Aromatase inhibitors (AIs) limit the synthesis of estrogen in peripheral tissues, ultimately lowering levels of estrogen altogether. They’re used, primarily, in breast cancer treatments, but also for chemoprevention in high-risk women and for the treatment of gynecomastia in men. As with any hormone therapy, though, patients run the risk of adverse ocular effects.  

A study published in The Ocular Surface sought to quantify any relationship between AI treatment and dry eye symptoms or signs. A secondary objective was to investigate whether symptoms of dry eye in postmenopausal women were associated with symptoms of non-eye pain, ocular pain or self-rated pain perception. The Australian investigators looked into 56 untreated postmenopausal women and 52 patients undergoing AI treatments.

The patients were evaluated using the ocular surface disease index (OSDI) and pain questionnaires as well as clinical signs of dry eye and meibomian gland dysfunction. In particular, the researchers found that meibum expressibility was worse in women undergoing AI treatment for early-stage breast cancer than in the untreated group. The AI patients also noted increased pain perception compared with the untreated group. Elevated ocular symptoms were observed in both AI treated and the untreated groups, with no difference between the groups.

Gibson E, Stapleton F, Dear R, et al. Dry eye signs and symptoms in aromatase inhibitor treatment and the relationship with pain. The Ocular Surface. October 24, 2019. [Epub ahead of print].