Ocular manifestations and systemic drugs
Systemic medications may directly impact the homeostasis of the cornea


Dermot McGrath
Published: Wednesday, September 25, 2019
[caption id="attachment_16643" align="alignleft" width="1024"]
Mohamed Elalfy[/caption]
Corneal changes secondary to systemic medications may affect all layers of the cornea, so it is critical that patients receiving particular medications should be closely monitored to avoid long-term complications associated with ocular toxicity, according to Mohamed Elalfy MD, FRCopth.
Speaking at the 10th EuCornea Congress, Dr Elalfy noted that systemic medications may reach the cornea via the tear film, aqueous humour and limbal vasculature and directly impact the homeostasis of the cornea.
“Homeostasis maintains a healthy state of the cornea and ocular surface with constant adjustment of biochemical and physiological pathways. It allows the maintenance and regulation of the tissue stability needed to function properly,” he said.
In dry eye disease (DED), for instance, the homeostasis of the tear film is disrupted leading to ocular surface inflammation and damage. Certain systemic drugs are known to potentially cause DED, said Dr Elalfy.
“It is surprising to note that among the top 100 selling systemic drugs in the United States, 22 are known to cause dry eye. This is why a history of systemic medication is paramount in managing dry eye disease patients,” he said.
Rigorous ophthalmic care is also required in acute and long-term management of Steven Johnson syndrome and toxic epidermal necrolysis (TEN), advised Dr Elalfy.

Tags: ocular toxicity, systemic medications
Latest Articles
Beyond the Numbers
Empowering patient participation fosters continuous innovation in cataract surgery.
Thinking Beyond the Surgery Room
Practice management workshop focuses on financial operations and AI business applications.
Picture This: Photo Contest Winners
ESCRS 2025 Refractive and Cataract Photo Contest winners.
Aid Cuts Threaten Global Eye Care Progress
USAID closure leads retreat in development assistance.
Supplement: ESCRS Clinical Trends Series: Presbyopia
Nutrition and the Eye: A Recipe for Success
A look at the evidence for tasty ways of lowering risks and improving ocular health.
New Award to Encourage Research into Sustainable Practices
Sharing a Vision for the Future
ESCRS leaders update Trieste conference on ESCRS initiatives.
Extending Depth of Satisfaction
The ESCRS Eye Journal Club discuss a new study reviewing the causes and management of dissatisfaction after implantation of an EDOF IOL.
Conventional Versus Laser-Assisted Cataract Surgery
Evidence favours conventional technique in most cases.