Ocular Allergy as a Risk Factor for Dry Eye in Adults and Children

Edoardo Villani; Giovanni Rabbiolo; Paolo Nucci


Curr Opin Allergy Clin Immunol. 2018;18(5):398-403. 

In This Article

Antiallergic Treatment and Iatrogenic dry eye

Dry eye can be caused by a variety of iatrogenic interventions, including topical or systemic drugs, the use of contact lenses, and ophthalmic surgical and nonsurgical procedures.

Large population-based studies showed that systemic antihistamines are a risk factor for DED (odds ratio: 1.6). These drugs have anticholinergic activity and can affect G-protein coupled muscarinic receptors in the lacrimal gland acini and conjunctival secreting cells.[44]

Topical drugs may affect the ocular surface determining allergic, toxic, and inflammatory effects by interaction with the tear film components, by tension-active effects, by reducing tear secretion, or by damaging goblet cells, epithelial cells, corneal nerves, and meibomian glands.

Several studies reported correlations between different topical antiallergic drugs, mainly epinastine and olopatadine, and DED. However, specific data on the active compounds are difficult to obtain because of the possible confounding role of preservatives and excipients.[44]

About preservatives, the role of benzalkonium chloride in damaging the ocular surface has been largely studied.[45]