The use of certain medicines for other disorders may sometimes mildly to seriously affect the eyes. It is important for patients to discuss their medical histories with the physician, as this can help the physician determine which medicines are to be prescribed. Despite the limitations or possible side effects associated with the use of certain medicines, there is no reason for alarm. Advice: consult your physician when you experience negative side effects and develop eye complaints caused by the use of certain medicines. Perhaps there are other treatments with fewer side effects.

Hypertension and urinating problems with men suffering from prostate enlargement are treated with alpha-blockers. These alpha-blockers may cause the intraoperative floppy iris syndrome, an eye disorder that occurs during cataract surgery. This medicine affects the smooth muscles that widen the iris as a result of which the pupil is often not properly widened. As the pupil often spontaneously shrinks, this makes surgery more difficult.

amiodarone (cordarone, pacerone) is a medicine applied by the physician when treating some heart disorders, such as irregular heart rhythms and heart spasms. As a result of taking amiodarone, the patient develops small sediments in the cornea, the lens, the retina and the optic nerve. In by far the most situations this medicine will not cause any serious trouble with visual acuity. However, lens opacity may occur. In case of prolonged use of this heart medication, various infections of the cornea and the nerve may develop. However, generally few problems are to be expected in connection with the eyesight. Eventually, the characteristic injuries and its possibly associated symptoms will disappear when the patient stops taking the medication.

This medicine will be applied by the physician in anaesthesia, because this will relax the muscles of the patient more quickly and decreases the production of saliva. Additionally, this medicine is used with all kinds of diseases and symptoms, e.g. instance neurological disorders, lung diseases, hypertension, etc. When taking this medicine, the eyesight of the patient will be a bit hazy because of its effect on the accommodation muscles. Also with some patients the pupils will widen, which in case of a shallow anterior chamber can trigger an attack of acute angle-closure glaucoma.

Antihistamines are medicines prescribed by the physician in connection with many disorders, including hypersensitivity reactions. Here think of conjunctivitis in the eye, heartburn and autoimmune disorders. When taking this medicine, the patients has an increased chance of developing glaucoma.

Anti-allergy eye drops often contain a local antihistamine (histamine is the by nature in the body produced transmitter, which often causes an allergic reaction). Eye drops containing antihistamine work well in case of conjunctivitis caused by an allergic reaction. However, with some people they can cause not only red, burning and red eyes, but also blurred vision, light sensitivity and an increased production of tear-water.

Antimalaria medicines
Patients with malaria often benefit from the medicine chloroquine. Hydroxychloroquine can be applied in case of similar clinical symptoms and when treating various collagen disorders, such as systemic lupus erythematosus. When a patient regularly takes these medicines for a longer time, opacity of the cornea will get blurred (corneal opacity) and changes in the macula will occur. These may go together with deterioration of the vision. The medicine hydroxychloroquine has the same side effects, though with a lower frequency in case of a normal dosage. This may also lead to a distorted view or problems when reading or carrying out precise visual tasks. The visual acuity usually is fine. Possible other symptoms caused by these medicines are a lazy eye, acute blindness, paralysis of the accommodating muscle in the eye, double view, seeing dark images, hypersensitivity for light, red eyes or seeing yellow flashing lights or green circles.

Anticoagulants slow down the blood clotting and prevent blood clots. Examples of anticoagulants are aspirin, clopidogrel (Plavix), warfarin (Coumadin), heparin, etc. Generally, anticoagulants lead to very few ocular side effects. They do not cause subconjunctival haemorrhages (bleedings below the conjunctival membrane), but they may lengthen the bleeding time of this type of bleedings in the eye. In some cases the patient stops taking this type of medication before undergoing eye surgery. Besides, frequent use of aspirin increases the risk of age-related macula degeneration. This risk grows as the patient takes more aspirin.

Bisphosphonates are medicines taken by the patient for various bone disorders, such as cancer disseminated to the bones, Paget’s disease (chronic infection of the bone) and osteoporosis (loss of bone mass with the risk of bone fractures). Also cancer patients suffering from hypercalcaemia (increased calcium content in the blood) may benefit from this medicine. When taking bisphosphonates, sometimes the eye socket may become infected and uveitis and scleritis are side effects as well. The side effects will disappear when the patient stops taking the medication. Other symptoms are hazy vision, pain in the eye, conjunctivitis and bilateral anterior uveitis.

Corticosteroids are very strong, anti-inflammatory medicines, which are, for instance, applied by the physician in case of various disorders, such as anaemia, arthritis, asthma, chronic obstructive pulmonary disease (COPD), leukaemia, systemic lupus erythematosus and urticaria (skin disease with itchy nodules on the skin surface). The patient also uses corticosteroids as a replacement for the hormone produced by the cortex of the suprarenal glands when the patient does not produce this him/herself. When the patient takes these medicines for a longer period, this will lead to chronic open-angle glaucoma and cataract (a blurred eye lens). Also decreased visual acuity may occur as a result of taking this medicine. As these complications may lead to serious loss of vision, the patient taking these medicines for a long time will go to the ophthalmologist two to four times a year for an extensive eye test. In case of pain, discharge of the eye, photophobia (hypersensitivity for light) or redness an eye test will be done as soon as possible.

Tranquillizers such as Valium, Lorazepam and Temesta are sedatives. When regular taken, these will reduce the production of tear fluid. As a result of this, the patient will have dry eyes or the eyes are more irritated.

Vitamin A
In many cases vitamin A promotes a proper functioning of the retina of the eye. However, taking too much vitamin A can be harmful. A large intake of vitamin A or food products with a high vitamin A content (e.g. liver or cod liver oil), will cause pseudotumor cerebri (increased pressure in the skull). This means that the patient will have an increased pressure of the fluid around the brain (increased intracranial pressure). All this will lead to visible swelling of the optic nerve and can cause symptoms, such as headache and visual disorders.

Some preparations may lead to visual problems, burning eyes and sometimes increased light sensitivity. In rare cases they also can cause discolouring of the cornea. The symptoms will disappear after the treatment with antibiotics.

The often used non-steroid antirheumatics (NSAIDs), including the medicines containing acetylsalicylic acid, diclofenac or ibuprofen, may in rare cases cause blurred vision or double view. Some painkillers will make the pupils smaller. This decreases the eyesight, especially in the dark.

Source: Mens en Gezondheid, Zeiss Oogzorg