While we often think of medications as targeting specific areas of the body, some oral drugs can unexpectedly affect our eyes. Ocular side effects can range from mild and reversible to severe and permanent. Being aware of these potential risks is crucial for early detection and prevention of long-term vision problems.
Below are some examples of commonly prescribed oral medications known to have ocular complications, their potential effects, and what to watch for.
1. Hydroxychloroquine (Plaquenil)
Use: Commonly prescribed for autoimmune diseases like lupus and rheumatoid arthritis.
Ocular Risk: Retinal toxicity, specifically bull’s-eye maculopathy.
What to Watch For:
- Blurred vision
- Difficulty reading
- Changes in color vision
- Central vision loss
Monitoring: Baseline eye exam and annual screening after 5 years of use, or earlier with high-risk patients.
2. Isotretinoin (Accutane)
Use: Severe acne.
Ocular Risk:
- Dry eyes
- Blepharoconjunctivitis
- Decreased night vision
- Rare cases of optic neuritis and corneal opacities
What to Watch For:
- Gritty or burning eye sensation
- Difficulty seeing at night
- Sudden vision changes
Monitoring: Inform patients of symptoms; use lubricating drops as needed; regular eye exams if on long-term therapy.
3. Topiramate (Topamax)
Use: Epilepsy, migraines, mood stabilization.
Ocular Risk: Acute angle-closure glaucoma, nearsighted shifts.
What to Watch For:
- Sudden onset eye pain
- Blurred vision
- Headache
- Red eye
Monitoring: Urgent ophthalmic evaluation if symptoms occur, particularly in the first few weeks of treatment.
4. Tetracyclines (e.g., Doxycycline)
Use: Infections, acne, rosacea.
Ocular Risk: Intracranial hypertension leading to papilledema (swelling of the optic nerve).
What to Watch For:
- Headache with visual disturbances
- Blurred or double vision
- Visual field loss
Monitoring: Immediate cessation if symptoms appear; neuro-ophthalmic evaluation may be needed.
5. Amiodarone
Use: Cardiac arrhythmias.
Ocular Risk:
- Vortex keratopathy (corneal deposits)
- Optic neuropathy (can be irreversible)
What to Watch For:
- Halos around lights
- Blurred vision
- Decreased visual acuity
Monitoring: Regular ophthalmic exams; report any vision changes promptly.
Conclusion:
These are just a few examples of the many oral medications that come with potential ocular side effects, often overlooked. Timely recognition and monitoring are essential to prevent irreversible damage. Patients should report any vision changes to their healthcare providers immediately, and physicians should maintain a high index of suspicion, especially with long-term use of high-risk drugs.
Remember: Eyes may be the windows to more than just the soul—they’re often early warning signs of systemic side effects!
We are happy to help! Please call our office with any questions! 770.926.2858