title: Pharmaceutical and herbal products that may contribute to dry eyes.
abstract: BACKGROUND
  Symptomatic dryness of the eyes is a most common blepharoplasty complication. The authors reviewed the medications and herbal products that may potentiate this complication.
  
  
  METHODS
  The MEDLINE and PubMed databases were searched for the years 1991 to 2011. Search terms included "dry eye syndrome," "keratitis sicca," "keratoconjunctivitis sicca," "ocular side effects," "herbal supplements," "herbals and dry eye," "dry eye risk factors," "etiology of dry eye," "drugs side effects," "drugs and dry eye," "dietary supplements," "ocular toxicity," and "tear film." References from herbal product reviews and eligible medication reports were searched for additional articles. A manual search was also conducted based on citations in the published literature.
  
  
  RESULTS
  Of 232 articles found to be related to dry eye syndrome and possible risk factors, 196 were excluded because they did not discuss medications or herbal products as risk factors in dry eye syndrome. Thirty-six articles that examined the pathophysiology and risk factors of dry eye were included. Nine books were reviewed that contained some information regarding the association of medications and herbal products with dry eye. These agents were then categorized based on mechanism of action and usage. Medications listed include antihistamines, decongestants, antidepressants, anticonvulsants, antipsychotics, antiparkinson drugs, beta-blockers, and hormone replacement therapy. The three main herbal products that contribute to dry eye are niacin, echinacea, and kava. There was a strong association between anticholinergic alkaloids and dry eye.
  
  
  CONCLUSIONS
  This study identifies the medications and herbal products that should be considered when a patient undergoes blepharoplasty and complains of symptoms associated with dryness of the eyes.
authors.affiliation: Cleveland, Ohio From the Department of Plastic Surgery, Case Western Reserve University.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Askeroglu
authors.forename: Brendan
authors.initials: B
authors.lastname: Alleyne
authors.forename: Bahman
authors.initials: B
authors.lastname: Guyuron
mesh_terms: D019882:Blepharoplasty; D064420:Drug-Related Side Effects and Adverse Reactions; D015352:Dry Eye Syndromes / Q000139:chemically induced* / Q000209:etiology; D006801:Humans; D028321:Plant Preparations / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*; D012307:Risk Factors
chemical_list: D028321:Plant Preparations