The Early Effects of Alcohol Consumption on Tear Functions and Ocular Surface

Abstract

Purpose: : Alcohol consumption has been reported to be a risk factor for dry eye with inconclusive evidence but with basis for a biological rationale. We investigated the early effects of alcohol intake on tear functions and ocular surface health in this study.

Methods: : Forty eyes of 20 subjects (16 males, 4 females; mean age:34.3 years) who drank 200 mL of 25% Japanese vodka and 14 eyes of age and sex matched 7 control subjects who drank green tea were investigated in this prospective controlled study. Subjects were requested to refrain from alcohol consumption from the previous day and food ingestion 6 hours prior to the study. Each subject consumed exactly the same order prepared dinner and same quantity of alcohol over the same time frame. Subjects were allowed to rehydrate with 350 mL of water until the next morning. Subjects underwent breath alcohol,tear evaporation and blink rate, tear lipid layer interferometry, tear film break-up time (BUT)measurements, fluorescein and Rose Bengal stainings, Schirmer test and visual analog scale(VAS) evaluation of dry eye symptoms before, 2 and 12 hours after alcohol intake.

Results: : The mean breath alcohol level was significantly higher in the alcohol group compared to the green tea group at 2 and 12 hours. The mean tear evaporation increased significantly from 3.0x10-7 to 5.25 x10-7 12 hours after alcohol intake. The mean BUT shortened significantly from 14.3±8 to 6.4±6 seconds 12 hours after alcohol intake. Tear lipid layer showed a significant thinning after 12 hours in the alcohol group with no significant changes in the green tea group. The mean blink rates increased significantly from 11.7 blinks/min to 17.4 blinks/min and 14.9 blinks/min at 2 and 12 hours. The blink rates were significantly higher than the green tea group in which no time wise increase in blinks was observed. The Schirmer test values decreased by 40% in 20 eyes 12 hours after alcohol intake.The mean fluorescein staining scores increased significantly at 12 hours (0.9±1pts) compared to prealcohol ingestion levels (0.1±0.3pts). The mean increase in dry eye VAS scores from baseline was 17.3% in the alcohol group at 12 hours (p<0.05). No significant time wise changes in tear functions were observed in the green tea group.

Conclusions: : The tear film and ocular surface epitheliae showed early and distinctive quantitative and qualitative disturbances with alcohol intake.

Keywords: cornea: tears/tear film/dry eye • cornea: clinical science • cornea: epithelium