Treatment and dry eye
Anticholinergic drugs however, are notorious for the side effect of provoking eye dryness. Male dry eye patients, especially those with BPH, should be queried regarding their use.
Lifestyle changes can reduce the need to therapeutically manage OAB.2 These changes include reducing fluid intake, especially alcohol and caffeine; avoiding medications that stimulate muscles in the bladder neck and prostate such as pseudoephedrine and other decongestants; and reducing or changing diuretic medication use for treating high blood pressure.
Another strategy is timed urination (following a bathroom schedule instead of “urge”). Excercises to strengthen the pelvic floor (Kegel excercises) are also beneficial in controlling OAB symptoms. Biofeedback is another option. Botox (onabotulinumtoxin A, Allergan) bladder treatments are another alternative to control OAB symptoms. Botox works for the bladder by relaxing the muscle of the bladder wall to reduce urinary urgency and incontinence: it can help the bladder muscles from squeezing too much. The effects of Botox last up to six months.
Another potential treatment is neuromodulation therapy. This type of treatment sends electrical pulses to nerves that share the same path for the bladder. In OAB, the nerve signals between your bladder and brain do not communicate correctly. These electrical pulses help the brain and the nerves to the bladder communicate so the bladder can function properly and improve OAB symptoms.
Look for other solutions
Remember to carefully consider the dry eye patient’s medical history and medication list. Be equipped with suggestions or alternatives to modify those pathologies that prompt other colleagues to prescribe medications that thwart our best dry eye therapies.
Empower your patient to have important conversations and be involved in decision-making with every member of their healthcare teams to limit or avoid oral therapies that impact the ocular surface system.
1. Eapen RS, Radomski SB. Review of the epidemiology of overactive bladder. Res Rep Urol. 2016 Jun 6;8:71-6.
2. Urology Care Foundation. What Is Overactive Bladder (OAB)? Available at: https://www.urologyhealth.org/urologicconditions/ overactive-bladder-(oab). Accessed 1/17/20.