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1.
Brand Name
Accutane
Generic Name
isotretinoin
Indication
acne, psoriasis
2.
Adalat
nifedipine
hypertension,
angina
3.
Albuterol
albuterol
asthma
4.
Amidarone
Cordarone
anti-arrhythmic
5.
Amoxil
amoxicillin
infection
6.
7.
8.
Aspirin
Augmentin
Beclovent
acetylsalicylic acid
amoxicillin
beclomethasone
anticoagulant
infection
asthma
9.
Calan
verapamil
hypertension
angina
captopril
hypertension
10. Capoten
Reported Ocular Side Effects
Blepharoconjunctivitis, dry eye and transient blurry vision, possibly
due to change in refraction. May cause small, reversible
subepithelial corneal opacities. May be a weak cataractogenic agent,
and may lead to optic neuritis in some patients.
Blurred vision, ocular irritation, periorbital edema, and transient
blindness at peak therapeutic levels due to ischemia. In patients
also taking topical beta blockers, calcium channel blockers may
rarely cause arrythmia.
Ocular side-effects rarely occur but could include decreased
vision and mydriasis.
Affects the cornea (micro-deposits similar to choroquine toxicity
with whorl-like pigment in the subepithelial layers) and the lens
anterior subcapsular lens deposits along the visual axis), and optic
neuropathy or optic neuritis which can lead to blindness.
Very rare.
Can aggravate any ocular bleeding.
Very rare.
Increased intraocular pressure and posterior subcapsular cataract,
particularly in susceptible individuals and in patients on high
dosages.
Ocular side-effects include decreased vision, photosensitivity, and
visual hallucinations. Periorbital edema and lacrimation can also
occur. Eyelids and conjunctiva can demonstrate chemosis,
erythema, non-specific conjunctivitis, angioneurotic edema,
urticaria, purpura, erythema multiforme, and subconjunctival
hemorrhages secondary to drug-induced anemia. (1) Retinal
hemorrhages can also occur secondary to drug-induced anemia.
Rare ocular side-effects may include decreased vision,
conjunctivitis, photosensitivity, visual hallucinations, and
subconjunctival or retinal hemorrhages secondary to drug-induced
anemia. Eyelids also may have angioneurotic edema, brown
discoloration, blepharoconjunctivitis, urticaria, lupoid syndrome,
erythema multiforme, Stevens-Johnson syndrome, exfoliative
dermatitis, or pemphigoid lesion. (1)
Brand Name
11. Cardizem
Generic Name
diltiazem
Indication
hypertension,
angina, atrial
fibrillation
12. Ceclor
13. Ceflin
14. Celebrex
cefaclor
cefuroxime axetil
celecoxib
infection
infections
arthritis
15. Chloroquine
Aralen phosphate
anti-malarial
16. Cipro
ciprofloxacin
infection
17. Claforin
cefotaxime
infections
18. Claritin
loratidine
antihistamine
19. Combivir
Lamivudine
zidovudine
HIV
20. Coumadin
21. Depakote
warfarin
divalproex
22. Diprivan
propofol
anticoagulant
epilepsy and
migraine
anesthesia
23. Epogen
epoetin alfa
red blood cell
enhancer
Reported Ocular Side Effects
Blurred vision, ocular irritation, periorbitaledema, and transient
blindness at peak therapeutic levels due to ischemia. In patients
also taking topical beta blockers, calcium channel blockers may
rarely cause arrythmia.
Rarely may result in mild reversible ocular surface inflammation.
Rarely may result in mild reversible ocular surface inflammation.
Blurred Vision, Conjunctivitis
can affect the cornea (whorl-pattern opacity) lids and retina
(pigmentary degeneration or stippling or ottling of the macular
pigmented epithelium and may progress to a "bull's eye
maculopathy.
Patients may report increased glare or brightness of colors or lights.
In high doses, optic neuropathy may result.
Rarely may result in mild reversible ocular surface inflammation.
Visual side-effects are uncommon and frequently disappear even if
drug use is continued. Common causes of increased dry eye,
headache, drowsiness, dry mouth, conjunctivits and ocular pain.
May have a weak atropine-like action that can produce pupillary
changes. Long-term use can cause anisocoria, decreased
accommodation, and blurred vision. (1) These side-effects should be
considered when the drugs are prescribed for long periods of time
or for pre-presbyopes who could experience near vision problems.
Have been known to cause cystoid macular edema, hypertrichosis,
and color vision abnormalities, along with urticaria, rashes, and
vasculitis of the eyelids. Overdoses can cause eyelid and
conjunctival hyperpigmentation, diplopia, visual hallucinations, and
nystagmus.
Can increase the risk of severe conjunctival or retinal hemorrhaging.
Very rarely may lead to oculomotor disturbances. Link to RP
is unconfirmed.
Transitory visual disturbances, including blurry vision, diplopia, and
inability to open eyes.
Patients who are receiving hemodialysis and this drug may
experience visual hallucinations within two to 13 weeks after
starting the medication.
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Brand Name
24. Fortaz
25. Fosamax
Generic Name
ceftazidime
aledronate
Indication
infection
osteoporosis
Reported Ocular Side Effects
26. Humulin
insulin
27. Indocin
indometbacin
28. Intron A
interferon alpha-2b
29. lopamiron
iopamidol
imaging
Unilateral and bilateral loss of vision may occur for hours after
administration. Hallucinations may occur beginning 12 hours
after administration.
30. Isovue
iopamidole
imaging
31. Klonopin
clonazepam
epilepsy
Unilateral and bilateral loss of vision may occur for hours after
administration. Hallucinations may occur beginning 12 hours after
administration.
Side effects from benzodiazepine derivatives are rare, but the drugs
can cause decreased corneal reflex, decreased depth perception
and abnormal extraocular muscle movement. Can cause a
temporary allergic conjunctivitis and may cause pupillary dilatation
leading to the isolated narrow-angle attack.
32. Lamictal
Lamotrigine
seizures
Rarely may result in mild reversible ocular surface inflammation.
Ocular side-effects include blurred vision, conjunctival irritation
with a burning sensation or gritty sensation and/or increased
lacrimation, hyperemia, ocular pain, anterior uveitis, episcleritis,
and scleritis.
Rare. Can include decreased vision, nystagmus, paresis of
diabetes mellitus
extraocular muscles and diplopia due to iatrogenic hypoglycemia.
Ocular side-effects including transient blurred vision, corneal
arthritis, gout
toxicity (11 to 16% of patients), optic neuritis and pseudotumor
cerebri.(1) Since this medication can also be a photosensitizer with
an adverse effect on the macula, UV protection is recommended
for patients taking Indocin.
marrow transplants Transitory pain, growth of thick, curly eyelashes that require
trimming, mild disc edema in high dosage patients, and rarely,
spatial disorientation.
Clinical trials have shown that at least 40% of the side-effects
caused by Lamictal® were ocular. (18) Diplopia comprised 22% of
the complaints, 15% of patients had blurred vision, and about 5%
reported nystagmus. A few patients also had ptosis, hallucinations,
and pigmentary retinal defects.
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Brand Name
33. Lanoxin
Generic Name
Digoxin
Indication
congestive heart
failure
Reported Ocular Side Effects
34. Lipitor
Atorvastin
cholesterol
35. Lupron
leuprolide acetate
prostate cancer
endometriosis
36. Medrol
methylprednisolone cortisone therapy
37. Mellaril
thioridazine
anti-pyschotic
38. Methotrexate
methotrexate
arthritis, psoriasis
39. Motrin
ibuprofen
pain, fever, arthritis
May cause color vision disturbance,flickering or flashing lights,
colored spots, snowy, hazy or blurred vision, dimming vision and
heightened sensitivity to glare. Color vision testing may indicate a
reduction in both red-green and blue-yellow discrimination. These
ocular symptoms indicates life-threatening cardiac consequences
and should be reported to the physician or cardiologists.
Ocular side-effects occur in less than 2% of patients taking
Lipitor®(2) but include dry eye, blurred vision, hemorrhages, and
increased intraocular pressure.
Some patients experience blurry vision Endometriosis following
injection; may last from one hour to as long as three weeks. May
cause pseudotumor cerebri.
Affect the lens (posterior subcapsular cataract) and elevate
intraocular pressure, can cause extraocular muscle palsy,
periorbital chemosis and ptosis. prolonged use of corticosteroids
may induce glaucoma and increase the risk of secondary ocular
infections due to fungi or viruses.
Can cause pigmentary changes in the cornea, conjunctiva, and
anterior subcapsular cataracts may create retinal pigmentary
changes which can affect visual acuity, color vision and dark
adaptation.
Blepharitis, periorbitaI edema, conjunctival hyperemia, and
increased tearing or photophobia. The drug is found in the tears and
may cause ocular irritation, thus interfering with corneal and
conjunctival epithelial metabolism
The most common side-effect associated with this medication is
transient blurred vision. In a drug re-challenge test, there were also
documented reports of refractive error changes, diplopia,
photophobia, dry eyes, visual field changes, and altered color
vision. (1) Dry eye symptoms probably occur because the drug is
secreted in the tears and aggravates previously existing dry eyes. If
they occur, vision changes usually resolve after 1-3 months, but
color vision problems can take up to 8 months to resolve.
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Brand Name
40. Myambutol
Generic Name
Ethambutol
Indication
tuberculosis
Reported Ocular Side Effects
41. Neurontin
Gabapentin
epilepsy, nerve
pain
42. Nitrobid
Nitrostat
nitroglycerin
angina
43. Nolvadex
tamoxifen
breast cancer
44. Norvasc
Amlopidipine
hypertension
Ocular side-effects can include decreased vision,
conjunctivitis, photosensitivity reactions, visual hallucinations,
and subconjunctival and retinal hemorrhages. Fortunately,
these side-effects occur in less than 1% of patients taking
calcium channel blockers
45. Ortho-Novum
norethindrone
mestranol
contraception
Women taking these drugs have a higher incidence of migraine,
thrombophlebitis and psuedotumor cerebri than normal. May
decrease tolerance to contact lenses. May be other side effects,
but they await further documentation.
46. Plaquenil
hydroxychloroquine arthritis, Iupus
Affects the optic nerve triggering optic neuritis (retrobulbar
neuritis) and blindness.
Visual disturbances may occur as a side-effect within a few days of
starting Neurontin®, but patients often improve within 7-10 days
while still on the usual dosage. Eight to 11% of patients taking
Neurontin® complain of nystagmus and 6°/o report diplopia. There
are also reports of macular edema, optic neuritis and visual field
changes associated with this drug; however field changes have not
been confirmed.
If side-effects do occur, they can include
decreased vision, variable 10P, vasodilation of the conjunctiva or
retina, colored haloes around lights, exfoliative dermatitis around
the eyelids, papilledema secondary to pseudotumor cerebri, and
hallucinations.
Six percent of all patients develop keratopathy or retinopathy.
Keratopathy appears as whorl-like subepithelial deposits; it usually
is reversible. Retinopathy may include edema, hemorrhage, optic
disc swelling and vision loss. After one or more years of dosage
with 100 mg/day or more, patients may develop tamoxifen
retinopathy, manifesting as striking white-to-yellow refractile bodies
around and temporal to the macula. Patients should have baseline
eye exams before beginning this drug.
Can affect the cornea (whorl-pattern opacity) lids and retina
(pigmentary degeneration or stippling or ottling of the macular
pigmented epithelium and may progress to a "bull's eye
maculopathy.
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Brand Name
47. Prednisone
Generic Name
prednisone
Indication
cortisone therapy
48. Premarin
estrogen
hormone
replacement
therapy
49. Prilosec
omeprazole
ulcers, gerd
50. Procardia
nifedipine
hypertension,
angina
51. Procrit
epoetin alfa
red blood cell
enhancement
52. Proventil
albuterol
asthma
53. Prozac
fluoxetine
depression
54. Pulmicort
budesonide
asthma
55. Quinine
quinine
leg cramps
56. Retrovir
zidovudine
HIV
Reported Ocular Side Effects
affect the lens (posterior subcapsular cataract) and elevate
intraocular pressure, can cause extraocular muscle palsy, periorbital
chemosis and ptosis. Prolonged use of corticosteroids may induce
glaucoma and increase the risk of secondary ocular infections due
to fungi or viruses.
May report increased symptoms of dry eyes, corneal sensitivity,
water retention including corneal edema and contact lens
intolerance.
Ocular side-effects include visual hallucinations and vertigo, which
occur in less than I% of patients.
Transient blindness at peak levels, blurred vision, ocular irritation
with periorbital edema. Causes side effects more often than other
calcium-channel blockers. Rarely, patients taking ocular betablockers in addition to this drug experience arrhythmia.
Patients who are receiving hemodialysis and this drug may
experience visual hallucinations within two to 13 weeks after starting
the medication.
Seldom clinically significant, though patients have reported vivid
hallucinations following administration.
Rare and reversible. Some evidence suggests the drug can cause
mydriasis leading to narrow angle glaucoma. Blurred vision may
occur but is usually not significant.
High dosage over an extended period significantly increases the
risk of ocular hypertension. Can lead to subcapsular cataract.
Ocular side-effects can include decreased vision, retinal changes,
and optic nerve damage.
Probably causes CME, definitely can cause hypertrichosis and skin
rashes. Hyperpigmentation of eyelids and conjunctiva reported in
heavily pigmented patients. Diplopia may occur secondary to a
generalized myopathy.
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Brand Name
57. Rifampin
Generic Name
Rimactane
Indication
tuberculosis
Reported Ocular Side Effects
58. Rocephin
ceftriaxone
infection
59. Sandimmune
cyclosporine
anti-rejection
60. Synthroid
levothyroxine
hypothyroid-ism
61. Tagamet
cimetidine
ulcers
62. Tamoxifen
nolvadex
anti-neoplastic
63. Tegretol
carbamazepine
epilepsy
64. Tenormin
Tenoretic
atenolol
hyperten-sion
angina, myocardial
infarction
65. Thorazine
chlorpromazine
anti-pyschotic
Can change tears, sweat, saliva,urine, feces and contact lenses a
red-orange color.
Rarely may result in mild reversible ocular surface inflammation.
Systemic: Severe ocular pain without any evidence of ocular
abnormality, severe visual hallucinations, reversible cortical
blindness, optic disc edema Topical ocular 2% solution (still
investigational in U.S.): eyelid irritation, superficial punctate
keratitis, ocular pain w/ or w/o hyperemia, eyelash proliferation and
possibly reactivation of stromal herpes simplex keratitis.
CNS effects, including hallucination, may occur in thyroid patients
with underlying psychiatric disorders. Pre- and peri-pubescent
children may be susceptible to pseudotumor cerebri.
Uncommon, but can include transient myopia, perception of yellow
or pink tinge to objects, and dry eye symptoms. There have been
isolated reports of angle closure glaucoma and visual hallucinations.
Can cause maculopathy with bilateral, superficial, yellow-white
crystalline, ringlike deposits, causing vision loss and central fields
abnormalities.
Diplopia, blurry vision, a "heavy feeling in the eyes." Effects are
most common when dosage exceeds 1.2g. About a fourth of all
patients develop neurologic or hematopoietic reactions; the
former can lead to ocular effects such as downbeat nystagmus.
Beta blockers can cause visual disturbances and vivid
hallucinations and increase myocardial infarction migrainous
scotomata. They can worsen myasthenia gravis and occasionally
cause extraocular paresis and diplopia. They can decrease tear
secretion.
Can cause pigmentary changes in the cornea, conjunctiva, and
anterior subcapsular cataracts.
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Brand Name
66. Topamax
Generic Name
topiramate
Indication
epilepsy, nerve
pain
Reported Ocular Side Effects
67. Toprol XL
metoprolol
succinate
hyperten-sion,
angina
68. Transdermnitro
nitroglycerin
angina
69. Unasyn
ampicillin,
sulbactam
infection
70. Valium
diazepam
anxiety
71. Vasotec
Vaseretic
Enalapril
Enalapril/htcz
72. Ventolin
albuterol sulfate
Hypertension
heart failure left
ventricular
dysfunction
asthma
73. Versed
midazolam
anesthesia
74. Viagra
sildenafil
erectile dysfunction
75. Videx
didanosine
HIV
Associated with an acute onset of myopia presumably due to ciliary
body edema, which causes zonule relaxation and an induced
myopic shift. Headaches, eye pain, and decrease acuity, most of
which occurred within one month of starting the medication.
Topamax® can also affect i ntraocular pressure.
This is a new drug, but other beta blockers have caused visual
disturbances and vivid hallucinations, worsened myasthenia gravis,
decreased tear secretion and decreased intraocular pressure.
Uncommon. Theoretically has potential to precipitate angle-closure
glaucoma.
May cause allergic skin reactions and unmask or aggravate the
symptoms of myasthenia gravis.
Dry Eye Syndrome
Rare, seldom clinically significant. The most common side effect
may be angioneurotic edema around the eyes, typically occurring
within three weeks after starting the drug. All reactions are
reversible with discontinued drug use.
Seldom clinically significant. Rarely, patients may experience vivid
hallucinations.
Side effects from benzodiazepine derivatives are rare, but the drugs
can cause decreased corneal reflex, decreased depth perception
and abnormal extraocular muscle movement. Can cause a
temporary allergic conjunctivitis and may cause pupillary dilatation
leading to the isolated narrow-angle attack.
Ocular side-effects include bluish tinge to the field, hypersensitivity
to light, and hazy vision. Reports of blindness are under
investigation.
Ocular side-effects include retinal changes such as RPE mottling
and atrophy, night blindness, and optic neuritis.
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Brand Name
76. Xanax
Generic Name
alprazolam
Indication
anxiety
77. Zantac
rantidine
ulcers
78. Zoloft
sertraline
depression
79. Zovirax
acyclovir
herpes
80. Zyrtec
antihistamine
Reported Ocular Side Effects
Side effects from benzodiazepine derivatives are rare, but the drugs
can cause decreased corneal reflex, decreased depth perception
and abnormal extraocular muscle movement. Can cause temporary
allergic conjunctivitis and may cause pupillary dilatation leading the
isolated narrow-angle attack.
Uncommon; typically occur only in young children or severely ill
elderly patients. Can include decreased vision, erythema,
conjunctivitis, angioneurotic edema and urticaria of the lids and
conjunctiva, hallucinations, color vision defects and subconjunctival
or retinal hemorrhages secondary to drug-induced anemia.
Ocular side-effects include eye pain, conjunctivitis, and
accommodation problems.
Rare. May cause periocular edema. May increase ocular irritation
in keratoconjunctivitis sicca patients.
Visual side-effects are uncommon and frequently disappear even if
drug use is continued. Common causes of increased dry eye,
headache, drowsiness, dry mouth, conjunctivits and ocular pain.
May have a weak atropine-like action that can produce pupillary
changes. Long-term use can cause anisocoria, decreased
accommodation, and blurred vision.(l) These side-effects should be
considered when the drugs are prescribed for long periods of time
or for pre-presbyopes who could experience near vision problems.
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