Dry eye syndrome may be more widespread than predicted, linked to systemic medications

DANA POINT, Calif. — Dry eye syndrome could be on the rise, and it may be correlated with the use of common systemic medications, according to a physician speaking at the Ocular Drug and Surgical Therapy Update meeting here.

"There does exist a pharmacologic explanation for many dry eye patients who take systemic medicines," Michael S. Conners, MD, PhD, said. "I want you to see what a tremendous impact these medications are having on tear production in our patients.

"Dry eye is more prevalent with age, and medication use is more prevalent with age. Many systemic medications exacerbate dry eye. Of the most-prescribed medications prescribed in 2005, 43% were associated with worsening dry eye syndrome. We are going to see these medications on a daily basis," Dr. Conners said.

Some drug categories associated with reduced tear production include antispasmodics, antiemetics, antihistamines, tricyclic antidepressants, selective serotonin reuptake inhibitors and antipsychotics.

He said the systemic medications have an effect on the parasympathetic and sympathetic nervous system, which control the lacrimal acini and their pump functions.

"If you block with anticholinergic (antimuscarinic) agents, you decrease tear production," he said.

One to two patients out of every 10 will statistically and epidemiologically carry a diagnosis of dry eye, Dr. Conners noted.

"The goal would be, as eye care providers, if we could educate the primary care physicians and subspecialists regarding better choices when available, we could maybe impact the effects on dry eye," Dr. Conners said.

"If we can modify these comorbidities, we can lessen their impact on dry eye and improve the quality of life of our patients," he said.