Good Hope, Heartlands, and Solihull Eye Clinics

Medications causing sore eyes

David Kinshuck

Normal tears

The tablets below often make eyes sore or watery, or both sore and watery. Normally the front of the eye is covered with a smooth layer of tears:

 

healthy tear film, side view

healthy tear film, front view

 

Side view                                              Front view

Normal tears cover your eye with a thin layer of tears

 

What happens with the medications

The mediations reduce the amount of tears or the spreading ability of tears, so that patches of the eye become dry. This makes the eyes sore or watery or both, and the eyes can be very uncomfortable, as though there is sand in them..  See animation

dry eyes, side view  dry eyes, front view

Side view                                              Front view

Dry eyes or poorly spreading tears: this is a type of 'superficial punctate keratitis'

 

The main medications, proton pump inhibitors and ranitidine

The main medications that do this are proton pump inhibitor tablets, used to reduce the acid in the stomach, for conditions such as hiatus hernia.

  1. Losec:  omeprazole
  2. zoton: lansoprazole
  3. Pantoprazole
  4. Rabeprazole
  5. Esomeprazole: Nexium,
  6. Ranitidine, although this is not a proton pump inhibitor, acts in the same way.

Loop diuretics

The second group of medications are the 'loop diuretics' used to help the body remove fluid from the body, caused a weak heart for example.

  1. Frusemide
  2. Bumetanide

If the proton pump inhibitor drops and the loop diuretics are used together, most patients will have sore eyes.

 

Treatment options to make the eyes more comfortable

The treatment options

  1. To accept the sore eyes, there is seldom any permanent damage caused.
  2. Use lubricants such as gel lubricants such as Viscotears four times a day
  3. Drop lubricants such as Hylofort every 1-4 hours
    (or Clinitas soothe, or Hyabak, Vismed, or other preservative free drop containing hyaluronic acid)
  4. Patients with very sore eyes will generally need to use these drops every hour.
  5. In addition, Xailin night at night or VitApos at night
  6. Loop diuretics ..the dose cannot usually be reduced.
  7. The proton pump inhibitor drugs..sometimes the dose can be reduced.