estrogen alone, are at increased risk of dry eye. The clinical research is mixed. It remains controversial whether dry eye is caused by estrogen excess or deficiency, androgen deficiency, or estrogen and androgen imbalance.
The women who are taking testosterone may be able to comment on whether it has improved their dry eye.
Drops are a quick fix. I've used many different types of eye drops/gels/ointments and Thealoz Duo works best for me. It's preservative-free and contains hyaluronic acid and trehalose.
Another option is a Bruder moist heat eye compress or similar mask. You heat it briefly in the microwave and it allows your natural oils to lubricate your eyes. It's used daily. It works well, but I had to stop using it because hormone therapy triggered melasma and the melasma was aggravated by the heat from the mask. Some people make their own mask using a nylon stocking or a cloth bag filled with rice and similarly microwaved. Be careful not to overheat.
A 2008 study determined that warm compresses applied to the eyelid must maintain a consistent 45C (113F) in order for the therapeutic heat to reach the oil glands. The heat source can be applied safely against the external eyelid skin without risk of thermal injury for the duration of a treatment. The heat needs to be applied for a minimum of 4 minutes in order for the heat to pass through anatomical barriers (skin, fat, etc.) that naturally shield the glands.
Do not massage your lids during or immedately after applying the warm compress, because the cornea is more susceptible to warpage when heated.
One of my doctors prefers to use a towel over his eyes while taking a hot shower. He finds it effective and more convenient.
Good to hear you've scheduled an appt. Keep us posted.
