Ocular ADRs of Drugs

C.V.S. drugs

_ Digitalis: Disturbance of colour vision, scotomas

_ Quinidine: Optic neuritis (rare)

_ Thiazides: Xanthopsia (yellow vision), Myopia

_ Carbonic anhydrase inhibitors: Ocular hypotony, Transient myopia

_ Amiodarone: Corneal deposits

_ Oxprenolol: Photophobia, Ocular irritation

G.I.T. drugs

_ Anticholinergic agents: Risk of angle-closure glaucoma due to mydriasis, Blurring of vision due to cycloplegia (Occasional).

C.N.S. drugs

_ Barbiturates: Extraocular muscle palsies with diplopia, Ptosis, Cortical blindness

_ Chloral hydrate: Diplopia, Ptosis, Miosis

_ Phenothiazines: Deposits of pigment in conjunctiva, cornea, lens and retina, Oculogyric crisis

_ Amphetamines: Widening of palpebral fissure, Dilatation of pupil, Paralysis of ciliary muscle with loss of accommodation

_ Monoamine oxidase inhibitors: Nystagmus, Extraocular muscle palsies, Optic atrophy

_ Tricyclic agents: Pupillary dilatation (glaucoma risk), Cycloplegia

_ Phenytoin: Nystagmus, Diplopia, Ptosis, Slightblurring of vision (rare)

_ Neostigmine: Nystagmus, Miosis

_ Morphine: Miosis

_ Haloperidol: Capsular cataract

_ Lithium carbonate: Exophthalmos, Oculogyric crisis

_ Diazepam: Nystagmus.

Hormones

Female sex hormones

_ Retinal artery thrombosis

_ Retinal vein thrombosis

_ Papilloedema

_ Ocular palsies with diplopia

_ Nystagmus

_ Optic neuritis and atrophy

_ Retinal vasculitis

_ Scotomas

_ Migraine

_ Mydriasis

_ Cyloplegia

_ Macular oedema

Corticosteroids

_ Cataract (posterior subcapsular)

_ Local immune suppression causing susceptibility to viral (herpes simplex), bacterial and fungal infections

_ Steroid-induced glaucoma

Antibiotics

_ Chloramphenicol: Optic neuritis and optic atrophy

_ Streptomycin: Optic neuritis

_ Tetracycline: Pseudotumour cerebri, Transient myopia

Antimalarial

Chloroquine

_ Macular changes (Bull’s eye maculopathy)

_ Central scotomas

_ Pigmentary degeneration of the retina

_ Chloroquine keratopathy

_ Ocular palsies

_ Ptosis

_ Electroretinographic depression

Amoebicides

_ Diiodohydroxy quinoline: Subacute myelo optic neuropathy (SMON), optic atrophy

Chemotherapeutic agents

_ Sulfonamides: Stevens-Johnson syndrome

_ Ethambutol: Optic neuritis and atrophy

_ Isoniazid: Optic neuritis and optic atrophy

Heavy metals

_ Gold salts: Deposits in the cornea and conjunctiva

_ Lead: Optic atrophy, Papilloedema, Ocular palsies

Chelating agents

_ Penicillamine: Ocular pemphigoid, Ocular neuritis, Ocular myasthenia

Oral hypoglycemic agents

_ Chloropropamide: Transient change in refractive error, Diplopia, Stevens-Johnson syndrome

Vitamins

Vitamin A

_ Papilloedema

_ Retinal haemorrhages

_ Loss of eyebrows and eyelashes

_ Nystagmus

_ Diplopia and blurring of vision

Vitamin D

_ Band-shaped keratopathy

Antirheumatic agents

_ Salicylates: Nystagmus, Retinal haemorrhages, Cortical blindness (rare)

_ Indomethacin: Corneal deposits

_ Phenylbutazone: Retinal haemorrhages