Differences between male, female eyes deserve further investigation
Key takeaways:
- Differences between female eyes and male eyes have not yet been fully considered.
- Eye care needs to account for these distinctions.
ATHENS, Greece — There are significant differences between the eyes of men and women, and more studies are needed to assess how these distinctions should be addressed in eye care.
At the ESCRS winter meeting, a panel discussion on this topic was guided by Marie-José Tassignon, MD, PhD.
“There is a difference between female eyes and male eyes in babies, and it continues in adults,” she said. “Now whether that is important, I don’t know because nobody has ever studied that.”
In the Project Gullstrand Study Group, named in honor of Nobel Prize-winning ophthalmologist Allvar Gullstrand, Tassignon and colleagues measured the eyes in a large population of all ages and found differences in axial length, lens thickness and shape, anterior chamber volume and other parameters between male and female eyes.
“But what is the meaning of this? This is the next question,” she said.
“Women have steeper corneas, shallower anterior chamber, shorter axial length and also greater pupil diameter,” Victor Lázaro-Rodríguez, MD, said, “so these differences have been significant in surgical outcomes.”
Nic Reus, MD, PhD, said that these differences have an impact on biometry and that current IOL calculation formulas might not take them into account.
“The Kane formula uses gender,” and this has been shown to improve outcomes, he said.
Anders Behndig, MD, PhD, said that a study based on the Swedish National Cataract Register showed that biometric prediction error was higher in women than in men.
“It was shocking, and it turned out that the SRK/T formula that we used back then didn’t really account for steeper corneas and shorter eyes in women. When we switched to more modern formulas, like the Haigis formula, this difference disappeared,” he said.
Sotiria Palioura, MD, MSc, PhD, said that differences between women and men are emerging through studies in various fields of medicine.
“This is very recent research that has happened over the last 5 years, and I’m sure most of you don’t know that until 1993, most women were not allowed to participate in clinical trials. It was in 1993 that a law was passed in the United States that allowed women to participate in clinical trials in medicine in general,” she said. “That means that a lot of the data we have now in medicine is based on only half of the population.”
Most medication dosages, for instance, are calculated for adult men because most of the trials included only adult men. Because these medications were not studied in women, this may be one of the reasons why women report more side effects from medications, Palioura said.
Troponin levels are another example of differences between men and women.
“The actual cutoff for troponin levels is actually much lower in women, but because the trials were based on the male population, there were a lot of heart attacks that were missed. This is also very recent data over the last 3 or 4 years,” she said.
References:
Behndig A, et al. Acta Ophthalmol. 2014;doi:10.1111/aos.12475.
Rozema JJ, et al. Optom Vis Sci. 2014;doi:10.1097/OPX.0000000000000296.
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Tassignon MJ, et al. Are there differences between female and male eyes? Presented at: ESCRS winter meeting; Feb. 28-March 2, 2025; Athens, Greece.
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