Topical androgen therapy: a potential advancement in treating post-menopausal dry eye

Post-menopausal dry eye disease is one of the frequently encountered conditions in ophthalmic and optometric practice. Despite the conventional treatment, it is often observed that these patients repeatedly show up to seek for help since their symptoms did not improve. In addition to pointing to the hormonal imbalance linked to post-menopause as a potential cause of dry eye, this also highlights the urgent need to review the necessary therapeutic approach. Evidence suggests that ocular testosterone therapy, particularly 0.03% testosterone eye drops, can significantly improve tear film stability and relieve dry eye symptoms. Furthermore, it has an added benefit of bypassing the systemic circulation, providing a targeted ocular effect with minimal side effects. However, challenges such as ocular barrier penetration, formulation stability, and regulatory issues in India hinder its widespread adoption. This review critically evaluates the efficacy and challenges of topical androgen treatment in this context. The necessity for more studies to confirm the safety and effectiveness of ocular testosterone therapy in improving the quality of life for postmenopausal women with dry eyes is also emphasised.