Possible ocular effects of anti-diabetes medications, and their relevance to contact lens wear

Abstract

Purpose. To asses what information on ocular effects of anti- diabetes medications are provided in medicines prescribing information, and whether or not any current guidelines actu- ally mention contact lens wear. Material and Methods. Medicines directories and patient information leaflets (PILs) for 28 diabetes medicines (insulin and various oral hypoglycaemic drugs) were searched for any information on possible ocular effects. A PubMed search was also undertaken on the medicines in relation to ocular side effects. Results. Almost all information sources examined included notes that a change in vision after taking anti-diabetes med- ications could indicate inadequate glucose control. The use of all diabetic medications can result in mild to moderate allergic reactions that could involve the conjunctiva, eyelids and eyelashes. A possible adverse effect of use of older oral hypoglycaemics (such as the sulfonylureas and acarbose) is a warning to patients of possible ‘yellowing of the eyes’ and of the skin. In the vast majority of published studies identified, almost no information has been provided on the oral anti- diabetes medications being used so it is essentially unknown if diabetic medications per se can have adverse effects on the cornea and conjunctiva. However, the information search (in both medical directories, PILs) revealed nothing in relation to contact lens wear and/or that there should be any obvious caution in prescribing contact lenses to diabetic patients. Conclusion. Information indicating that contact lens wear is potentially problematic is not obviously included in medicines directories, so contact lens wear can offer a viable option for vision correction in diabetics. Keywords Diabetes, medication, contact lens wear