Over the last two decades, prescription drug use has grown in the U.S. from an average of 7.3 prescriptions per person in 1992, to 11.6 per person in 2002, to 12.6 per person in 2009 (the latest statistic).

Along with increasing prescription drug use come many adverse symptoms that affect the eyes. When diagnosing symptoms, it is helpful to know what medications a patient is taking to properly identify the cause and prescribe the best treatment.

Following are the top 10 most commonly prescribed systemic drug classes and their ocular side effects:

Analgesics (ie Vicodin/Ibuprofen) – dry eye, diplopia (double vision), mydriasis, retinal hemorrhages, decreased vision, light sensitivity, eye pain

Antihyperlipidemics (Niacin/Zocor) – dry eye, lid edema, diplopia, retinal edema of the macula

Diuretics (Hydrochlorothiazide) – dry eye, conjunctivitis, retinal edema, choroidal effusion, decreased focusing ability (accommodation), reduced intra-ocular pressure, decreased vision, acute angle closure glaucoma

Beta Blockers (Atenolol) – dry eye, Ptosis (droopy eye), diplopia, retinal hemorrhages secondary to induced anemia, decreased intra-ocular pressure, light sensitivity and eye pain

Acid Reflux (Cimetidine) – redness of the conjunctiva, spontaneous anterior chamber hyphema (blood in the anterior chamber), decreased focusing ability

Antibiotics (Zithromax/Tetracyclines) – dry eye, pigment deposits on eyelids and conjunctiva, keratitis (corneal inflammation), intracranial hypertension

Antibiotics (Sulfonamides) – tearing, conjunctival swelling, loss of eyelashes or eye brows, keratitis, uveitis (inflammation of iris or choroid), optic neuritis, color distortion, blurred vision, angle closure glaucoma

Hyperglycemics (Glipizide, Metformin) – double vision, extra-ocular muscle paresis, reduced focusing, optic neuritis, forward placement of lens diaphragm

Thyroid Replacement (Synthroid) – redness of the conjunctiva, blurred vision, light sensitivity, open angle glaucoma

Anti-anxiety (Ambien) – double vision, reduced focusing, eye irritation, eye pain, inflammation of the sclera, light sensitivity, conjunctivitis (redness of eye)

One can see by this list that many prescription and over the counter medications can have significant ocular side effects.

When you are seen for an eye examination, make sure to bring a complete list of your medications with you. No drug–prescription or over the counter – is insignificant,  so be sure to list them all. Your examination findings may be related to your systemic medication, and your doctor will be better informed to properly diagnose and treat you.

Dr. Evans is the founding owner of Evans Eye Care in Palm Desert and can be reached at 760.674.8806.

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