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Hormone Replacement Therapy in Post Menopause May Increase Cataract Risk

Clouding of the eye lens by a cataract is an important and preventable cause of impaired vision and blindness. Cataracts start out small and may involve a little blurred vision or light from the sun or lamp may seem too bright or colors may not seem as bright. Most cataracts are related to aging so they are very common in older people. Other risk factors would be: certain diseases such as diabetes; smoking and alcohol use; prolonged exposure to sunlight. The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

Hormonal replacement is supplemental hormonal therapy with synthetic estrogen, usually including a progestin. Hormone Replacement Therapy (HRT) relieves climacteric symptoms and may protect against osteoporosis and Alzheimer’s disease. HRT increases risk for cardiovascular disease, breast and endometrial cancer, and stroke. A decision to use HRT may depend on a woman's individual views of the menopausal transition, the postmenopausal phase, and its consequences. Health providers and patients should be thoroughly informed about the symptoms associated with hormonal deprivation.

A study published in the journal, Ophthalmology, sought to investigate whether there is an association between hormone replacement therapy (HRT) and the incidence of cataracts in postmenopausal women. The study participants included 30,861 postmenopausal women who were part of the Swedish Mammography Cohort. The women were between the ages of 49 and 83 years and completed a self-administered questionnaire about hormone status, HRT and lifestyle factors and were followed from 1997 through 2005. Researchers found that a total of 4,324 incident cases of cataract extractions were identified during the follow-up period. After analyzing the data, it was determined the risk for cataract removal was increased by 14 percent in women who had ever used HRT and by 18 percent in current HRT users, compared with women who never used HRT. It was found that longer duration of HRT use further increased the risk of cataract extraction. Current HRT users who also reported having more than one alcoholic drink per day had a 42 percent increased risk compared with women who used neither HRT nor alcohol, while smoking did not appear to have any association with cataract extraction. The researchers suggest that hormonal differences influenced by HRT may act to promote cataract development in postmenopausal women.1

1 Lindblad BE, Hakansson N, Philipson B, et al. Hormone replacement therapy in relation to risk of cataract extraction: a prospective study of women.Ophthalmology. 2010;117(3):424-30.