Drugs causing ocular toxicity
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Drugs causing ocular toxicity
- 2. 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
- 3. Toxicity may be of minor complications like Conjunctivitis Medicamentosa or aplastic anemia death
- 4. 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
- 5. OCULAR MANIFESTATION OF SYSTEMIC MEDICATION
- 6. ANTI-INFECTIVE AGENTS: DRUG SIDE EFFECTS • CHLORAMPHENICOL >>>>> optic neuritis central scotoma rare toxic amblyopia • ETHAMBUTOL >>>>> inflammation of optic disc,nerve,tract color vision disturbance
- 7. • 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
- 8. • GRISEOFULVIN >>>>> macular degeneration macular oedema papilloedema pseudotumour cerebri photosensitivity • TETRACYCLINES >>>>> blurring of vision diplopia rare, papilloedema reversible pseudo tumour cerebri • STREPTOMYCIN >>>>> optic neuritis
- 9. 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
- 10. • 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
- 11. 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
- 12. • OXYPHENBUTAZONE >>>>> conjunctival and corneal scarring • PHENYLBUTAZONE >>>>> steven-Johnson syndrome • TOIMETIN >>>>> toxic amblyopia diplopia • GOLD SALT >>>>> corneal deposits reversible • ACETAMINOPHEN >>>>> steven-Johnson syndrome
- 13. CARDIOVASCULAR : DRUGS SIDE EFFECTS • AMIODARONE >>>>> corneal deposit lens opacities reversible conjunctival hyperemia • VASODILATOR-HYDRALAZINE >>>>> lacrimation conjunctivitis very rare • QUANITHIDINE >>>>> ptosis
- 14. NERVOUS SYSTEM: DRUGS SIDE EFFECTS • PENTAZOCINE >>>>> miosis hallucination • PHENACETIN >>>>> xanthopsia • ANTICHOLENERGICS >>>>> mydriasis problem in accommodation reversible raise in IOP in angle closure glaucoma
- 15. ANTI CONVULSANT: DRUGS SIDE EFFECTS • PHENYTOIN >>>>> nystagmus diplopia frequent weakness of accommodation and convergence reversible • TRIMETHADIONE >>>>> glare in bright light fading of colors reversible
- 16. 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
- 17. ANTI-PARKINSONISM DRUG: DRUGS SIDE EFFECTS • AMANTADINE >>>>> visual hallucination frequent in elders reversible • BENZTROPINE >>>>> blurring of near vision dilatation of pupil
- 18. BENZODIAZEPINES & DERIVATIVES: DRUGS SIDE EFFECTS • CHLORDIAZE POXIDE HCL >>>>> blurred vision reversible with overdose diplopia irreversible • CLORAZEPATE DIPOTASSIUM >>>>> nystagmus DIAZEPAM diplopia allergic conjunctivitis
- 19. HYPONOTICS: DRUGS SIDE EFFECTS • FENFLURAMINE >>>>> dilatation of pupil • KETAMINE >>>>> visual hallucination rare nystagmus reversible
- 20. 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
- 21. HORMONES: DRUGS SIDE EFFECTS • CONTRACEPTIVES >>>>> retinal haemorrhages papilloedema corneal edema & swelling rare nystagmus
- 22. THANK YOU