I Took Accutane in the Early 2000s—And I’m Only Now Realizing It Affected My Eyes

I Took Accutane in the Early 2000s—And I’m Only Now Realizing It Affected My Eyes

This blog was medically reviewed.

It often starts quietly. Your eyes feel a little gritty at the end of the day. Maybe itchy. Maybe red. Vision seems fine in the morning, but by evening, especially around dusk, things look a bit blurrier. Lights feel harsher. Screens feel harder to tolerate. Your eyes are tired before the rest of you.

At first, you assume it’s stress. Or aging. Or too much screen time. But then a memory surfaces or maybe you hear a news blurb - Accutane.

Or maybe one of its generic versions—isotretinoin, sold in the early 2000s under names like Accutane, and later as Claravis®, Amnesteem®, Myorisan®, Zenatane®, or Absorica®.

And suddenly the pieces start to connect.

Making the Connection: “Could This Be From Accutane?”

Short answer: YES!

For many adults, isotretinoin was something they took years, or decades, ago. Acne cleared. Life moved on. Eye symptoms weren’t part of the conversation back then. Parents were unaware of the side effects and long term consequences. So, you never had a meibography or other early baseline treatment.

Thus, it can be surprising to learn that some people develop dry eye symptoms long after treatment ends.

Not everyone. Not even most people. But uncommon doesn’t mean rare. Since 2000, more than 5 million prescriptions have been dispensed to patients. So, hundreds of thousands of people are experiencing this same realization.

Medical research now shows that in a subset of patients, isotretinoin can contribute to long-term changes in the oil-producing glands of the eyelids, called the meibomian glands.

These glands are critical for tear stability. And once they deteriorate, they don’t regenerate. As one of our teammates might say - “spooky”.

How Gland Loss Can Show Up Years Later

Meibomian glands produce the oil layer of your tears. That oil prevents tears from evaporating too quickly. 

When glands are damaged or lost:

  • Tears evaporate faster

  • Eyes feel dry even if they water

  • Vision can fluctuate, especially in low light

  • Symptoms worsen later in the day

This explains why many people notice problems (1) in the evening, around dusk, or during night driving, (2) after prolonged screen use which is a time of poor or incomplete blinks, (3) in dry, windy, or even air-conditioned (blowing air) environments.

Isotretinoin doesn’t always cause immediate, obvious damage. In some people, it reduces gland reserve. This means that the glands become smaller and produce fewer good, lubricating oils. Later life stressors (screens, hormones, aging) reveal the deficit.

What to Do Next: Seeing the Right Eye Doctor

This is where the right evaluation matters. A standard eye exam is important, but for suspected isotretinoin-related dry eye, many patients benefit from seeing an eye doctor with expertise in ocular surface disease or dry eye. Many offices will identify themselves as dry eye specialists, or the doctor may self-identify as an ocular surface disease expert.

Optometrists often are actually better choices than Ophthalmologists because they provide long-term, progressive care for many diseases, whereas many Ophthalmologists are primarily surgeons or focus on surgeries. This is particularly noteworthy in dry eye as surgery is only a last resort. Other treatments should be identified, potentially tried, and only rejected at failure.

The visit often progresses in stages. If you are a new patient, the doctor will likely want you to do a comprehensive eye exam. This will include visual acuity, eye pressure, and potentially other tests. A true dry eye doctor is likely to do a meibography, tear break-up time test (TBUT), and other dry eye diagnostics. The goal is to rule out other causes.

Assuming the doctor identifies dry eye tied to previous use of isotretinoin, then they will likely suggest an ocular surface disease evaluation. This exam is usually covered by medical insurance and is more in depth including pictures and a variety of additional ocular surface tests. The goal is to ensure that the genesis of the dry eye disease can be ascertained.

These tests help determine whether symptoms are driven by evaporative dry eye from gland loss, rather than simple dryness alone.

The Good News: Function Can Often Be Improved

Learning that gland loss exists can feel scary, but it’s not the end of the story. Even with partial or significant gland loss:

  • Remaining glands can often work better

  • Inflammation can be reduced

  • Symptoms can improve substantially

The goal becomes maximizing the function of the glands you still have. Many patients feel better once treatment is targeted correctly. It may include pharmaceutical solutions, procedures (such as LipiFlow or Intense Pulsed Light (IPL) Therapy). And almost always, the doctor will help build a daily hygiene and maintenance program - eyelid wash, eye drops, and a warm compress.

Practical Action Steps You Can Start Today

1. Eyelid Hygiene

Gentle daily lid cleaning helps reduce inflammation and keep gland openings clear. Obviously, we recommend Peeq Pro’s daily eyelid and facial cleanser. But, we have a number of others that we also like - such as Pure&Clean’s Hydrogel or Eyes Are The Story’s Eyelid and Facial Wash.

2. Warm Compresses

The heat from the warm compress softens oil and improves flow from functioning glands. Consistency matters more than intensity. And honestly, people do this in spas. It feels pretty great.

3. Use Oil-Based, Preservative-Free Drops

These support the missing oil layer of tears. Examples include:

Using drops proactively, not just when eyes feel terrible, works best. Beyond picking the right drops, sometimes not picking the wrong drops is also helpful. Don’t use drops for red eyes, such as Visine or even Lumify to treat dry eye. This is not what they are for. Look for eye drops that are targeted specifically for people with dry eye. And, if you are not sure, this is a good thing to ask your doctor about.

4. Practice Smart Screen Habits

If you are on your computer or mobile phone, don’t fixate. Follow the 20-20-20 rule: every 20 minutes, look 20 feet away for 20 seconds. We’d also suggest you intentionally blink fully during this time.

Blink fully. Screens reduce blink quality more than people realize. Be intentional if you notice that you are fixating to pause and blink a couple of times throughout the day. A University of Iowa study showed that people only blink 30% as frequently while watching screens. Intentional blinking can help level set.

5. Support Overall Eye Health

Stay hydrated. Manage airflow (fans, car vents). Wear sunglasses outdoors. Wear sunscreen around your eyes. Get adequate sleep. These are things that help your whole health, but particularly if you are noticing dry eye symptoms, some intentional care can help. And, these small steps add up.

A Balanced Takeaway

If you took Accutane or isotretinoin in the early 2000s and are only now connecting it to dry eye symptoms, you’re not imagining things. Long-term gland effects are not universal, but real.

However, awareness has improved dramatically over the last 20 years about the role of medicine in common ocular surface conditions. And, modern dry eye care is far more effective than it once was.

With the right evaluation and consistent care, many people regain comfort in their eyes. Don’t endure dry eye, get the care that you need and deserve.

Medical Reference

Lamberg O, et al. (2023). Ocular side effects of systemic isotretinoin: a systematic review and summary of case reports. Journal of Dermatological Treatment.

This publication is a systematic review and meta-analysis synthesizing approximately 20 years of peer-reviewed research, including large population studies and detailed case reports documenting both reversible and long-term ocular effects of isotretinoin, including meibomian gland dysfunction, gland loss, and persistent dry eye disease.

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