Statins Tied to Modest Dry Eye Risk Increase

The researchers speculate that statin drugs may interfere with cholesterol synthesis within the meibomian glands, reducing lipid secretions. Photo: Dan Fuller, OD. Click image to enlarge. A new study in American Journal of Ophthalmology reported that statin use was linked to a small but notable increase in dry eye disease risk.Canadian researchers analyzed six observational studies, comprising a total of 560,821 adult patients, including 356,012 statin users, to clarify whether medications for dyslipidemia contribute to dry eye disease (DED). The studies included cohort, case-control and cross-sectional designs and followed participants for a median of two years. The median age across studies was 54, and women made up 59% of participants. The authors noted in the paper that “to ascertain a diagnosis of DED, three (60.0%) studies used data from electronic medical records, two (40.0%) used symptom-based assessments and one used clinical assessment via the Schirmer test.”Statin use was associated with a 9% overall increase in the odds of DED, corresponding to approximately 10 additional cases per 1,000 patients. Heterogeneity among studies was moderate, and further sensitivity analyses showed that the association remained consistent regardless of study design, outcome deduction method or risk of bias. However, the authors deemed these results “very low quality” because all included studies were observational and susceptible to confounding.The authors also explored whether statin dose, duration or type influenced risk. Duration of use did not appear to affect DED risk, and no clear differences emerged between low-, moderate- and high-intensity therapy. One study “found no difference” between lipophilic and hydrophilic statins, while in another, rosuvastatin was associated with higher odds of DED and atorvastatin, pravastatin and simvastatin were not. Other studies evaluating tear break-up time, staining scores, Schirmer test results and meibum quality failed to show consistent changes associated with statin use.The authors suggested that statins may interfere with cholesterol synthesis within meibomian gland epithelial cells, potentially destabilizing the tear film and promoting evaporative dry eye. They emphasized that the “modest increase” in risk should not lead to discontinuation of statin therapy because of its established cardiovascular benefits. Instead, clinicians should monitor ocular surface symptoms and educate patients who already show a DED risk.Click here for the journal source. Gao D, Qiu W, Chang V, et al. Association between statin use and dry eye disease: A systematic review and meta-analysis. Am J Ophthalmol. June 22, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.