Around 16 years ago, through the work of David Sullivan, low testosterone was found to be correlated with dry eye disease. It is thought that testosterone increases the production of oil in the meibomian glands and also tears from the lacrimal glands. There is also some evidence that testosterone helps prevent scarring over the pores through which the oil makes its way from the meibomian glands onto the eyelids. This means that the treatment is suitable for both oil deficiency and tear deficiency dry eye.
This could explain the increased prevalence of dry eye in women as they age and their testosterone levels drop off. It also could explain the increased dry eye found in individuals on drugs that block testosterone such as men being treated for prostate cancer and women being treated for polycystic ovary syndrome.
Testosterone supplementation for dry eye is not currently approved by the American FDA but it is being used “off-label” as an ointment and in some cases drops. It is possible to have a blood test to check for testosterone levels and then if low consider the possibility of supplementation.
Typically a cream is applied at night around the eyelids and it takes about a month to show improvements. While this hasn’t been studied very much, dosages of between 2% and 10% have been used and found to be safe in the short term. No long-term studies have been performed.
Another approach has been to use DHEA (dehydroepiandrosterone) which is a precursor to testosterone as drops and it has been found to have similar effects.
If you are not keen on taking the medication on an ongoing basis you may wish to consider natural ways to boost your testosterone levels. If your levels are low then you may not notice much impact but if you are borderline then this may be all you need. The natural way to increase testosterone is through strength training or sprint training. From a dietary perspective it helps to loose weight and reduce sugar intake. Supplements of zinc are helpful, but keep under 40mg per day and ensure you are getting enough Vit D.
The chance of hirsutism in women is fairly low at around 5 in one thousand cases and can be reversed by reducing the dose. The main contraindication would be prostate cancer. Although testosterone is a steroid it does not increase eye pressure.