A review on drug-induced dry eye disease

Abstract

Dry eye disease encompasses a broad range of etiologies and disease subtypes which have similar clinical manifestations. Medications can cause dry eye disease or symptoms of dryness as a side effect by either interfering with the lacrimal gland or meibomian gland function, or both, and by other mechanisms that affect the ocular surface homeostasis. This is important to know and recognize as eliminating the offending medication can reverse the symptoms and, in many cases, prevent further deterioration of the ocular surface inflammation. This review focuses on drugs like systemic isotretinoin and taxanes, which cause meibomian gland dysfunction; immune checkpoint inhibitors that cause lacrimal gland dysfunction; gliptins and topical antiglaucoma medications that cause cicatrizing conjunctivitis; and epidermal growth factor receptor inhibitors, fibroblast growth factor receptor inhibitors, and belantamab mafodotin, which cause mucosal epitheliopathy. Many of these medications, particularly the newer anticancer agents, have only recently been introduced for clinical use, and knowledge and awareness of their ocular side effects are still evolving. This review aims to update ophthalmologists on the drug-induced causes of dry eye disease or symptoms of dryness, which is avoidable by discontinuation of the incriminating agent or can be mitigated by reducing the dose or frequency of usage.

Uncommon Blepharitis

“…Taxanes, such as paclitaxel and docetaxel, induce blepharitis [14], likely due to direct damage to the meibomian glands that leads to the disruption of the tear film, causing dry eyes and subsequent blepharitis [15].…”

Recommendations for nutritional supplements for dry eye disease: current advances

“…Dry Eye Disease (DED) is a complex, chronic ocular surface disease arising from diverse etiologies, significantly impacting quality of life ( Figure 1 ) ( Liu et al, 2022 ; Coassin et al, 2023 ; Craig et al, 2023 ; Kam et al, 2023 ; Montero-Iruzubieta et al, 2023 ; Narang et al, 2023 ; Buonfiglio et al, 2024 ; Xiong et al, 2024 ). The ocular surface system consists primarily of the cornea, conjunctiva, lacrimal glands, and meibomian glands, collaboratively maintains a smooth refractive surface and protects the visual system.…”

Seeing through tears: Understanding and managing dry eye disease

“…Several medications, both topical and systemic, can be responsible for causing or exaggerating the problem, and therefore the role of these medications needs to be ruled out. [ 12 ] Stopping the offending agents can in such cases completely resolve all symptoms, and no other treatment is required. Some of the adjunctive therapies such as systemic immunosuppression, scleral contact lenses, and autologous serum eyedrops are often overlooked when they can provide significant relief if used judiciously.…”