drugs causing ocular toxicity
TRANSCRIPT
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DRUGS CAUSING OCULAR TOXICITY
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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
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Toxicity may be of minor complications like
Conjunctivitis
Medicamentosa or aplastic anemia
death
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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
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OCULAR MANIFESTATION OF SYSTEMIC MEDICATION
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ANTI-INFECTIVE AGENTS:
DRUG SIDE EFFECTS
• CHLORAMPHENICOL >>>>> optic neuritis
central scotoma rare
toxic amblyopia
• ETHAMBUTOL >>>>> inflammation of optic disc,nerve,tract
color vision disturbance
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• 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
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• GRISEOFULVIN >>>>> macular degeneration
macular oedema
papilloedema
pseudotumour cerebri
photosensitivity
• TETRACYCLINES >>>>> blurring of vision
diplopia rare,
papilloedema reversible
pseudo tumour cerebri
• STREPTOMYCIN >>>>> optic neuritis
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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
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• 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
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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
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• OXYPHENBUTAZONE >>>>> conjunctival and corneal scarring
• PHENYLBUTAZONE >>>>> steven-Johnson syndrome
• TOIMETIN >>>>> toxic amblyopia
diplopia
• GOLD SALT >>>>> corneal deposits reversible
• ACETAMINOPHEN >>>>> steven-Johnson syndrome
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CARDIOVASCULAR :
DRUGS SIDE EFFECTS
• AMIODARONE >>>>> corneal deposit
lens opacities reversible
conjunctival hyperemia
• VASODILATOR-HYDRALAZINE >>>>> lacrimation
conjunctivitis very rare
• QUANITHIDINE >>>>> ptosis
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NERVOUS SYSTEM:
DRUGS SIDE EFFECTS
• PENTAZOCINE >>>>> miosis
hallucination
• PHENACETIN >>>>> xanthopsia
• ANTICHOLENERGICS >>>>> mydriasis
problem in accommodation reversible
raise in IOP in angle closure glaucoma
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ANTI CONVULSANT:
DRUGS SIDE EFFECTS
• PHENYTOIN >>>>> nystagmus
diplopia frequent
weakness of accommodation and convergence reversible
• TRIMETHADIONE >>>>> glare in bright light
fading of colors reversible
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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
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ANTI-PARKINSONISM DRUG:
DRUGS SIDE EFFECTS
• AMANTADINE >>>>> visual hallucination frequent in elders
reversible
• BENZTROPINE >>>>> blurring of near vision
dilatation of pupil
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BENZODIAZEPINES & DERIVATIVES:
DRUGS SIDE EFFECTS
• CHLORDIAZE
POXIDE HCL >>>>> blurred vision reversible with overdose
diplopia irreversible
• CLORAZEPATE
DIPOTASSIUM >>>>> nystagmus
DIAZEPAM diplopia
allergic conjunctivitis
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HYPONOTICS:
DRUGS SIDE EFFECTS
• FENFLURAMINE >>>>> dilatation of pupil
• KETAMINE >>>>> visual hallucination rare
nystagmus reversible
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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
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HORMONES:
DRUGS SIDE EFFECTS
• CONTRACEPTIVES >>>>> retinal haemorrhages
papilloedema
corneal edema & swelling rare
nystagmus
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THANK YOU
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DONE BY
V.YOGAPRIYA