July 09, 2015
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Oral pilocarpine may be treatment option for severe dry eye

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The administration of oral pilocarpine may be a treatment option for severe dry eye, according to a study.

Perspective from David R. Hardten, MD

The prospective study evaluated 28 eyes of 15 patients who were administered 2.5 mg of oral pilocarpine three times a day for the treatment of Sjögren’s syndrome that was complicated by dry eye in which previous conventional conservative treatment failed.

After 3 months of administration, dry eye sensation scores significantly declined from 2.5 ± 0.8 at baseline to 1.7 ± 0.5 at month 3, and eye pain scores significantly decreased from 1.7 ± 0.7 at baseline to 1.0 ± 0.6 at month 3.

Fluorescein staining declined from 2.1 ± 1.3 at baseline to 1.7 ± 1.5 at month 3, which was not significantly different, and rose bengal staining scores significantly decreased from 3.3 ± 1.7 at baseline to 2.3 ± 2.0 at month 3.

Tear film break-up time significantly increased from 2.6 ± 1.3 seconds at baseline to 3.3 ± 1.7 seconds at month 3.

Six patients had adverse reactions within 1 week of treatment; five patients reported stomach discomfort, and four patients reported sweating. The reactions were mild and resolved over the course of the treatment.

“To demonstrate the usefulness in treating dry eye, which requires long-term therapy, it may be necessary to carry out a study in a larger number of subjects for a longer period, and a study to establish a control group may be necessary,” the study authors said. – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.