[Ophthalmic drug therapy in professional athletes-what is allowed, what is doping?]

At first sight, ophthalmic drugs are not necessarily suspected of being used as performance-enhancing agents in competitive sports. However, there are some restrictions that must be noted, especially when certain drugs are taken orally. A structured analysis of the doping relevance of ophthalmic drugs was performed on the basis of a literature review, taking into account the current guidelines of the National Anti-Doping Agency of Germany and the World Anti-Doping Agency. Use of the most common ophthalmological drug groups is possible without restrictions, especially in the case of topical application. An exception is the oral use of diuretics, which is prohibited at all times. For glucocorticoids, topical application to the eye is allowed, but oral application is prohibited in competition. A similar restriction applies to the use of epinephrin, for which all forms of systemic application are prohibited in competition. When taking beta-blockers, the sport being played is the determining factor: use is prohibited in billiards, archery, darts, golf, motor sports, shooting sports, skiing/snowboarding, ski jumping, freestyle aerials/half pipe, snowboard half pipe/big air, and underwater sports. For shooting and archery, beta-blockers are also prohibited outside of competitions. Athletes with pre-existing ophthalmological conditions should seek comprehensive advice from an ophthalmologist before using any medication, and together they should choose a permissible active ingredient, consider the appropriate route of application, and, if necessary, apply for a Therapeutic Use Exemption. It is currently not known how many of the national and international athletes have to be treated with eye drops.