Systemic Med Use Linked to Blepharitis, MGD and Chalazion

This new study observed various associations between systemic medications and common ocular surface diseases; specifically, meibomian gland dysfunction was overrepresented in patients on finasteride, bortezomib was frequently associated with chalazia and dupilumab was linked to MGD, chalazia and blepharitis. Photo: Mile Brujic, OD; Paymaun Asnaashari, OD. Click image to enlarge. Pharmaceutical agents that affect the sebaceous glands, alter immune responses or influence vascular permeability can unintentionally disturb the fragile equilibrium of ocular surface homeostasis, contributing to the development of conditions like blepharitis, meibomian gland dysfunction (MGD) and chalazion. A recent study published in Eye highlighted significant associations between these three common ocular surface disorders and various systemic medications, underscoring the often-overlooked role that these drugs may play in localized eyelid inflammation.The researchers analyzed records from the FDA Adverse Event Reporting System (FAERS), encompassing data from the fourth quarter of 2003 to the second quarter of 2024. A total of 1,923 reports of blepharitis, 202 reports of MGD and 290 reports of chalazia were collected. The average age of individuals with these conditions was about 54 years for blepharitis and 51 years for both MGD and chalazia, with a significant female predominance (58.3% for blepharitis, 60.9% for MGD and 64.5% for chalazia). Roughly 70% of reports originated from North America, with healthcare professionals submitting nearly 55% of cases.The results showed a significantly increased risk of these ocular conditions among patients taking certain systemic medications. Finasteride showed a significant overrepresentation in cases of MGD, and chalazia was overreported for bortezomib. Dupilumab emerged as a common factor across all three conditions, indicating that it is frequently linked to blepharitis, MGD and chalazia. Additionally, the study identified several safety signals primarily associated with blepharitis related to other medications, including isotretinoin, docetaxel, panitumumab, cetuximab, tretinoin, alendronate, erlotinib, zoledronate, daxibotulinumtoxinA and infliximab.“Associations between systemic medications and these disorders are particularly noteworthy, as clinicians may not consider systemic medications as potential contributors to localized lid inflammation,” the study authors noted in the discussion portion of their paper.While the authors urge clinicians to consider the use of certain systemic medications in differential diagnoses for ocular surface disorders, they also recognize that it may not be feasible for patients to discontinue use due to ocular symptoms, given that “these drugs are known to reduce morbidity and mortality across many diseases.” Therefore, they concluded, “while risks may not necessarily outweigh benefits to warrant changes in prescribing practices, clinicians should remain vigilant for such side effects, particularly in patients at higher risk, and to consider prophylactic measures when appropriate, such as educating patients about eyelid hygiene and counseling them to promptly report symptoms.”Click here for the journal source. Taghaddos D, Mihalache A, Huang RS, et al. Drugs linked to blepharitis, meibomian gland dysfunction, and chalazion: a real-world, population-based pharmacovigilance analysis. Eye. September 9, 2025. [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.