Oral contraceptive use and intraocular pressure: findings from a population-based cross-sectional study

BMC Ophthalmol. 2025 Oct 6;25(1):544. doi: 10.1186/s12886-025-04413-0.

Abstract

Purpose: To investigate the association between oral contraceptive pill (OCP) use and intraocular pressure (IOP) among women aged 35–50 years, considering confounding factors such as age, body mass index (BMI), hypertension, and family history of glaucoma.

Methods: This population-based cross-sectional study included 100 women aged 35–50 years. Participants were categorized into OCP users (n = 50) and non-users (n = 50). Ocular examinations, including Goldmann applanation tonometry for IOP measurement, were conducted between 7:30 a.m. and 9:00 a.m. Detailed medical histories were obtained, and relevant covariates such as age, BMI, blood pressure, and family history of glaucoma were recorded. Statistical analysis involved descriptive statistics, independent t-tests, and analysis of covariance (ANCOVA) to assess the relationship between OCP use and IOP, adjusting for identified confounding factors.

Results: The mean duration of OCP use in the user group was 6.57 ± 5.21 years. After adjusting for age, BMI, hypertension, and family history of glaucoma, no statistically significant difference in mean IOP was found between OCP users (14.2 ± 2.8 mmHg) and non-users (14.5 ± 3.1 mmHg) (p = 0.592). The 95% confidence interval for the mean difference in IOP was − 1.24 to 0.73 mmHg.

Conclusion: This study found no statistically significant association between oral contraceptive pill use and intraocular pressure in women aged 35–50 years after controlling for key confounding variables. While the difference was not statistically significant, the findings suggest that OCPs, as used by this cohort, do not lead to clinically meaningful alterations in IOP that would be of concern in routine ophthalmologic practice, considering the Minimal Clinically Important Difference for IOP is typically 2–3 mmHg. Further research with larger sample sizes and detailed OCP specifications is warranted.

Keywords: Epidemiology; Glaucoma; Intraocular pressure; Oral contraceptive pills; Women's health.