Introduction

Androgens exert a significant effect on neutral and polar lipids in human meibomian gland secretions, and these hormonal effects may be mediated through androgen receptors causing tear film instability and evaporative dry eye (EDE).1–3 Consequently, the androgen deficiency that occurs during menopause, ageing, and even Sjogren's syndrome4 may contribute to meibomian gland dysfunction and EDE often observed in these conditions.5

Having frequently identified low serum testosterone in patients with EDE, in 2010, with specialist gynaecological consultation, we began recommending the use of a transdermal androgen patch (Intrinsa, Procter and Gamble, UK) therapy for patients attending an eye clinic with persistent and symptomatic EDE found to have low serum testosterone. We report the outcomes of our audit.