A recent wide-ranging study gave this week’s ARVO 2018 attendees a fresh look at associations between various medications and dry eye disease (DED) symptoms. The study assessed frequency of dryness and irritation symptoms in a pool of 79,866 subjects from the Netherlands, then used logistic regression analysis to determine the risk of the 62 most-used therapeutic/pharmacological medication subgroups and the 100 most-used individual drugs on DED symptoms. Of the medication subgroups, 38 (or 61% of those evaluated) were associated with dry eye. For individual drugs, 52 (or 52%) showed DED association.

Within the subgroups, medications with the highest risk for DED symptoms included drugs for the following uses: glaucoma, gastrointestinal disorders (in particular, peptic ulcers and constipation), attention-deficit/hyperactivity disorder and urinary dysfunction. At the same time, certain fast-acting diuretics appeared to protect against dry eye symptoms.

Drugs that showed the highest risk for DED symptoms included mebeverine, methylphenidate, pantoprazole, omeprazole, isphagula and risedronic acid; the fewest symptoms were seen in patients taking hydrochlorthiazide and the oral contraceptives desogestrel and ethinylestradiol.

According to the study, this “underlines the importance for doctors to assess medication status in DED” and could be helpful in finding “potential treatment options and prevention strategies in DED.” Joseph P. Shovlin, OD, of Scranton, PA, agrees. “Many of these drugs are known to cause dryness, but since the study is so large and extensive it does have potential for clinical relevancy,” he says “It could help practitioners in substituting a medication that may be less detrimental to a patient’s dry eye.”

With glaucoma medications strongly associated, optometrists can play a key role in reducing DED risk by carefully considering those prescribing decisions in particular, says Dr. Shovlin. The remaining associations remind ODs of the importance of close communication with GPs and other doctors seen by their patients, he says.

Wolpert L, Bazeer S, Hammond CJ, Vehof J. A hypothesis-free study of medication use and symptomatic dry eye in 79,866 participants. ARVO 2018. Abstract 958.