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Drug-Induced Oculotoxicity!

 DRUG-INDUCED OCULOTOXICITY

  • Occasionally, non-specific blurred vision occurs with almost all the drugs.
  • The drugs listed below are associated with a specific pattern of drug-induced oculotoxicity when administered systemically:


1. Allopurinol:

Despite the discovery of Allopurinol in cataractous lenses taken from patients on long term (>2 years) therapy, there is no clinical evidence for an increased risk of cataracts in allopurinol-treated patients.

2. Beta-Adrenergic Blocking Agents:

  • A reduction in tear production occurs, which can produce a hot, dry, gritty sensation in the eyes.
  • This is rapidly reversible with drug discontinuation.

3. Contraceptives, (Oral):

  • A variety of retinal vascular disorders have been occurred due to oral contraceptives, but the association remains unproved.
  • Some oral contraceptives users cannot tolerate contact lenses, possibly because of ocular edema or dryness. However, a prospective study failed to show any difference in lens tolerance between oral contraceptive users and non-users.

4. Sympathomimetic Agents:

  • These drugs can dilate the pupil and precipitate narrow-angle glaucoma.
  • Sympathomimetics with marked alpha-adrenergic activity Epinephrine, Phenylpropanolamine, should be avoided.
  • Large doses taken orally, or the drugs applied topically are at higher risk.

5. Gold Salts:

  • Parenteral gold can produce microscopic crystalline deposits in the cornea, most commonly in superficial layers.
  • These deposits are dose-related and rarely occur until the dosage of parenteral gold exceeds 1g.
  • The deposits slowly resolve after drug discontinuation, do not affect vision.
  • Auranofin does not produce these ocular effects.


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