Treatment of menopausal keratoconjunctivitis sicca with topical oestradiol

Br J Obstet Gynaecol. 1998 Jan;105(1):100-2. doi: 10.1111/j.1471-0528.1998.tb09358.x.


Objective: To investigate the effect of 17 beta-oestradiol ophthalmic drops in comparison with a traditional tear substitute in postmenopausal women with keratoconjunctivitis sicca.

Design: Randomised prospective trial.

Setting: Menopause clinic.

Participants: Eighty-four postmenopausal women suffering from keratoconjunctivitis sicca and necessitating a hormone replacement therapy (HRT) for general climacteric symptoms.

Methods: The women were randomised into two groups and were given 17 beta-oestradiol eye drops (n = 42, group 1) or a tear substitute (n = 42, group 2). Both groups received a systemic HRT.

Main outcome measures: A Schirmer's test was performed immediately before the beginning of therapy and after four months. In addition, eye symptoms were assessed using a visual analogue scale.

Results: A comparison of visual analogue scores at four months in the women who received 17 beta-oestradiol eye drops versus those who received a tear substitute demonstrated a statistically significant difference in all observed ocular symptoms (P < 0.0001). The Schirmer's test revealed a significant difference of results before and after treatment in the oestradiol group (P < 0.0001) while in group 2 no significant difference was found.

Conclusions: Our study demonstrates that topical oestrogen is successful in treating keratoconjunctivitis sicca while it seems that the blood-eye barrier prevents systemic oestrogens from acting on the conjunctivae.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Estradiol / administration & dosage*
  • Female
  • Humans
  • Keratoconjunctivitis / drug therapy*
  • Menopause
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome


  • Estradiol