drugs that require eye exam

Introduction

Includes:

• amiodarone (Cordarone)
  • corneal deposits
    • occur in ~70% of patients on amiodarone
    • may result in vision loss
  • optic neuritis
  • optic neuropathy
  • optic neuropathy &/or neuritis may occur any time after starting amiodarone (2% of patients on amiodarone) visual impairment & blindness can result
  • photosensitivity
  • patients taking amiodarone should have a baseline eye exam & eye exams every 6-12 months
  • patients should call provider if visual disturbances
• chloroquine (Aralen), hydroxychloroquine (Plaquenil)
  • blurred vision
  • contact lens intolerance
  • corneal deposits
  • retinopathy
  • dose-related, occurs with long-term therapy
  • retinal changes & visual disturbances may progress after drug is stopped
  • baseline & eye exams every 3-6 months
  • discontinue for any visual disturbances
• ethambutol (Myambutol, Etibi)
  • color vision changes
  • optic neuropathy
    • may be related to dose and duration of treatment
    • generally reversible when ethambutol is stopped
    • may continue to progress for 1-2 months after discontinuation
    • recovery may be delayed for > 1 year
    • irreversible blindness has been reported
  • visual field defects
  • eye exams at baseline & periodically thereafter
    • patients on > 15 mg/kg/day should have monthly eye exams
  • notify provider of any vision changes
• isotretinoin (Accutane), vitamin A1
  • cataracts
  • conjunctivitis
  • corneal opacities
    • dose-related & resolve in a couple of months after therapy is stopped
  • decreased night vision may persist after therapy is stopped
  • pseudotumor cerebri (intracranial hypertension)
  • papilledema
  • photophobia
  • reduced tolerance to contact lenses
  • visual changes are dose related
  • stop retinoid if any visual difficulties or headaches, with eye exam to rule out papilledema secondary to intracranial hypertension
  • periodic eye exams if oral retinoid therapy for >= 6 months
• linezolid (Zyvox, Zyvoxam)
  • optic neuropathy
    • decreased vision & color vision, visual field defects
  • reported cases occurred after 5-11 months of therapy
  • symptoms improve after discontinuation
  • eye exam if treatment for >= 3 months
• vigabatrin (Sabril)-Canada only
  • optic atrophy
  • optic neuritis
  • peripheral constriction of visual field
    • occurs in ~ 30% of patients
    • usually occurs in the first 4 years of treatment
  • mechanism may be retinal toxicity from elevated levels of GABA
  • visual field defects are likely permanent even after stopping vigabatrin
  • visual field examinations before or soon after starting vigabatrin are recommended, then every 3 months thereafter
• voriconazole (Vfend)
  • optic neuritis
  • papilledema
  • ocular adverse effects have occurred mainly in severely ill patients
  • if administration > 28 days, visual function should be monitored

More general terms

• drugs with adverse ocular effects

Additional terms

• drug-induced eye disease
• pharmaceutical herbs with adverse ocular effects