Bisphosphonates and Eye Health

Alvin B. Lin, MD, FAAFP
 
Dr. Lin is an associate professor of family and community medicine at University of Nevada School of Medicine and an adjunct professor of family medicine and geriatrics at Touro University Nevada College of Medicine. He also serves as an advisory medical director for Infinity Hospice Care and as medical director of Lions HealthFirst Foundation. Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at http://alvinblin.blogspot.com/.

The bisphosphonate class of osteoporosis medications just can't seem to win. They've been hung out to dry as causing osteonecrosis of the jaw and most recently, atypical femur fractures.  And as of this week, the Canadians have now linked bisphosphonate use to inflammatory eye disease, eg uveitis and scleritis.  A retrospective cohort study of 934,147 persons followed for up to 6 years demonstrated an increase risk of uveitis and scleritis in 10,827 bisphosphonate users compared to 923,320 non-users.  Granted, this study does not prove cause and effect but rather only demonstrates an association.  By doing so, it offers a basis for a hypothesis for future studies.  But while we wait for outcomes of a randomized controlled trial, we better remember to add another check-off box to discuss with potential users of bisphosphonates.