Vitamin D Insufficiency May Explain DED in Women Who Are Postmenopausal

Patients with DED who are postmenopausal may benefit from vitamin D level screenings.

Vitamin D insufficiency may be associated with dry eye disease (DED) in women who are postmenopausal, according to research published in the International Journal of Applied and Basic Medical Research. These individuals may benefit from an evaluation of vitamin D levels during DED workups, the report suggests.

Investigators included 140 women (mean age, 60.1 years) who were post menopausal in a case-control study to determine the correlation between vitamin D insufficiency and DED. The team stratified study participants according to DED status as determined by Ocular Surface Disease Index (OSDI) score (DED: OSDI ≥12; n=70 vs no DED: OSDI <12; n=70). Participants with DED were further stratified into groups based on clinically positive (tear breakup time [TBUT] ≤5 seconds; Schirmer test ≤5 mm strip wetting in 5 minutes; n=40) or clinically negative DED (n=30) based on objective Schirmer and TBUT assessments. Study individuals underwent vitamin D level measurements using enzyme‐linked immunosorbent assay (vitamin D insufficient: 10–30 ng/ml; vitamin D deficient: <10 ng/ml).

[A]n additional therapeutic modality of Vitamin D supplementation may open a new avenue in the treatment of DED patients.

The researchers note the role of vitamin D as an immunomodulatory agent and suggest that “it cannot be a chance association that most of the comorbidities associated with DED including increasing age, female gender, menopause, thyroid disease, diabetes
mellitus, arthritis, depression, anxiety; are all associated with decreased Vitamin‐D levels.”

Study participants with DED, according to OSDI score, had significantly lower vitamin D levels compared with control group individuals, (14.36 vs 19.19 ng/ml; P =.001), the report shows. Individuals with clinically positive DED had significantly lower vitamin D levels compared with participants with clinically negative DED (13.15 vs 15.7 ng/ml; P =.01). However, no significant differences in OSDI scores were noted between individuals with clinically positive and clinically negative DED.

“[A]n early identification and timely initiation of treatment may prevent dry eye sequelae in this vulnerable group of [postmenopausal women],” the study authors explain. “[A]n additional therapeutic modality of Vitamin D supplementation may open a new avenue in the treatment of DED patients.”

Study limitations include a hospital-based nature, a limited sample size, and an ethnically homogenous cohort, which may limit globalization of the study findings.


Malik D, Garg R, Sethi S, Mahendru R, Singh S. Serum vitamin D levels and dry eye disease in postmenopausal women: a case-control study at a tertiary care center in rural HaryanaInt J Appl Basic Med Res. Published online July 17, 2023. doi:10.4103/ijabmr.ijabmr_637_22