Prevalence of dry eye disease in patients on anti-depressants

Introduction: Dry eye is a complex multifactorial disease which forms a major proportion of ophthalmology out patients. Most of the patients are on chronic medications including psychiatric drugs. So prevalence of dry eye was studied in psychiatric patients on antidepressants. Methods: A cross sectional comparative study was conducted among 22 patients / 21 controls in a tertiary eye care hospital in Northern Kerala for a period of 1 year by assessing Ocular surface disease index score/Tear film break up time/ Schirmer test .Association of age gender, smoking, alcoholism, with dry eye disease was also studied. Results: Study showed a statistically significant correlation between antidepressant medications and dry eye with a P value of 0.012. Tricyclic anti-depressants contributed the majority for dry eye followed by selective serotonin re-uptake inhibitors and serotonin norepinephrine reuptake inhibitors. Females, old age and smoking showed high prevalence. Schirmer test was found to be 100% sensitive and specific and TBUT; 35% sensitive and 100% specific. Conclusion: Prevalence of dry eye disease is 50 % in patients on antidepressants compared to 14.2 % in control group. Schirmer test can be effectively used in patients for early detection of dry eye disease. The drugs with least side effects can be selected and treatment modified accordingly.