Research progress in pathogenesis, prevention and treatment of drug-induced dry eye disorders

Drug-induced dry eye disorders may cause potential damage to the ocular surface which can seriously decrease the quality of life of patients. The main clinical manifestations include eye dryness, burning-like feeling, foreign body sensation, itching, redness, photophobia, and blurred vision. The common drugs causing drug-induced dry eye disorders include systemic anticholinergic drugs such as psychotropic drugs, antihistamines and decongestant, steroids, chemotherapeutic drugs, antiviral drug, anti-malarial, antirheumatic agents, chelating agent, and neurotoxin. The drug for local application around the eye include eye drops and botox with or without preservative. The main mechanisms of drug-induced dry eye disorders may involve decrease of glandular secretion, affecting the aqueous layer and mucin layer; disturbing the stabilization of tear lipid layer and decreasing the lipid secretory volume; inducing the inflammatory reaction which damages the conjunctival goblet cells, eyelid glands, conjunctiva and cornea; reducing the degree of corneal sensation, the reduction of afferent nerve impulse, and tear production. Unnecessary drugs application in multiple systemic or topical use of drugs around the eye should be avoided. If the diagnosis of drug-induced dry eye was confirmed, the above-mentioned drugs should be withdrawn or replace the drugs which those having a low level of adverse drug reactions. Key words: Drug toxicity; Dry eye syndromes