أ.محمد العشي
17-10-2007, 01:02 AM
DRUGS and the EYE
Antihistamines
Antihistamines are found as prescription and non-prescription pills, capsules, liquids, and effervescent tablets (like alka-seltzer). They may be sold as and individual medication or in combination with other medications such as decongestants, pain medications, etc. Often listed as a warning in package information sheets for antihistamines is that the drug should not be used if one has glaucoma. However, for most people with glaucoma, antihistamines can be used safely. The most common type of glaucoma is termed "open angle glaucoma". Antihistamines generally should have no effect with this type of glaucoma.
With a more rare type of glaucoma termed "angle closure glaucoma" or "narrow angle glaucoma", the use of antihistamines may trigger an attack of angle closure glaucoma. Basically, the part of the eye that drains fluid becomes blocked and the pressure within the eye will skyrocket. This is usually accompanied by pain, blurred vision, eye redness, seeing rainbows around lights, and even nausea or vomiting. Angle closure glaucoma is an emergency, and vision can be permanently lost. Many people may be at risk for angle closure glaucoma unknowingly. A recent study found that people of Vietnamese descent may have increased risk for this type of glaucoma. If in doubt, consult with an ophthalmologist who can determine if it is safe to use antihistamines. For more information on glaucoma, go to Glaucoma.
Aspirin
Vitamin A has a reputation for being beneficial to the eye. The retina does need a normal amount of vitamin A to properly function, and this amount can be obtained with a well balanced diet without supplements. Large dosages of vitamin A have NOT been shown to help to preserve vision in conditions which cause retinal degeneration (such as retinitis pigmentosa). Large vitamin A intake can be harmful, as it is stored by the body. One condition that can be caused by a large intake of vitamin A (or of foods containing a large amount of vitamin A such as liver) is "pseudotumor cerebi", which is an increase in the pressure of the fluid around the brain (increased intracranial pressure). This can cause visible swelling of the optic nerve within the eye, as well as headache and visual disturbances.
Pharmaceutical Drugs
Accutane
Accutane is commonly used to treat acne, and is known to cause dryness of mucous membranes, and the eye is included. Symptoms of dry eye include the sensation that something is in the eye, redness, burning, and even blurred vision. Artificial tears and ointments may help. Accutane may also lead to temporary visual disturbances and trouble with night vision.
Amitriptyline (Tri-cyclic antidepressants)
This class of medication including amitriptyline can have several ocular side effects. They can cause a decrease in tearing, which can lead to dry eye problems. They also can lead to a decrease in focusing ability (accommodation). This temporary effect may cause difficulty with reading or even distance vision. Finally, these medications may have a risk for causing acute angle closure glaucoma, in those persons at risk for this type of glaucoma. Most people with glaucoma have "open angle" glaucoma, and would have no problem with taking these medication. Consult with your ophthalmologist is you are unsure. For more information on this risk of glaucoma, see the section above under Antihistamines.
Antipsychotic medications
Many of these psychiatric medications can have risk for angle closure glaucoma in those persons at risk for this type of glaucoma. Most people with glaucoma have "open angle" glaucoma, and would not be at risk with taking these medication. Consult with your ophthalmologist if you are unsure. For more information on this risk of glaucoma, see the section above under Antihistamines.
Amiodarone
Amiodarone is a potent cardiac medication with a common ocular side effect which rarely gives any symptoms. A person taking this medication will develop a whorl-like pattern on the surface of the cornea over a period of time. Rarely this may interfere with vision or cause glare symptoms. The condition is reversible.
Recently, an association between amiodarone and optic neuritis or optic neuropathy has been made. This has prompted the manufacturer of Cordarone (amiodarone) to revise the Warnings section of this medication's prescribing information. It now states that cases of optic neuritis and/or optic neuropathy have been reported in patients receiving this drug, and that the problem could develop at any time during the use of the drug. It has NOT been clearly established that the drug causes the optic nerve problem, but if there are any changes in vision or peripheral vision then an prompt ophthalmic examination should be performed. Regular ophthalmic examination is recommended for patients receiving amiodarone.
Chloroquine
This is an anti-malarial drug also rarely now used in arthritic conditions. Currently, Plaquenil (hydroxychloroquine) is more commonly used in arthritis, with fewer side effects. Chloroquine can cause degeneration of the optic nerve. It can also cause a retinal degeneration which can lead to blind spots in the vision, reduced color vision, and blurred central vision. The risk of retinal problems may be related to the total cummulative amount of chloroquine taken over time. See the section on Plaquenil below for more information on this potential retinal problem.
Cimetidine
This anti-ulcer medication can rarely lead to angle closure glaucoma in people susceptible to this type of glaucoma. Most people with glaucoma have "open angle" glaucoma, and would not be at risk with taking these medication. Consult with your ophthalmologist if you are unsure. For more information on this risk of glaucoma, see the section above under Antihistamines.
Chlorpromazine (Thorazine)
Thorazine, a psychiatric medication, taken in large dosages can lead to pigmentation of the conjunctiva, cornea, and eyelids. A pigmentary retinal degeneration can also occur. Cataract is also possible. This drug is in the class of drugs known as "phenothiazines", and Mellaril (thioridazine) can have similar side effects.
Chlorpropamide
This diabetic medication can rarely cause a degeneration of the optic nerve.
Digitalis
This cardiac drug can cause a few ocular symptoms, such as glare symptoms and seeing halos around light. In cases of overdosage of digoxin, the vision may become yellowish. This is important since the blood level of digoxin needs to be monitored and may fluctuate for different reasons.
Ephedrine
This stimulant can lead to pupillary dilation and may give risk for angle closure glaucoma in people susceptible to this type of glaucoma.
Estrogen
Estrogens are commonly used in post-menopausal women for symptoms related to estrogen deficiency, and their use has also been associated with a decreased risk for heart disease and hip fracture. A recent study suggests that estrogen use in post-menopausal women may give a protective effect against the formation of cataract (the nuclear sclerotic type of cataract).
5-Fluoro-Uracil (5-FU)
This cancer chemotherapeutic agent can lead to scarring and closure of the tear drainage system (nasolacrimal obstruction). This commonly leads to spontaneous tearing.
Ethambutal
This agent used in the treatment of tuberculosis can rarely lead to a degeneration of the optic nerve.
Haldol
This psychiatric sedative medication can lead to decreased tear production, decreased focusing ability, pupillary dilation, and may give risk for angle closure glaucoma in people susceptible to this type of glaucoma. See the section discussing Tricyclic Antidepressants for more information on these side effects.
Indomethacin
This anti-inflammatory medication can rarely lead to whorl-like changes on the surface of the eye (cornea). This rarely causes any visual symptoms.
Isoniazide
This agent used in the treatment of tuberculosis can rarely lead to a degeneration of the optic nerve.
Minocycline
Minocycline, which is a drug similar to tetracycline, is commonly used orally in the treatment of acne and rosacea. Recently reported is a pigmentation of the white of the eye (sclera) which can occur with the use of this drug. It is typically a blue-gray discoloration, but may also be black or brownish. It may be worse in areas exposed to sunlight. This is also true with the similar skin pigmentation which can occur with the drug, as well as fingernail and tooth discoloration. If the abnormal pigmentation is recognized quickly, discontinuation of the drug may allow the skin, eye, etc. to return to their normal appearance.
To be continue....................
Antihistamines
Antihistamines are found as prescription and non-prescription pills, capsules, liquids, and effervescent tablets (like alka-seltzer). They may be sold as and individual medication or in combination with other medications such as decongestants, pain medications, etc. Often listed as a warning in package information sheets for antihistamines is that the drug should not be used if one has glaucoma. However, for most people with glaucoma, antihistamines can be used safely. The most common type of glaucoma is termed "open angle glaucoma". Antihistamines generally should have no effect with this type of glaucoma.
With a more rare type of glaucoma termed "angle closure glaucoma" or "narrow angle glaucoma", the use of antihistamines may trigger an attack of angle closure glaucoma. Basically, the part of the eye that drains fluid becomes blocked and the pressure within the eye will skyrocket. This is usually accompanied by pain, blurred vision, eye redness, seeing rainbows around lights, and even nausea or vomiting. Angle closure glaucoma is an emergency, and vision can be permanently lost. Many people may be at risk for angle closure glaucoma unknowingly. A recent study found that people of Vietnamese descent may have increased risk for this type of glaucoma. If in doubt, consult with an ophthalmologist who can determine if it is safe to use antihistamines. For more information on glaucoma, go to Glaucoma.
Aspirin
Vitamin A has a reputation for being beneficial to the eye. The retina does need a normal amount of vitamin A to properly function, and this amount can be obtained with a well balanced diet without supplements. Large dosages of vitamin A have NOT been shown to help to preserve vision in conditions which cause retinal degeneration (such as retinitis pigmentosa). Large vitamin A intake can be harmful, as it is stored by the body. One condition that can be caused by a large intake of vitamin A (or of foods containing a large amount of vitamin A such as liver) is "pseudotumor cerebi", which is an increase in the pressure of the fluid around the brain (increased intracranial pressure). This can cause visible swelling of the optic nerve within the eye, as well as headache and visual disturbances.
Pharmaceutical Drugs
Accutane
Accutane is commonly used to treat acne, and is known to cause dryness of mucous membranes, and the eye is included. Symptoms of dry eye include the sensation that something is in the eye, redness, burning, and even blurred vision. Artificial tears and ointments may help. Accutane may also lead to temporary visual disturbances and trouble with night vision.
Amitriptyline (Tri-cyclic antidepressants)
This class of medication including amitriptyline can have several ocular side effects. They can cause a decrease in tearing, which can lead to dry eye problems. They also can lead to a decrease in focusing ability (accommodation). This temporary effect may cause difficulty with reading or even distance vision. Finally, these medications may have a risk for causing acute angle closure glaucoma, in those persons at risk for this type of glaucoma. Most people with glaucoma have "open angle" glaucoma, and would have no problem with taking these medication. Consult with your ophthalmologist is you are unsure. For more information on this risk of glaucoma, see the section above under Antihistamines.
Antipsychotic medications
Many of these psychiatric medications can have risk for angle closure glaucoma in those persons at risk for this type of glaucoma. Most people with glaucoma have "open angle" glaucoma, and would not be at risk with taking these medication. Consult with your ophthalmologist if you are unsure. For more information on this risk of glaucoma, see the section above under Antihistamines.
Amiodarone
Amiodarone is a potent cardiac medication with a common ocular side effect which rarely gives any symptoms. A person taking this medication will develop a whorl-like pattern on the surface of the cornea over a period of time. Rarely this may interfere with vision or cause glare symptoms. The condition is reversible.
Recently, an association between amiodarone and optic neuritis or optic neuropathy has been made. This has prompted the manufacturer of Cordarone (amiodarone) to revise the Warnings section of this medication's prescribing information. It now states that cases of optic neuritis and/or optic neuropathy have been reported in patients receiving this drug, and that the problem could develop at any time during the use of the drug. It has NOT been clearly established that the drug causes the optic nerve problem, but if there are any changes in vision or peripheral vision then an prompt ophthalmic examination should be performed. Regular ophthalmic examination is recommended for patients receiving amiodarone.
Chloroquine
This is an anti-malarial drug also rarely now used in arthritic conditions. Currently, Plaquenil (hydroxychloroquine) is more commonly used in arthritis, with fewer side effects. Chloroquine can cause degeneration of the optic nerve. It can also cause a retinal degeneration which can lead to blind spots in the vision, reduced color vision, and blurred central vision. The risk of retinal problems may be related to the total cummulative amount of chloroquine taken over time. See the section on Plaquenil below for more information on this potential retinal problem.
Cimetidine
This anti-ulcer medication can rarely lead to angle closure glaucoma in people susceptible to this type of glaucoma. Most people with glaucoma have "open angle" glaucoma, and would not be at risk with taking these medication. Consult with your ophthalmologist if you are unsure. For more information on this risk of glaucoma, see the section above under Antihistamines.
Chlorpromazine (Thorazine)
Thorazine, a psychiatric medication, taken in large dosages can lead to pigmentation of the conjunctiva, cornea, and eyelids. A pigmentary retinal degeneration can also occur. Cataract is also possible. This drug is in the class of drugs known as "phenothiazines", and Mellaril (thioridazine) can have similar side effects.
Chlorpropamide
This diabetic medication can rarely cause a degeneration of the optic nerve.
Digitalis
This cardiac drug can cause a few ocular symptoms, such as glare symptoms and seeing halos around light. In cases of overdosage of digoxin, the vision may become yellowish. This is important since the blood level of digoxin needs to be monitored and may fluctuate for different reasons.
Ephedrine
This stimulant can lead to pupillary dilation and may give risk for angle closure glaucoma in people susceptible to this type of glaucoma.
Estrogen
Estrogens are commonly used in post-menopausal women for symptoms related to estrogen deficiency, and their use has also been associated with a decreased risk for heart disease and hip fracture. A recent study suggests that estrogen use in post-menopausal women may give a protective effect against the formation of cataract (the nuclear sclerotic type of cataract).
5-Fluoro-Uracil (5-FU)
This cancer chemotherapeutic agent can lead to scarring and closure of the tear drainage system (nasolacrimal obstruction). This commonly leads to spontaneous tearing.
Ethambutal
This agent used in the treatment of tuberculosis can rarely lead to a degeneration of the optic nerve.
Haldol
This psychiatric sedative medication can lead to decreased tear production, decreased focusing ability, pupillary dilation, and may give risk for angle closure glaucoma in people susceptible to this type of glaucoma. See the section discussing Tricyclic Antidepressants for more information on these side effects.
Indomethacin
This anti-inflammatory medication can rarely lead to whorl-like changes on the surface of the eye (cornea). This rarely causes any visual symptoms.
Isoniazide
This agent used in the treatment of tuberculosis can rarely lead to a degeneration of the optic nerve.
Minocycline
Minocycline, which is a drug similar to tetracycline, is commonly used orally in the treatment of acne and rosacea. Recently reported is a pigmentation of the white of the eye (sclera) which can occur with the use of this drug. It is typically a blue-gray discoloration, but may also be black or brownish. It may be worse in areas exposed to sunlight. This is also true with the similar skin pigmentation which can occur with the drug, as well as fingernail and tooth discoloration. If the abnormal pigmentation is recognized quickly, discontinuation of the drug may allow the skin, eye, etc. to return to their normal appearance.
To be continue....................