EFFECT OF SYSTEMIC STEROIDS ON TEAR FILM STABILITY
DOI:
https://doi.org/10.71000/h9wvx212Keywords:
Tear film, systemic steroids, Tear Production, Corticosteroids, , Dry Eye, Intraocular Pressure, Schirmer TestAbstract
Background: Systemic corticosteroids are widely prescribed for managing inflammatory and autoimmune conditions; however, their impact on ocular surface health, particularly tear film stability, remains underexplored. Alterations in tear production can compromise visual comfort and ocular integrity, making it essential to assess the potential ocular side effects of systemic medications. This study investigated the association between systemic steroid use and tear film stability using clinical tear production measurements.
Objective: To evaluate the clinical outcomes of the effect on tear film stability associated with systemic steroid use.
Methods: This randomized controlled trial was conducted at the Department of Ophthalmology, University of Lahore Teaching Hospital. A total of 100 participants aged 20 to 50 years, of both genders, were enrolled using non-probability convenient sampling and divided equally into two groups (n = 50 each). Group One included individuals not using systemic steroids, while Group Two comprised patients undergoing systemic steroid therapy. Tear film stability was assessed using Schirmer test strips and slit-lamp biomicroscopy. Ethical approval was obtained, and informed consent was secured. Data were analyzed using SPSS version 26. Independent samples t-test and Mann-Whitney U test were applied to evaluate group differences.
Results: The mean age of participants was 23.43 ± 2.324 years. Intraocular pressure ranged from 14 to 18 mmHg (mean 16.09 ± 1.303 mmHg). Schirmer test scores in Group One ranged from 12 to 18 mm with a mean of 14.32 ± 1.558 mm, whereas Group Two ranged from 5 to 14 mm with a significantly lower mean of 9.24 ± 2.446 mm. The mean difference in tear production between groups was 5.08 mm (p < 0.001), indicating significantly reduced tear film stability among steroid users.
Conclusion: Systemic steroid use was significantly associated with reduced tear production, suggesting its negative impact on tear film stability. Routine ocular screening should be considered prior to initiating steroid therapy.
References
Ahmadi H, Tahmasbian S, Janbazi M, Amiri A, Heidari Z. Evaluation of cyclosporine 0.05% and artificial tears for the management of dry eye disease following cataract surgery: a randomized controlled trial. Ann Med Surg (Lond). 2024;86(4):1983-1988.
Alotaibi S, Papas E, Mobeen R, Ozkan J, Misra SL, Markoulli M. Tear film hTERT and corneal nerve characteristics in dry eye disease. Clin Exp Optom. 2024;10.1080/08164622.2024.2354775:1-6.
Antman G, Ritzer L, Galor A, Verticchio Vercellin A, Siesky BA, Alabi D, et al. The relationship between dry eye disease and human microbiota: A review of the science. Exp Eye Res. 2024;245:109951.
Deo N, Nagrale P. Dry Eye Disease: An Overview of Its Risk Factors, Diagnosis, and Prevalence by Age, Sex, and Race. Cureus. 2024;16(2):e54028.
Bashorun SD, Balogun BG, Ibidapo O, Bashorun AO. Prevalence of Dry Eye Disease in Type 2 Diabetic and Non-Diabetics: A Cross-Sectional Hospital-Based Study. J West Afr Coll Surg. 2024;14(2):180-187.
Mamoon I, Ayub F, Sarwat S. Prevalence of dry eye disease among IT students in Pakistan. International ophthalmology. 2024;44(1):204.
Bello-Alvarez C, Camacho-Arroyo I. Impact of sex in the prevalence and progression of glioblastomas: the role of gonadal steroid hormones. Biol Sex Differ. 2021;12(1):28.
Mistry AM, Jonathan SV, Monsour MA, Mobley BC, Clark SW, Moots PL. Impact of postoperative dexamethasone on survival, steroid dependency, and infections in newly diagnosed glioblastoma patients. Neurooncol Pract. 2021;8(5):589-600.
Neevel AJ, Schuman AD, Morrison RJ, Hogikyan ND, Kupfer RA. Serial Intralesional Steroid Injection for Subglottic Stenosis: Systemic Side Effects and Impact on Surgery-Free Interval. OTO Open. 2021;5(4):2473974X211054842.
Kulkarni S, Fernandes J, Selvam S, Idiculla J. A Study of the Profile and the Impact of Diabetes, Steroid and Stress Hyperglycaemia on COVID-19 Outcomes. Indian J Endocrinol Metab. 2022;26(6):551-557.
Evbayekha EO, Alugba G, Akewe TO, Obadare OO, Agberien VO, Omogunwa AE, et al. Impact of Long-Term Steroid Use on the Disposition of Patients Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Nationwide Sample Analysis. Cureus. 2023;15(4):e38048.
Diviccaro S, Caputi V, Cioffi L, Giatti S, Lyte JM, Caruso D, et al. Exploring the Impact of the Microbiome on Neuroactive Steroid Levels in Germ-Free Animals. Int J Mol Sci. 2021;22(22).
Tintut Y, Demer LL. Potential impact of the steroid hormone, vitamin D, on the vasculature. Am Heart J. 2021;239:147-153.
Ishii S, Sakurashita H, Mashida E, Saeki Y, Matsuo H. Impact of systemic steroid treatment on talc pleurodesis: a report of six cases. J Pharm Health Care Sci. 2020;6:15.
Kwak MY, Yang CJ, Shim HJ, Song CI, Kim JY, Lee IW, et al. Intratympanic steroid injection for sudden sensorineural hearing loss: Impact of injection interval on therapeutic efficacy. Auris Nasus Larynx. 2020;47(6):982-989.
Mayneris-Perxachs J, Arnoriaga-Rodriguez M, Luque-Cordoba D, Priego-Capote F, Perez-Brocal V, Moya A, et al. Gut microbiota steroid sexual dimorphism and its impact on gonadal steroids: influences of obesity and menopausal status. Microbiome. 2020;8(1):136.
Mittal S, Madan K, Mohan A. COVID-19 and steroid therapy: Impact on diabetes. Prim Care Diabetes. 2020;14(5):568.
Watanabe Y, Fujinaga S, Endo A, Endo S, Nakagawa M, Sakuraya K. Baseline characteristics and long-term outcomes of steroid-resistant nephrotic syndrome in children: impact of initial kidney histology. Pediatr Nephrol. 2020;35(12):2377-2381.
Onoe S, Yokoyama Y, Ebata T, Igami T, Mizuno T, Yamaguchi J, et al. Impact of Perioperative Steroid Administration in Patients Undergoing Major Hepatectomy with Extrahepatic Bile Duct Resection: A Randomized Controlled Trial. Ann Surg Oncol. 2021;28(1):121-130.
Reichhardt CC, Okamoto LL, Motsinger LA, Griffin BP, Murdoch GK, Thornton KJ. The Impact of Polyamine Precursors, Polyamines, and Steroid Hormones on Temporal Messenger RNA Abundance in Bovine Satellite Cells Induced to Differentiate. Animals (Basel). 2021;11(3).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Areej Chaudhary, Ummara Shafiq, Tahir Shaukat (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
