DRUGS CAUSING OCULAR TOXICITY
INTRODUCTION
Ocular toxicity,as all other areas of toxicology is a never ending,ever expanding branch till the scientist work and ophthalmologist prescribe
Clinicians must base their decision on
Available data
Past experience
Human variables
Toxicity may be of minor complications like
Conjunctivitis
Medicamentosa or aplastic anemia
death
Ocular toxicology may be discussed in following lines
Ocular manifestation of systemic medication
Systemic manifestation following topical ocular medication
Ocular complications following topical ocular preparations
Agents affecting specific ocular areas
OCULAR MANIFESTATION OF SYSTEMIC MEDICATION
ANTI-INFECTIVE AGENTS:
DRUG SIDE EFFECTS
• CHLORAMPHENICOL >>>>> optic neuritis
central scotoma rare
toxic amblyopia
• ETHAMBUTOL >>>>> inflammation of optic disc,nerve,tract
color vision disturbance
• ISONIAZID >>>>> optic neuritis
optic atrophy
• NALIDIXIC ACID >>>>> minor visual disturbance
color vision defects rare,
papilloedema reversible
sixth nerve palsy
• RIFAMPICIN >>>>> conjunctival hyperemia
lacrimation
• SULFONAMIDE >>>>> conjunctival and corneal scarring
steven-Johnson syndrome
• GRISEOFULVIN >>>>> macular degeneration
macular oedema
papilloedema
pseudotumour cerebri
photosensitivity
• TETRACYCLINES >>>>> blurring of vision
diplopia rare,
papilloedema reversible
pseudo tumour cerebri
• STREPTOMYCIN >>>>> optic neuritis
ANTI-PARASITE DRUGS:
DRUGS SIDE EFFECTS
• AMODIAQINE >>>>> corneal deposit rare,
retinopathy reversible
• CHLOROQUINE >>>>> corneal deposit CD is frequent
bilateral macular degeneration reversible
when total dose is more than 100gm irreversible macular change occurs
• QUININE >>>>> retinal vascular disorders with
cherry red spot at macula
acute loss of vision with excessive doses partially
toxic amblyopia reversible
• TRYPARSAMIDE >>>>> impaired vision
optic atrophy reversible
ANTI-INFLAMMATORY AGENTS:
DRUGS SIDE EFFECTS
• IBUPROFEN >>>>> disturbance of colour vision rare
blurring of vision reversible
optic neuritis
• INDOMETHACIN >>>>> corneal deposit rare
diplopia reversible
mydriasis
possible retinal damage
• NAPROXEN >>>>> blurred vision
scotomas
• OXYPHENBUTAZONE >>>>> conjunctival and corneal scarring
• PHENYLBUTAZONE >>>>> steven-Johnson syndrome
• TOIMETIN >>>>> toxic amblyopia
diplopia
• GOLD SALT >>>>> corneal deposits reversible
• ACETAMINOPHEN >>>>> steven-Johnson syndrome
CARDIOVASCULAR :
DRUGS SIDE EFFECTS
• AMIODARONE >>>>> corneal deposit
lens opacities reversible
conjunctival hyperemia
• VASODILATOR-HYDRALAZINE >>>>> lacrimation
conjunctivitis very rare
• QUANITHIDINE >>>>> ptosis
NERVOUS SYSTEM:
DRUGS SIDE EFFECTS
• PENTAZOCINE >>>>> miosis
hallucination
• PHENACETIN >>>>> xanthopsia
• ANTICHOLENERGICS >>>>> mydriasis
problem in accommodation reversible
raise in IOP in angle closure glaucoma
ANTI CONVULSANT:
DRUGS SIDE EFFECTS
• PHENYTOIN >>>>> nystagmus
diplopia frequent
weakness of accommodation and convergence reversible
• TRIMETHADIONE >>>>> glare in bright light
fading of colors reversible
ANTI DE-PRESSANTS:
• LITHIUM CARBONATE >>>>> blurred vision sodium def
accommodative weakness reversible
• MONOAMINE-OXIDASE >>>>> changes in color perception
INHIBITORS papilloedema rare
visual acuity
• IMIPRAMINE
• DESIPRAMINE
• NORTRIPTYLINE >>>>> increased IOP frequent
• TRICYCLICS impairement of accommodation
ANTI-PARKINSONISM DRUG:
DRUGS SIDE EFFECTS
• AMANTADINE >>>>> visual hallucination frequent in elders
reversible
• BENZTROPINE >>>>> blurring of near vision
dilatation of pupil
BENZODIAZEPINES & DERIVATIVES:
DRUGS SIDE EFFECTS
• CHLORDIAZE
POXIDE HCL >>>>> blurred vision reversible with overdose
diplopia irreversible
• CLORAZEPATE
DIPOTASSIUM >>>>> nystagmus
DIAZEPAM diplopia
allergic conjunctivitis
HYPONOTICS:
DRUGS SIDE EFFECTS
• FENFLURAMINE >>>>> dilatation of pupil
• KETAMINE >>>>> visual hallucination rare
nystagmus reversible
ANTI PSYCHOTIC:
DRUGS SIDE EFFECTS
• CHLORPROMAZINE HCL >>>>> pigment deposition in anterior
portion of lens & posterior cornea
• PERPHENAZINE >>>>> blurring of near vision
enlarged pupil rare
• PROCHLORPERAZINE >>>>> uncontrolled eye movement
• PHENOTHIAZINES >>>>> conjunctival deposit
corneal opacity
retinal degeneration
HORMONES:
DRUGS SIDE EFFECTS
• CONTRACEPTIVES >>>>> retinal haemorrhages
papilloedema
corneal edema & swelling rare
nystagmus
THANK YOU
DONE BY
V.YOGAPRIYA
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