title: Effects of oral mucolytics on tear film and ocular surface.
abstract: OBJECTIVE
  To evaluate the effects of oral ambroxol on tear film and ocular surface.
  
  
  METHODS
  Twenty healthy male subjects with no ocular disease were recruited. Subjects were divided into 2 groups: a control group and an ambroxol group. Ambroxol hydrochloride was administered orally to the ambroxol group. The tear film and ocular surface were evaluated at baseline (10 AM), 12 PM, 6 PM, and 10 AM the next day. Visual analog pain scale, tear film break-up time, fluorescein corneal staining, Schirmer test, tear osmolality, and fluorescein clearance test were measured.
  
  
  RESULTS
  The mean visual analog pain scale score increased at 6 PM and 10 AM the next day in the ambroxol group (P = 0.007 and P = 0.018, respectively). The tear film break-up time did not show any significant change in the control group and shortened at 6 PM in the ambroxol group (P = 0.011). The fluorescein corneal staining scores increased at 6 PM in both groups (P = 0.007 and P = 0.004, respectively), and they were higher in the ambroxol group compared with control group at 10 AM the next day (P = 0.035). The mean tear secretion did not show a significant change in the control group and increased at 10 AM the next day in the ambroxol group (P = 0.022). In both groups, the tear osmolality increased at 6 PM (P = 0.009 and P = 0.005, respectively), but the tear osmolality in the ambroxol group was higher compared with control group at 6 PM (P = 0.043).
  
  
  CONCLUSIONS
  Oral ambroxol may disturb tear film and ocular surfaces by attenuating the mucin layer of the tear film.
authors.affiliation: Department of Ophthalmology, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Dongwook
authors.initials: D
authors.lastname: Kim
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Hyon
authors.forename: Won Ryang
authors.initials: WR
authors.lastname: Wee
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Shin
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000551:Ambroxol / Q000008:administration & dosage*; D003315:Cornea / Q000187:drug effects* / Q000378:metabolism; D005100:Expectorants / Q000008:administration & dosage*; D019793:Fluorescein / Q000493:pharmacokinetics; D015590:Fluorophotometry; D006801:Humans; D007765:Lacrimal Apparatus / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D009994:Osmolar Concentration; D010147:Pain Measurement; D013666:Tears / Q000737:chemistry / Q000378:metabolism*
chemical_list: D005100:Expectorants; D000551:Ambroxol; D019793:Fluorescein