The influence of gender on the ocular surface.

Purpose: Dry eye is more prevalent among women than men. To examine whether gender influences the ocular surface, conjunctival goblet-cell density was monitored for a 30-day period. Changes in goblet-cell density are a sensitive marker for ocular surface disease.

Methods: Six men and twelve women who were free from ocular surface disease were sampled by impression cytology on the inferior bulbar conjunctiva every other day for 30 days. Samples were analyzed for goblet-cell content. The mean age of the subjects was 24 years for the men and 25.4 years for the women. A minimum of 200 epithelial cells were scored per microscopic field examined.

Results: There is a statistically significant difference in goblet-cell count between men and women over the 30-day test period. The mean goblet-cell count measured for men was 3.75% +/- 1.04%, while the mean count for women was 2.545% +/- 0.8%. When the data on women were replotted with reference to the menstrual cycle, the largest and longest depression of goblet-cell count occurs midcycle, around the time of ovulation. A significant difference in goblet-cell count was also noted when subjects using oral contraceptives (3.065% +/- 0.98%) are compared with those not using oral contraceptives (2.28% +/- 0.92%).

Conclusion: It appears there may be a reproductive hormonal influence on conjunctival goblet-cell count.