Medications That Could Harm Vision
You’d expect your eyecare providers to know if you have glaucoma, dry eyes or astigmatism. It
just as important that they know if you have arthritis, acne, heart problems or
even hay fever.
Some prescription and even over-the-counter medications
taken for these and other conditions can harm your vision and in some cases,
cause irreversible damage.
This doesn’t mean you should stop taking those medications or feel you must choose
between your sight and other aspects of your health.
What is does mean is that you need to notify all your doctors – especially eyecare
providers – on the exact dosage and length of use for every drug you
consume.
“Often, a lower drug dose or, if possible,
prescribing a different drug may help to prevent serious visual problems,”
says Siret Jaanus, PhD, FAAO, a professor of pharmacology at SUNY College of
Optometry and co-editor of Clinical Ocular
Pharmacology (Butterworth, 2001), a textbook for eyecare providers. Among
the drugs most commonly associated with ocular side effects:
Heart Medications
Digoxin, which is marketed as Lanoxin, Digoxin, Lanoxicaps and Digitek,
is a commonly prescribed medication for congestive heart
failure and certain cardiac arrhythmias. Side effects can include seeing
flickering or flashes of light or colored spots. Vision can become snowy or
hazy, and dimming of vision can also occur and complaints of color vision
disturbances are not uncommon. “I can remember my grandmother, who was taking
the drug, having trouble threading a needle with black thread,” says Dr.
Jaanus. Symptoms tend to subside within a few weeks after the drug is
discontinued or the dose is lowered and serum levels of the drug decrease.
Normal therapeutic doses of Amiodarone (amiodarone HCl, also marketed as Cordarone
and Pacerone), used to treat cardiac arrhythmias, can cause changes
in the cornea and lens. These changes consist of deposits that are easily
visible by your eye doctor during slit lamp examination and are most likely to
occur at higher drug dosages that resolve within 6-18 months after
discontinuation of therapy. “These changes can come on quickly—as early as
two weeks into therapy—and can progress from mild to severe, but are usually
benign,” says Dr. Jaanus.
Arthritis Medications
Hydroxychloroquine,an antimalarial drug, is used in severe cases of rheumatoid arthritis.
At doses greater than 400 mg a day, Plaquenil
can cause irreversible changes in both the lens and the retina that can lead to
cataract. If you are prescribed this drug, you should have an eye baseline
examination before starting it and should be examined periodically. Once the
dose is reduced or the drug is discontinued, opacities usually decrease or
disappear within an average of 8 months.
Corticosteroids
Taken at high doses (25-80 mg/day) for more than two years, these drugs (which are commonly
prescribed for rheumatoid arthritis, lupus and other immune-mediated diseases)
can lead to cataract formation and increased susceptibility to fungal and viral
infections. Though the resultant lens changes are generally irreversible, they
will not progress once the dose is lowered or the drug is withdrawn.
Acne Medications
Accutane(isotretinoin) taken at usual clinical dosages can cause dryness of the
eyes, which may make contact lens wear uncomfortable or worsen existing symptoms
of dryness. Basically, it enhances the evaporation of the tear film, says Dr.
Jaanus. Dry eye caused by Accutane is reversible, usually after withdrawal of the drug and possibly after lowering the
dose.
Nonprescription Antihistamines
Antihistamines, prescribed for allergies and also present in over-the-counter (OTC) cold and
allergy remedies, can also cause dry eye. “You should really be aware of the
problem with these drugs because if they are taken for a long time, both the
quantity and the components present in normal tears can be altered,” says Dr.
Jaanus. The drugs reduce the volume of tears that are produced by the lacrimal
gland. If this sounds familiar, speak to your eyecare provider about the
possibility of switching to prescription antihistamine such as loratadine (Claritin),
which seems to have less of an effect. Using artificial tears, up to 4 times per
day, can be helpful while you’re taking the antihistamine.
Posted: Oct. 29, 2001
|
