Consequences of Psychotropic Medicines on the Ocular Surface and its Significance in Contact Lens Practice: A Case-control Study

A BSTRACT Background: Ocular dryness is a major factor for contact lens discomfort and intolerance. It’s important to be aware of drug interactions with contact lenses to prevent damage and discomfort for contact lens wearers. Considering this we aim to investigate the presence of ocular dryness in patients on psychiatric medications such as antidepressants, in combination with benzodiazepines and antipsychotics. Objective: To estimate the severity of dry eyes in the patients taking psychotropic medicines as compared with that of the general population. Patients: The participants more than 18 years old, on psychotropic medicines, and who consented to participate in the study were included. They were categorized into two groups: the patient on psychotropic medicine (case) as Group 1, and age and sex-matched participants from the general population (controls) as Group 2. The patients who had positive past ocular and systemic disease history and patients on addiction were excluded. Results: A total of 103 participants, 53 participants were in Group 1 and 50 were in Group 2. Mean TBUT was 7.23 ± 3.09 seconds in group 1 and 11.13 ± 4.58 seconds in group 2. The mean Schirmer test value was 13.28 ± 7.68 mm in group 1 and 16.27 ± 6.28 mm in group 2. Positive corneal staining was observed at 54.71% in group 1 and 20% in group 2. The mean OSDI score was 29.83 ± 18.80 in group 1 and 15.67 ± 11.20 in group 2. Conclusion: From the perspective of optometric practice, this study indicates that a review of history on medications, and dry eye evaluation is the most important aspect before prescribing contact lenses, especially in a patient suffering from psychiatric illness and patients requesting to be fit in contact lenses.