Download Can My Medications Cause Visual Problems?

Can My Medications Cause Visual Problems?
Course Description:
This course will inform attendees about the 10 most common systemic medications that
can cause vision problems, what specific visual side effects these medications have and
how to minimize visual loss while taking these medications.
Course Objectives:

You will learn the importance of reviewing your patient’s medical health history, what
medications they're taking, and how those medications may increase their risk of developing
certain eye problems.

You will gain an understanding of why, in certain systemic illnesses like diabetes mellitus
and cardiovascular disease, the signs of these diseases are visible in or around the eyes long
before symptoms appear.

You will learn the importance of catching visual problems early and monitoring your
patients regularly in order to prevent permanent damage to their vision and eye health.
Course Outline
I. What are the Top 10 systemic medications with visual side effects
A. Acne Medication-Isotretinoin (5 mins)
1. Brand names
a. Acutane-most common
b. Amnesteem
c. Claravis
d. Sotret
2. Uses- Treatment of severe acne that hasn’t responded
to other treatments
3. Visual Side Effects
a. Dry eyes-mild to severe
b. Sudden decrease in night vision
4. Prevention
a. Annual eye exam
B. Antihistamines
(5 mins)
1. Brand names
a. Claritin
b. Zyrtec
c. Benadryl
2. Uses
a. Relieves hay fever/allergy symptoms
b. Reduces inflammation due to allergic reaction
3. Mechanism of action
a. Blocks histamines produced by the body that cause a runny nose,
watery eyes, sneezing, itching, inflammation due to allergic
reaction
4. Visual Side Effects
a. Angle-closure glaucoma occurs when the pressure inside
the eye increases rapidly.
1. Symptoms
a. Headache
b. Severe eye pain
c. Nausea and vomiting
d. Blurred vision
e. Seeing halos around lights
5. Prevention
a. Avoid Mydriatics
b. Avoid Anticholinergics/Antispasmodic medications which may
include scopolamine patches for sea sickness and drugs that
calm diarrhea and muscle spasms in people with gastrointestinal
problems.
C. Anti-Malarials
(5 mins)
1. Generic and brand names
a. Hydroxychloroquine (Plaquenil, Quineprox)
b. Chloroquine (Aralen)
2. Uses
a. Treat rheumatoid arthritis and lupus
b. Prevent or treat malaria
3. Visual Side Effects
a. Retinal toxicity, leading to permanent vision loss.
"Plaquenil toxicity of the retina is typically dose related,"
4. Prevention
a. Vision exam as baseline prior to treatment
b. Specific tests at annual exams
D. Corticosteroids (5 mins)
1. Generic name
a. Prednisone
2. Uses
a. Treat conditions such as arthritis, lupus, psoriasis
b. Treat severe allergies, ulcerative colitis, breathing disorders
c. Others
3. Visual Side Effects
a. Cataract
b. Glaucoma
c. Elevation in IOP
4. Prevention
a. Call your doctor right away if develop eye pain, halos
around lights, or blurred vision.
b. Comprehensive eye exam annually- check for GLA and CATs
E. Erectile Dysfuntion Meds (5 mins)
1. Brand names
a. Viagra
b. Cialis
c. Levitra
2. Uses
3. Visual Side Effects
a. Blurred vision,
b. Sensitivity to light
c. Seeing a temporary blue tinge to objects
d. Commercials for these drugs also warn of sudden vision loss
e. Non Arteritic Anterior Ischemic Optic Neuropathy ??
4. Prevention
a. Call doc if notice vision change
b. Annual eye exams
F. Ethambutol
(5 mins)
1. Brand Name
a. Myambutol
2. Uses
a. Antibiotic used to treat tuberculosis (TB)
3. Visual Side effects
a. Decrease in visual acuity or clarity
b. Difficulty seeing certain colors
c. Optic Nerve problems
4. Prevention
a. Call doc if notice visual changes or change to color vision
b. Annual eye exams
G. Flomax (5 mins)
1. Generic name
a. Tamsulosin
2. Uses
a. Men with an enlarged prostrate with difficulty urinating
b. Alpha blockers which work by relaxing certain muscles
3. Visual side effects
a. Builds up in the iris which can prevent the pupil from dilating
b. IFIS-intraoperative floppy iris syndrome during cataract surgery
4. Prevention
a. Males make sure to tell cataract surgeon if considering cataract surgery
b. Annual eye exams
H.
Phenothiazines (5 mins)
1. Generic names
a. Thorazine
b. Mellaril
2. Uses
a. Antipsychotics to treat schizophrenia and other mental illness
3. Visual side effects
a. Sensitivity to light
b. Color vision changes
c. Difficulty with night vision
d. Pigment changes on the lens
4. Prevention
a. Keep on lowest dosage possible
b. Avoid long term use
c. Annual eye exams
I. Tamoxifen
( 5 mins)
1. Generic names
a. Soltamox
b. Nolvadex
2. Uses
a. Anti-estrogen drug to treat breast cancer
3. Visual side effects
a. Crystalline retinopathy
b. Functional and anatomical changes to the retina
c. Blurred vision
d. Corneal changes
e. Increased risk of cataracts
4. Prevention
a. Annual eye exam
J. Topiramate
( 5 mins)
1. Brand names
a. Topamax
2. Uses
a. Anti-convulsant to treat seizure disorders
b. Prevention of migraine Has
3. Visual side effects
a. Angle-closure GLA- medical emergency
i. Sudden vision change
ii. Blurred or double vision
iii. Headache pain around the eyes
4. Prevention
a. Seek immediate treatment if experience symptoms