EFFECT OF SYSTEMIC STEROIDS ON TEAR FILM STABILITY

Background: Systemic corticosteroids are widely prescribed for managing inflammatory and autoimmune conditions; however, their impact on ocular surface health, particularly tear film stability, remains underexplored. Alterations in tear production can compromise visual comfort and ocular integrity, making it essential to assess the potential ocular side effects of systemic medications. This study investigated the association between systemic steroid use and tear film stability using clinical tear production measurements. Objective: To evaluate the clinical outcomes of the effect on tear film stability associated with systemic steroid use. Methods: This randomized controlled trial was conducted at the Department of Ophthalmology, University of Lahore Teaching Hospital. A total of 100 participants aged 20 to 50 years, of both genders, were enrolled using non-probability convenient sampling and divided equally into two groups (n = 50 each). Group One included individuals not using systemic steroids, while Group Two comprised patients undergoing systemic steroid therapy. Tear film stability was assessed using Schirmer test strips and slit-lamp biomicroscopy. Ethical approval was obtained, and informed consent was secured. Data were analyzed using SPSS version 26. Independent samples t-test and Mann-Whitney U test were applied to evaluate group differences. Results: The mean age of participants was 23.43 ± 2.324 years. Intraocular pressure ranged from 14 to 18 mmHg (mean 16.09 ± 1.303 mmHg). Schirmer test scores in Group One ranged from 12 to 18 mm with a mean of 14.32 ± 1.558 mm, whereas Group Two ranged from 5 to 14 mm with a significantly lower mean of 9.24 ± 2.446 mm. The mean difference in tear production between groups was 5.08 mm (p < 0.001), indicating significantly reduced tear film stability among steroid users. Conclusion: Systemic steroid use was significantly associated with reduced tear production, suggesting its negative impact on tear film stability. Routine ocular screening should be considered prior to initiating steroid therapy.