An epidemiologic study of medication use and symptoms of dry eye

Purpose. To assess the potential relationship between symptoms of dry eye and the use of medications that may cause "dryness". Methods. A population-based prevalence study of dry eye was performed in Salisbury, MD, in a sample of 2.520 individuals age 65-84. The evaluation included a 6-item dry eye questionnaire, standardized Schirmer's and Rose Bengal testing, medical history, and currenî use of systemic medications. A medical co-morbidity score was constructed by summing reported major system (eg. cardiovascular) disease, and the medications were coded using Iowa Drug Information System ingredients codes. Results, The use of 6 classes of medications (antihistamines, parasympatholytics. antidepressants and antipsychotics, diuretics, antiemetics, and specific other antihypertensiyes) was significantly associated with the report of at least one dry eye symptom present frequently or always. No association was observed for sympathomimetics, alpha or beta blockers, estrogens. or progestogens. A dose-response effect was seen regarding the use of the 6 classes of medications and dry eye symptoms wherein those taking none of the medications had a dry eye symptom prevalence of 12%; those taking 1. a prevalence of 14.4%; 2, a prevalence of 22%: and 3 or more of the medications, a dry eye symptom prevalence of 26%. The attributable risk to the overai! prevalence of symptoms of dry eye and the use of one or more of these medications is estimated at 20%. Conclusions. The use of specific medications is strongly associated with symptoms of dry eye among the elderly. The dose response effect and attributable risk estimate suggest that medication use may play an important pathogenetic role in this nonnlaiinn.