與乾眼症 (DED) 和瞼板腺功能障礙 (MGD) 相關的藥物包括口服避孕藥,由於其含有雌激素和黃體素,可能導致與 MGD 相關的乾眼症。用於治療攝護腺問題的坦索羅辛和特拉唑嗪也與乾眼症有關。某些抗癌藥物,如甲胺蝶呤和西妥昔單抗,會影響淚腺,導致乾眼症。此外,常用於治療胃灼熱的質子幫浦抑制劑 (PPI) 也可能透過維生素 B12 缺乏或影響腸道菌叢而導致乾眼症。
局部用藥時,苯扎氯銨 (BAK) 是一種存在於許多眼藥水中的防腐劑,它與乾眼症和 MGD 密切相關,因為它會破壞淚膜。許多青光眼藥物也含有 BAK,長期使用會加重乾眼症。
其他可能導致乾眼症 (DED) 和瞼板腺分泌障礙 (MGD) 的因素包括配戴隱形眼鏡(這會加劇症狀)以及眼瞼衛生不良(會導致細菌積聚,從而對瞼板腺分泌產生負面影響)。蠕形蟎在這些疾病中的作用仍在研究中,但一些研究表明其與瞼板腺分泌障礙 (MGD) 有關,尤其是在乾眼症 (DED) 患者中。
治療方法包括透過熱敷、眼瞼按摩和眼瞼擦洗來保持眼瞼衛生,以改善瞼板腺分泌。脂質類人工淚液有助於穩定淚膜,而局部或全身性用藥則可根據 DED/MGD 的嚴重程度進行。診室內操作,例如瞼板腺擠壓術或 LipiFlow,可以幫助疏通阻塞的腺體。
Medications associated with Dry Eye Disease (DED) and Meibomian Gland Dysfunction (MGD) include oral contraceptives, which can lead to MGD-related dry eye due to their estrogen and progesterone content. Tamsulosin and terazosin, used for prostate issues, are also linked to DED. Certain anticancer drugs, such as methotrexate and cetuximab, can affect the lacrimal glands, contributing to dry eye. Additionally, proton pump inhibitors (PPIs), commonly used for heartburn, may cause DED through vitamin B12 deficiency or impacts on the gut microbiome.
Topically, benzalkonium chloride (BAK), a preservative found in many eye drops, is strongly associated with DED and MGD as it disrupts the tear film. Many glaucoma medications contain BAK as well and can worsen dry eye with prolonged use.
Other factors that can contribute to DED and MGD include contact lens wear, which can exacerbate symptoms, and poor eyelid hygiene that allows bacteria to accumulate, thereby negatively affecting meibomian gland secretion. The role of Demodex mites in these conditions is still under investigation, though some studies suggest a link with MGD, particularly in patients with DED.
Treatment options include maintaining eyelid hygiene through the use of warm compresses, eyelid massage, and lid scrubs to improve meibomian gland flow. Lipid-based artificial tears can help stabilise the tear film, while topical or systemic medications may be prescribed based on the severity of DED/MGD. In-office procedures, such as meibomian gland expression or LipiFlow, can help clear blocked glands.