Patients’ Awareness of the Ocular Side Effects of Isotretinoin Therapy: A Study From Saudi Arabia

Introduction Isotretinoin is one of the most commonly prescribed drugs among dermatologists because it's used in the treatment of Acne vulgaris. Despite having an adequate safety profile, isotretinoin-related adverse events are common, with ocular manifestations being one of them. Although being generally mild, ophthalmologic manifestations associated with isotretinoin may cause significant ocular morbidity. Objectives The objective is to evaluate the awareness of the ocular side effects of isotretinoin treatment in patients with acne and to understand the treating physicians' practice of prescribing isotretinoin from the patient's point of view. Method A descriptive cross-sectional study was conducted on a Saudi Arabian population from June to September 2021. We used a self-administered questionnaire to collect data on drug dose, treatment duration, ocular adverse effects, patients' awareness, and patients' perception of treating physicians' practice. Results Of 1,157 responders, 452 (39.1%) consisted of participants who met the inclusion criteria, therefore they were enrolled in the study. Out of our responders, 308 (68.1%) were women. Approximately, 91.6% of participants had a dermatologist's prescription for isotretinoin. Eye dryness was the most commonly reported ocular adverse effect (83.4%). Blepharitis and conjunctivitis were the most commonly diagnosed complications after starting isotretinoin (5.4% for each). Approximately, 71.2% participants were not advised to see an ophthalmologist for ophthalmological screening. Physicians asked only 78 (17.3%) respondents about a recent refractive surgery before starting isotretinoin or if they intended to undergo a refractive surgery in the next six months. Approximately, 57.5% participants were unaware of possible contact lens intolerance. Lubricant eye drops were prescribed to 305 (67.5%) respondents during isotretinoin treatment. Approximately, 36.7% participants were advised to consult their treating physicians if they had any serious ocular signs or symptoms. Approximately, 67.9% participants reported their awareness of the ocular side effects of isotretinoin therapy. However, 236 (52.2%) participants responded that they were not provided with sufficient information on the ocular side effects of isotretinoin therapy.