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Dry Eyes Illness in Psychiatric Patients Placed on Antipsychotic Medications

Balogun MM, Coker AO.

Abstract

Introduction: Psychosis is used to describe conditions that affect the mind where there has been loss of contact with reality. Most psychotic disorders are treated with a combination of medications and psychotherapy. A significant ocular side effect of anti-psychotic drugs is dry eyes which often do not get adequate attention thus leading to great discomfort to the patient.


Methodology: The study was a hospital-based, case-control prospective study where patients diagnosed with a psychotic disorders within the age groups of 18 to 70 years and who have been on anti-psychotic treatment for at least one year were examined by a consultant ophthalmologist. Healthy adults were enrolled from the Ophthalmology outpatient clinic as the control for the study.

Result: The case group comprised 53(44.9%) males and 65(55.1%) females. The age group with the highest representation amongst the cases- 29.7% was the 29-38-year-olds. On the medication history, 65(55.1%) started taking antipsychotic drugs within 1-5 years. 65.3% of the respondents were on antipsychotic monotherapy-commonly Olanzapine tablets.

Schirmer’s test was normal in most of the participants in both cases 50.8% and control 53.4% but those that have been on medication for 5 years or less demonstrated the highest occurrence of severe dry eyes with a prevalence rate of 23.1% while those on medication for over 10 years showed a higher prevalence of mild dry eyes accounting for 20.8% of the cases. 

Tear film Break-up Time (TBUT) showed Dry eyes in 50.8% of cases. A significant proportion (56.9%) of those who had been on medication for 1-5 years were found to be exhibiting dry eyes. 

Conclusion: An association was observed between Dry eye disease and antipsychotic medication as early as within 1-5 years of using the medication. Ophthalmic assessment should be incorporated early in the course of treatment.