Oral contraceptives and dry eye

[Rebecca Petris]

This subject came up i our Facebook group, and I know others will be interested so I thought I would post the relevant excerpts here.

From TFOS DEWS II Sex, gender and hormone report

3.1.1.2.2 ...Researchers have also suggested that the decrease in serum androgen levels that occurs during menopause, pregnancy, lactation, or the use of estrogen-containing oral contraceptives may trigger the development of a non-immune type of DED, termed primary lacrimal gland deficiency. [387]

3.2.7 ...Anecdotal evidence and case reports imply that oral contraceptive use may be associated with increased symptoms of dry eye and contact lens intolerance. However these observations have not been confirmed by formal investigations, which found that oral contraceptive use did not impact ocular symptoms, tear osmolarity, tear secretion, tear stability or other aspects of tear physiology [698,699,710]. Of possible relevance is a case series of two instances of dry eye and reduced tear secretion in young women, associated with development of Sjögren syndrome following high dose estrogen treatment [711].

4.2 ...In another study, the combination of oral contraceptive pill use and contact lens wear appeared to increase the severity of DED symptoms in young women [58,699,983].

References re contraceptives in this subreport:
[222] Soni PS. Effects of oral contraceptive steroids on the thickness of human cornea. Am J Optom Physiol Opt 1980;57:825–834.
[228] Yovel G, Shakhar K, Ben-Eliyahu S. The effects of sex, menstrual cycle, and oral contraceptives on the number and activity of natural killer cells. Gynecol Oncol 2001;81:254–262.
[688] Arowojolu AO, Gallo MF, Lopez LM, Grimes DA. Combined oral contraceptive pills for treatment of acne. Cochrane Database Syst Rev 2012;7:CD004425.
[698] Tomlinson A, Pearce EI, Simmons PA, Blades K. Effect of oral contraceptives on tear physiology. Ophthalmic Physiol Opt 2001;21:9–16.
[710] Kemdinum Idu F, Osita Emina M, Oyem Ubaru C. Tear secretion and tear stability of women on hormonal contraceptives. J Optom 2013;6:45–50.

[Rebecca Petris]

.....gawd how I am loving TFOS DEWS II. This is SO MUCH EASIER than endlessly prowling pubmed and gnashing my teeth over the inaccessibility of the full studies when I want to know which ones I should actually be paying attention to. Instead, everything of note is nice and compact and in one place.

[ntr113]

Thanks, Rebecca. It's good to know that this has happened to others besides me. A few days after taking loestrin FE at age 32, I got Sjogren's and knew it was the cause, but could not convince anyone.