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