engleski

The association between psychiatric disorders and dry eye disease

AIM: The aim of this paper is evaluate the association of dry eye disease (DED) with psychiatric drugs and disorders. INTRODUCTION: Dry eye disease is defined as a multifactorial disorder of tears and ocular surface that causes discomfort, visual disturbance and tear film instability with potential damage to the ocular surface. Some drugs used in psychiatry are known to cause ocular dryness. METHODS: We conducted a systematic review of the literature. RESULTS: DED is frequent in patients with depressive and anxiety disorders, particularly older patients, patients who use selective serotonin reuptake inhibitors (SSRI) and those with longer duration of psychiatric disorder. SSRI are most commonly prescribed antidepressants and their usage may affect ocular surface by influencing tear film stability. Several studies show that both SSRIs and serotonin-norepinephrine reuptake inhibitors increase the risk for DED. Patients with PTSD have ocular surface symptoms that can not only be explained by tear indicators. Lithium carbonate and sodium valproate may also decrease tear film stability, resulting in eye dryness. Clozapine, through its anticolinergic and dopaminergic activities may induce DED and lead to morphological alterations of corneal parameters. There are no reports on whether newer generation of anti-psychotic agents contribute to ocular toxicity. Further, oral alcohol administration also disturbs tear film influencing ocular surface parameters. Chronic smoking which is very common in psychiatric patients also causes adverse effects on the precorneal tear film stability. CONCLUSION: Psychiatric patients use number of drugs such as antidepressants, antipsychotics, lithium carbonate and sodium valproate and during the treatment they frequently experience dry eye symptoms. It was noticed that incidence of ocular side effects increases rapidly with polypharmacy that is very common in psychiatric patients.

dry eye disease ; psychiatric drugs ; psychiatric disorders

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