Age-related eye diseases: impact of hormone replacement therapy, and reproductive and other risk factors

In Western countries, age-related macular degeneration is the leading cause of legal blindness in the population over 60 years of age, and cataract is the leading cause of visual impairment worldwide. Because postmenopausal women are living longer, they have a greater probability of developing a variety of age-related visual disorders. As the population ages, the physical and emotional toll of these ailments, as well as the burden on the health care system, will escalate. Currently, interventional therapy for age-related macular degeneration is limited to a small subpopulation of patients who can benefit from laser treatment, whereas surgery is the only effective treatment for cataract. The need for other therapeutic options and preventive measures remains a major challenge for the future. Studies among women have suggested that exposure to estrogens is associated with a reduction in risk of developing ocular diseases associated with aging. This article addresses the epidemiology of age-related macular degeneration and cataract, focusing on the specific risks for women, and discusses factors that may influence development or progression of these visual disorders.