It is important to be aware that many commonly prescribed medications have ocular side effects. Some say that the eye is the second most common site to manifest drug toxicity, second only to the liver. It is no wonder that ocular side effects are so common. Ocular side effects are best managed by your eye doctor. With specialized equipment and instruments, your eye doctor can thoroughly evaluate your vision and eye health. It is important to report symptoms as they occur to your eye doctor as well as your prescribing physician.
Ocular side affects of medications, either prescribed by a physician or over the counter, are more prevalent than you may think. Some medications require a baseline eye exam, and eye exams every six months thereafter. Anytime you begin a new medication it is prudent to ask your prescribing physician for a schedule of follow-up care. Let’s take a look at just a few medications, there are simply too many to provide a comprehensive list,; all of which are known to have ocular side effects, sometimes referred to as ocular adverse reactions, and require regular monitoring by your eye doctor.
Adalimumab (Humira) - Optic neuritis
Alendronate (Fosamax) - Uveitis, scleritis or episcleritis
Amiodarone (Cordarone) - Photosensitivity, corneal verticillata, thyroid eye disease
Aripiprazole (Abilify) - Diplopia (double vision)
Canthaxanthine (Orobronze) - Crystalline retinopathy
Carbamazepine (Tegretol) - Blurred vision, transient diplopia, nystagmus
Cetirizine (Zyrtec) - Mydriasis, oculogyric crisis
Digoxin (Lanoxin) - Yellow vision, halo effect, retrobulbar neuritis
Ezogabine (Potiga) - Retinal pigmentary abnormalities
Fingolimod (Gilenya) - Macular edema
Flecainide (Tambocor) - Eye pain or irritation, photophobia, nystagmus
Hydrochlorothiazide (Microzide) - Acute myopia and secondary angle-closure glaucoma
Hydroxychloroquine (Plaquenil) - Retinal toxicity
Isotretinoin (Accutane) - Decreased night vision, corneal opacities
Linezolid (Zyvox) - Pheripheral and optic neuropathy
Methotrexate (Trexall) - Conjunctivitis, optic neuropathy
Niacin (Niacor) - Toxic amblyopia, cystoids macular edema
Phenothiazines - Corneal and lens deposits, conjunctival pigmentation
Pioglitazone (Actos) - Macular edema
Tamoxifen (Nolvadex) - Cataract, corneal deposits, crystalline retinopathy
Tamsulosin (Flomax) - Intraoperative floppy iris syndrome, blurred vision
Topiramate (Topamax) - Bilateral acute angle-closure, myopic shift
Vigabatrin (Sabril) - Bilateral concentric visual field constriction
Often times, individuals do not associate the use of medication with the side effects. One of the most common and often unreported ocular side effects is dry eyes. Individuals commonly associate dry eyes with contact lens wear, the result of working on the computer for extended periods of time, or being outdoors during dry or windy conditions. You may be surprised to learn that many prescribed medications list dry eyes as a common side effect. Keep in mind, dry eyes is just one example of a common ocular side effect. That’s why it is important to provide an updated health history and medication list to your eye doctor at your annual exam; and report any changes more frequently if your eye doctor is monitoring your vision or eye health on a more regular basis.
Truly, no medication is without some side effect. However, keeping abreast of common side effects and discussing what to be aware of with both your physicians as well as your eye doctor will aid in correct and timely diagnosis.
Prescription medications are important in maintaining overall health. However, it is equally important to be aware of medication side effects and report any health changes to the prescribing physician as they occur.