Ocular ADRs
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
- compiled & published by Dr Dhaval Patel MD AIIMS
