This retrospective analysis of the Blue Mountains Eye Study III cohort (Caucasian Australians residing west of Sydney n=1680; mean age >74 years, range 60-97) analysed the association between dyslipidaemia, use of oral statins and symptoms of dry disease (DED) among older adults. It has been postulated that statins may reduce the cholesterol output in meibomian glands and cause blepharitis and dry eye. Serum lipid profiles were determined from fasting blood tests. Information on DED and statin use were obtained from an interviewer-administered questionnaire. At least one DED symptom was reported in 52% (n=1029). Patients with hypercholesterolaemia (>5.5mmol/L) did not report more DED than those without hyperlipidaemia. Neither high density nor low density lipoprotein were associated with DED. Patients taking oral statins were more likely to report one or more moderate to severe symptoms of DED (odds ratio: 2.054, 95% CI; 1.281-3.295). The authors state that more work is needed to ascertain any causal nature of this association. Limitations included no analysis of the phenotype of the DED and type of statin taken. There is no evidence whether statins are found within the tarsal circulation and whether this affects the Meibomian glands. 

Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study.
Kenneth G, Lee M, Burlutsky G, et al.
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
2019;47:187-92.
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Ivan Yip

St Pauls', Royal Liverpool University Hospital, UK.

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