Evaluation of Tear Function among Acne Vulgaris Patients Undergoing Treatment with Isotretinoin

Purpose: To evaluate the effect of Isotretinoin on tear secretion among patients with Acne Vulgaris. Patients and Methods: In this prospective study patients candidate for isotretinoin (Accutane) therapy for two months underwent complete eye examination. The best corrected visual acuity was measures and slit lamp examination of anterior segment, evaluation of tear break-up-time and Schirmer’s test were performed. The post surgical examination carried out two months post therapy consisted of complete eye examination and evaluation of dry eye level. Findings: Thirty nine patients entered the study. There were 5 patients complaining of eye strain before treatment, which rose to 19 patients after Isotretinoin therapy (p<0.001). The tear break up time was 13±1 seconds which decreased to 9±1 (p<0.001) after therapy and the Schirmer’s test mean reading was 22±2mm, which was reduced to 18±5 (p<0.001) after treatment. There were 4 patients with blepharitis before the treatment which rose to 19 patients after the end of Isotretinoin treatment (p<0.001). Conclusion: Isotretinoin usage (0.5-1mg/kg for two months) impairs the tear secretion and causes dry eye and blepharitis among patients. Considering the young age of patients using this drug, some of them candidates for keratorefractive surgery, a history of Isotretinoin usage should be considered before commencing the surgery. We recommend postponing the refractive surgery among these patients until the signs of dry eye are subsided.