Chapter 37
Ocular Toxicology
F.W. FRAUNFELDER and F.T. FRAUNFELDER
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Adverse reactions to medicines used for ocular disease can occur both in the eye itself and in other organ systems. Whether the drug is administered locally or systemically, side effects are varied and often difficult to diagnose. Clinicians must base their diagnoses and decision making on many factors, including their own past experience, published data, and confounding variables (i.e., multidrug therapy). Much of the accumulated literature on adverse drug reactions is of limited value because of difficulty in proving a cause-and-effect relationship between the side effect and the possible inciting agent. One of the most reliable ways to prove cause-and-effect is to assess rechallenge data. If the side effect disappears on removal of the drug (positive dechallenge) and recurs when it is restarted, strong evidence exists for a cause-and-effect relationship. In practice, however, it is not practical or even ethical to subject patients to a rechallenge of a drug they may have had an adverse reaction to.

Ocular changes may be of minor importance with no apparent adverse sequelae. Iris color change secondary to latanaprost therapy or mild mydriasis due to antidepressant medications are of this nature. Conversely, toxic ocular reactions, such as glaucoma from corticosteroid therapy, retinopathy of chloroquine therapy, or optic neuropathy of ethambutol therapy, may threaten sight. Ocular toxicity may also be part of a more widespread toxic reaction. Examples of this include Stevens-Johnson syndrome from a wide variety of drugs and fetal alcohol syndrome seen in offspring of alcoholic mothers. In certain cases, it may be useful to make use of mild toxic ocular reactions as an indicator of more serious systemic toxicity, such as abnormal color vision seen with digitalis toxicity.

The onset of a drug-induced ocular event may be within minutes or may ake years, such as systemic hypertension occurring within 10 to 20 minutes after topical use of ocular 10% phenylephrine or permanent ocular sicca after years of oral isotretinoin use. The adverse ocular event may be dose dependent, as with phenothiazine or hydroxychloroquine. The reaction can be reversible, as with corneal deposits from amiodarone, or irreversible, as with amiodarone neuropathy. Other reactions may be idiosyncratic, such as aplastic anemia due to topical ocular chloramphenicol or optic neuritis due to ibuprofen.

This chapter reviews toxic effects of topical ocular therapy and ocular toxicity of systemic drugs. The list of adverse effects is not comprehensive and our intent is to provide information on adverse drug effects of medications commonly used by ophthalmologists. Much of the data collected here come from the National Registry of Drug-Induced Ocular Side Effects, a clearinghouse for drug information on adverse ocular effects. Health care professionals suspecting a possible drug-induced ocular change are encouraged to send reports to the Registry. Cases of greatest interest include previously unsuspected, rare, severe, or unusual drug-related ocular side-effects. Data can be forwarded to F.T. Fraunfelder, MD, Casey Eye Institute, Oregon Health Sciences University, 3375 SW Terwilliger Boulevard, Portland, OR 97201; fax: (503) 494–4286.

 

TABLE 1. Adverse Oadar Reactions of Drugs


DrugPharmacologic ActionAdverse Ocular Reactions
Acetaminophen.Mild analgesicsAbnormal color vision (phenacetin)
 Acetanifid. Conjunctivitis
 Phenacetin Decreased vision
  Stevens-Johnson syndrome
  Mild analgesic
Acetandid See Acetantinophen
Alcohol (ethanol)Sedative and hypnoticAcute:
   Convergence abnormality
   Decreased accommodation
   Decreased color vision
   Decreased dark adaptation
   Decreased depth perception
   Decreased vision
   Diplopia
   Eso or exophoria.
   Mydriasis
   Nystagmus
   Ptosis
  Chronic:
   Decreased vision
   Downbeat nystagmus
   Extraocular muscle paralysis
   Fetal alcohol syndrome
   Optic neuritis
   Paralysis accommodation
   Pupil abnormalities
AllopurinolAgent used to treat goutCataracts
  Decreased vision
Aluminum nicotinatePeripheral vasodilatorsCystoid macular edema
 Niacin Decreased vision
 Niacinamide Aggravates ocular sicca.
 Nicotinyl alcohol  
AmiodaroneAntianginal agentAbnormal visual sensations
  Corneal opacity
  Decreased vision
  Optic neuropathy
  Photosensitivity
AmitriptylineAntidepressantsDecreased lacrimation
 Imipramine Decreased vision
 Nortriptyline Diplopia
 Protriptyline Mydriasis
  Narrow-angle glaucoma
  Paralysis of accommodation
AmobarbitalSedatives and hypnoticsConjunctivitis
 Barbital Paralysis of extraocular muscles
 Pentobarbital. Photosensitivity
 Phenobarbital Ptosis
 Primidone Stevens-Johnson syndrome
 Secobarbital  
 Talbutal  
 Thiopental.  
AmodiaquineAntimalarial agentsCorneal opacity
 Chloroquine Decreased vision
Hydroxychloroquine Macular or retinal pigmentary degeneration
   
  Visual field defects
AmphetamineAnorexiantsDecreased accommodation
 Dextroamphetamine Decreased vision
 Methamphetamine Mydriasis
 Phenmetrazine Narrow-angle glaucoma
  Visual hallucinations
Amyl nitriteAntianginaI agentAbnormal color vision
  Decreased vision
  Mydriasis
  Retinal vascular disorders
  Visual hallucinations
AspirinMild analgesicsAbnormal color vision
 Sodium salicytate Conjunctivitis
  Decreased vision
  Aggravates ocular sicca,
  Myopia (transient)
AtropineAntispasmodics (systemic)Decreased vision
 Belladonna Mydriasis
 Homatropine Narrow-angle glaucoma
  Paresis or paralysis of accommodation
  Visual hallucinations
 Mydriatics (topical ophthalmic)Conjunctivitis
  Decreased vision
  Decrease or paralysis of accommodation
  Mydriasis
  Narrow-angle glaucoma
AurothioglucoseAntirheumatic agentsBlepharoconjunctivitis
 Aurothioglycamde Corneal opacity
 Gold Au-198 Lens deposits
 Gold sodium thionialate Stevens-Johnson syndrome
AurothioglycanideAntirlieumatic agentSee Aurothioglucose
BarbitalSedative and hypnoticSee Amobarbital
BelladonnaAntispasmodicSee Atropine
BenoxinateTopical local anestheticsConjunctivitis
 Butacaine, Corneal edema
 Cocaine Corneal ulceration
 Dibucaine, Delayed corneal wound healing
 Dyclonine, Punctate keratitis
 Phenacaine Uveitis
 Piperocaine  
 Proparacaine  
 Tetracaine  
 BenzalkoniumOphthalmic preservativeConjunctivitis
  Punctate keratitis
BetamethasoneAdrenal corticosteroids (systemic and topical ophthalmic)Decreased resistance to infections
 Cortisone Decreased vision
 Dexamethasone Delayed corneal wound healing
 Fludrocortisone Diplopia.
 Fluorometholone (topical ophthahnic)Exoplithalmos 
 Fluprednisolone Glaucoma
 Hydrocortisone Posterior subcapsular cataracts
 Methylprednisolone Myopia
 Paramethasone Papillederna (pseudotumor cerebri)
 Prednisolone,  
 Prednisone  
 Triamcinolone  
BetaxololP-Adrenergic blockers (topical ocular ophthalmic)Blepharoconjunctivitis
 Levobunolol Corneal anesthesia
 Timolol Decreased vision
  Keratoconjunctivitis sicca.
  Myopia
  Paralysis of extraocular muscles
  Ptosis
  Punctate keratitis
  Visual hallucinations
BupivacaineLocal anestheticsBlepharoclonus
 Chloroprocaine Decreased vision
 Lidocaine Diplopia
 Mepivacame Miosis
 Prilocaine Paralysis of extraocular muscles
 Procaine  
 Propoxycame  
BusulfanAntineoplastic agentCataracts
  Decreased vision
  Hyperpigmentation
  Keratoconjunctivitis sicca
Butacaine,Topical local anestheticSee Benoxinate
CannabisPsychedelic agentsConjunctivitis
 Hashish Mydriasis
 Marihuana Visual hallucinations
 Tetrahydrocannabinol  
CarbamazepmeAntidepressantDecreased vision
  Diplopia
  Mydriasis (toxic)
  Nystagmus
  Paralysis of extraocular muscles
  Stevens-Johnson syndrome
  Visual hallucinations
Carbon dioxideTherapeutic gasDecreased vision
  Paresis or paralysis of accommodation
  Retinal vascular disorders
Carmustine,Antineoplastic agentGlaucoma
  Optic neuritis
  Retinal vascular disorders
Chloral hydrateSedative and hypnoticDecreased accommodation
  Miosis
  Ptosis
  Visual hallucinations
ChloramphenicolAntibioticDecreased vision
  Optic atrophy
  Retrobulbar or optic neuritis
  Toxic amblyopia
  Visual field defects
ChlordiazepoxideAntianxiety agentsDecreased corneal reflex
 Diazepam. Decreased vision
 Flurazepam Decreased accommodation
  Decreased depth perception
  Diplopia,
  Nystagmus;
  Oculogyric crises
ChlorisondamineAntihypertensive agentsConjunctival edema
 Mecamylamine Decreased vision
 Pentolinium Mydriasis
 Tetraethylammonium Paralysis of accommodation
 Trimethaphan  
 Trimethidinium  
ChloroquineAntimalarial agentSee Amodiaquine
ChlorphentermineAnorexiantsDecreased accommodation
 Diethylpropion Decreased vision
 Phentermine Mydriasis
  Narrow-angle glaucoma
ChlorpromazineAntipsychotic agentsAbnormal color vision
 MesoridazIne Corneal opacity
 Perphenazine Decreased vision
 Prochlorperazine Lacrimation
 Promethazine Lens pigmentary deposits
 Thioridazine Myopia
 Trifluoperazine Oculogyric crises
  Paralysis of accommodation
  Photosensitivity
  Pigmentary retinopathy
  Punctate keratitis
ChlorpropamideAgent used to treat hyperglycemiaSee Acetohexamide
ChlorprothixeneAntipsychotic agents (long-term therapy)Corneal opacity (chlorprothixene)
 Thiothixene Decreased vision
  Lens pigmentary deposits (thiothixene)
  Mydriasis
  Photosensitivity
ChlortetracyclineAntibiotics 
 Demeclocycline Decreased vision
 Doxycycline Myopia
 Methacycline Papilledema (pseudotumor cerebri)
 Minocycline Photophobia
 Oxytetracycline Photosensitivity
 Tetracycline Seleral pigmentation (minocycline)
ChrysarobinHeavy metal antagonistConjunctivitis
  Keratoconjunctivitis
ChymotrypsinProteolytic enzymeGlaucoma
  Uveitis
CimetidineGastrointestinal agentMydriasis
  Narrow-angle glaucoma
  Visual hallucinations
CisplatinAntineoplastic agentCortical blindness
  Papilledema
  Retrobulbar neuritis
ClomipheneOvulatory agentAbnormal visual sensations (e.g., flashing fights, glaze, various colored lines, multiple images, prolonged after images)
  Decreased vision
  Mydriasis
  Contact lens intolerance
  Visual field changes
CocaineTopical local anestheticSee Benoxinate
ColchicineAgent used to treat goutRetards wound healing
Colloidal silverOphthalmic antibacterial agentsConjunctival deposits
 Silver nitrate Conjunctivitis
 Silver protein Corneal deposits
  Lacrimal sac deposits
  Lens deposits
  Narrowing or occlusion of lacrimal puncta
CortisoneAdrenal corticosteroidSee Betanteduisone
CyclopentolateMydriatics and cycloplegicsConjunctivitis
 Tropicamide Decreased vision
  Narrow-angle glaucoma
CycloserineAntitubercular agentDecreased vision
  Optic neuritis
  Photosensitivity
Danazol.AndrogenPseudotumor cerebri
DeferoxamineChelating agentRetinal pigmentary degeneration
  Retrobulbar neuritis
DemecariumMiotic'sCataracts
 Echothiophate Conjunctivitis
 Isoflurophate Decreased accommodation
  Decreased vision
  Nhosis
  Retinal detachment
DemeclocyclineAntibioticSee Chlortetracycline
DexamethasoneAdrenal corticosteroidSee Betamethasone
DextroamphetamineAnorexiantSee Amphetamine
Diatrizoate megiumine/sodiumDiagnostic aid 
  Perflimbal corneal infiltrates
  Follicular conjunctivitis
  Retinal vascular disorders
DiazeparnAntianxiety agentSee Chlordiazepoxide
DiazoxideAntihypertensive agentLacrimation.
DibucaineTopical local anestheticSee Benoxinate
DiethylpropionAnorexiantSee Chlorphentermine
DigitalisDigitalis glycosidesAbnormal color vision
 Digitoxin Abnormal visual sensations
 Digoxin Visual hallucinations
 Ouabain  
DigitoxinDigitalis glycosideSee Digitalis
DigoxinDigitalis glycosideSee Digita&
DipivefrinAdrenergic agentsCystoid macular edema
 Epinephrine Decreased vision
  Mydriasis
  Narrow-angle glaucoma
  Ocular pain
  Rebound conjunctivitis
DoxycyclineAntibioticSee Chlortetracychne
DroperidolAntipsychotic agentsDecreased accommodation
 Haloperidol Decreased vision
 Trifluperidol Mydriasis
  Oculogyric crises
DyclonineTopical local anestheticSee Benoxinate
EchothiophateMioticSee Dentecarium
EphedrineVasopressorMydrasis
  Narrow-angle glaucoma
  Visual hallucinations
EpinephrineVasopressor (systemic)Abnormal color vision
  Lacrimation
  Mydriasis
  Narrow-angle glaucoma
 Adrenergic agent (topical ophthalmic)See Dipivefirin
ErgonovineAgents used to treat migraineAbnormal visual sensations
 Ergotamine Corneal opacity
 Methylergonovine Corneal ulceration
 Methysergide Decreased vision
  Miosis
  Photosensitivity
  Retinal vascular disorders
ErgotamineAgent used to treat migraineSee Ergonovine
EthambutolAntitubercular agentAbnormal color vision
  Decreased vision
  Optic atrophy
  Optic neuritis
  Visual field defects
EthchlorvynolSedative and hypnoticDecreased vision
  Diplopia
  Nystagmus
  Visual hallucinations
Etretinate Blepharitis
 IsotretinoinDermatologic: agentsCorneal opacities
  Decreased color vision
  Decreased contact lens tolerance
  Decreased night vision
  Decreased vision
  Keratitis sicca.
  Myopia
  Photophobia.
  Pseudotumor cerebri
FerrocholinateAgents used to treat deficiency anemiasCorneal opacity
 Ferrous fumarate Decreased vision
 Ferrous gluconate Retinal degeneration
 Ferrous succinate  
 Ferr ous sulfate  
 Iron dextran  
 Iron sorbitex  
 Polysaccharide-iron complex  
Ferrous fumarateAgent used to treat deficiency anemiasSee Ferrocholinate
Ferrous gluconateAgent used to treat deficiency anemiasSee Ferrocholinate
Ferrous succinateAgent used to treat deficiency anemiasSee Ferrocholinate
Ferrous sulfateAgent used to treat deficiency anemiasSee Ferrocholinate
FloxuridineAntineoplastic agentsBlepharitis
 Fluorouracil Conjunctival edema
  Conjunctivitis
  Lacrimation
  Hyperpigmentation
  Narrowing or occlusion of lacrimal puncta
  Ocular pain
  Photophobia,
FludrocortisoneAdrenal corticosteroidSee Betantedwone
Fluoromethalone,Adrenal corticosteroidSee Betanzethasone
FluorouracilAntineoplastic agentSee Hoxuridine
FluprednisoloneAdrenal corticosteroidSee Betantethoone
FlurazepamAntianxiety agentSee Chlordiazepoxide
GentamicinAntibioticDecreased vision
  Papilledema.
  Pseudotumor cerebri
GlycerinOsmotic (systemic)Subconjunctival or retinal hemorrhages
  Visual hallucinations
 Osmotic (topical ophthalmic)Conjunctivitis
  Subconjunctival hemorrhages
Gold Au-198Antirlieumatic agentSee Aurothioglucose
Gold sodium thiomalateAntirlieumatic agentSee Aurothioglucose
GriseoftdvinAntifungal. agentPhotophobia
  Papilledema
  Pseudotumor cerebri
GuanethidineAntihypertensive agent (systemic)Conjunctivitis
  Decreased vision
  Diplopia
  Paralysis of extraocular muscles
  Ptosis
 Adrenergic blocker (topical ophthalmic)Conjunctival edema
  Conjunctivitis
  Mydriasis
  Ocular pain
  Paralysis of extraocular muscles
  Photophobia
  Ptosis
  Punctate keratitis
Haloperidol.Antipsychotic agentSee Droperidol
HashishPsychedelic agentSee Cannabis
HexamethoniumAntihypertensive agentDecreased vision
  Mydriasis
  Paralysis of accommodation
HomatropineAntispasmodic/mydriaticSee Atropine
HydrocortisoneAdrenal corti-steroidSee Betantethwone
HydromorphoneStrong analgesicsDecreased accommodation
 Oxymorphone Decreased vision
HydroxychloroquineAntimalarial agentSee Amodiaquine
lbuprofen.Antirlieumatic agentAbnormal color vision
  Decreased color vision
  Decreased vision
  Diplopia
  Optic neuritis
  Sicca
IdoxuridineAntiviral agentsConjunctivitis
 TriffuridineCorneal epithelial opacity
 VidarabineDelayed corneal wound healing
  Lacrimal stenosis
  Ptosis
  Punctate keratitis
ImipramineAntidepressantSee Amitriptyline
IndomethacinAntirlieumatic agentAbnormal color vision
  Cornea/opacity
  Decreased vision
  Diplopia
  Visual hallucinations
IodochlorhydroxyquinAmebicideSee Broxyquinoline
IodoquinolAmebicideSee Broxyquinoline
Iothalamate meglumine/soditanDiagnostic aidConjunctivitis
  Diplopia
  Macular disorders
  Visual field defects
Iron dextranAgent used to treat deficiency anemiasSee Ferrocholinate
Iron sorbitexAgent used to treat deficiency anemiasSee Ferrocholinate
IsomboxazidAntidepressantsAbnormal color vision
 Nialamide Decreased vision
 Phenelzine Ptosis
 Tranylcypromine  
IsoflurophateMioticSee Demecarium
IsoniazidAntitubercular agentAbnormal color vision
  Decreased vision
  Mydriasis
  Nystagmus
  Optic atrophy
  Optic neuritis
  Papilledema
  Paralysis of accommodation
  Visual field defects
IsotretinoinDermatologic, agentSee Etretinate
KetamineGeneral anestheticDecreased vision
  Diplopia
  Increased intraocular pressure
  Nystagmus
LevobunololP-Adrenergic blockerSee Betaxolol
LidocaineLocal anestheticSee Bupivacaine
Lithium carbonateAntipsychotic agentAggravates ocular sicca
  Decreased accommodation
  Decreased vision
  Nystagmus
  Oculogyric crises
  Papilledema
  Pseudotuinor cerebri
  Visual field defects
Lysergide (LSD)Psychedelic agentAbnormal visual sensations
  Decreased vision
  Diplopia.
  Visual hallucinations
MarihuanaPsychedelic agentSee Cannabis
MecamylainineAntihypertensive agentSee Chlorisondamine
MedrysoneAdrenal corticosteroidSee Betameduisone
MepivacaineLocal anestheticSee Bupivacaine
MeprobamateAntianxiety agentDecreased accommodation
  Decreased corneal reflex
  Decreased vision
  Diplopia
  Mydriasis
  Paralysis of extraocular muscles
MesoridazineAntipsychotic agentSee Chlorpromazine
MethacyclineAntibioticSee Chlortetracycline
MethamphetamineAnorexiantSee Amphetamine
MethaqualoneSedative and hypnoticAbnormal color vision
  Decreased vision
  Diplopia.
  Lacrimation
  Mydriasis
  Nystagmus
  Visual hallucinations (withdrawal)
MethylergonovineAgent used to treat migraineSee Ergonovine
MethylpentynolSedative and hypnoticConjunctival edema
  Diplopia.
  Nystagmus
MethylprednisoloneAdrenal corticosteroidSee Betamethayone
MethysergideAgent used to treat migraineSee Ergonovine
MetrizamideDiagnostic aidCortical blindness
  Extraocular muscle disturbances
  Visual hallucinations
Metubine iodideAdjuncts to anesthesiaDecreased accommodation
Tubarine Diplopia,
  Nystagmus
  Paralysis of extraocular muscles
  Ptosis
MinocyclineAntibioticSee Chloretracycline
MorphineStroiig analgesicsDecreased accommodation
 Opium Decreased lacrimation
  Decreased vision
  Miosis
  Myopia
Nalidixic acidAntibioticAbnormal color vision
  Abnormal visual sensations
  Diplopia
  Papilledema
  Photophobia
  Pseudotumor cerebri
NaproxenAntirheumatic agentCorneal opacity
  Periorbital edema
NeomycinAntibioticAllergic reactions
  Folticular conjunctivitis
  Punctate keratitis
NeostigmineMioticsConjunctivitis
 Physostigmine Decreased accommodation
  Decreased vision
  Miosis
  Retinal detachment
NiacinPeripheral vasodflatorSee Aluminum nicotinate
NiacinamidePeripheral vasodilatorSSee Aluminum nicotinate
NialamideAntidepressantSee Isocarboxazid
Nicotinyl alcoholPeripheral vasodilatorSee Aluminum nicotinate
NitrofurantoinAntibioticChronic ocular irritation (even after the drug is stopped)
  Conjunctivitis
  Extraocular muscle paralysis
  Nystagmus
  Papilledema
  Photosensitivity
  Pseudotumor cerebri
NitroglycerinAntianginal agentAbnormal visual sensations
  Decreased vision
  Retinal vascular disorders
NortriptylineAntidepressantSee Amitriptyline
OpiumStrong analgesicSee Morphine
Oral contraceptivesOvulatory agentsDecreased vision
  Diplopia
  Keratoconjunctivitis sicca
  Myopia
  Papilledema
  Retinatvascular disorders
  Retrobulbar or optic neuritis
  Visual field defects
OuabainDigitalis glycosideSee Digitalis
OxprenololAntiarrhythmic agentConjunctivitis
  Decreased vision
  Keratoconjunctivitis sicca
  Visual hallucinations
OxygenIberapeutic gasDecreased vision
  Retinal vascular disorders
  Visual field defects
OxymorphoneStrong analgesicSee Hydromorphone
OxyphenbutazoneAntirheumatic agentsColor vision defects
 Phenylbutazone Decreased vision
  Diplopia
  Optic neuritis
  Paralysis of extraocular muscles
OxytetracyclineAntibioticSee Chlortetracycline
ParaldehydeSedative and hypnoticDecreased corneal reflex
  Decreased vision
  Miosis
  Visual hallucinations
ParamethadioneAnticonvulsantsAbnormal color vision
 Trimethadione Abnormal visual sensations
  Diplopia
  Night blindness
  Photophobia
ParamethasoneAdrenal corticosteroidSee Betamethasone
PentobarbitalSedative and hypnoticSee Amobarbital
PentoliniumAntihypertensive agentSee Chlorisondamine
PerphenazineAntipsychotic agentSee Chlorpromazine
PhenacaineTopical local anestheticSee Benoxinate
PhenacetinMild analgesicSee Acetaminophen
PhencyclidinePsychedelic agentNystagmus
  Visual hallucinations
PhenelzineAntidepressantSee Isocarboxazid
PhenmetrazineAnorexiantSee Amphetamine
PhenobarbitalSedative and hypnoticSee Antobarbital
PhenoxybenzarninePeripheral vasodilatorConjunctivitis
  Miosis
  Ptosis
PhentermineAnorexiantSee Chlorphenterntine
PhenylbutazoneAntirheumatic agentSee Oxyphenbutazone
PhenylephrmieVasopressor (systemic)Conjunctival vasoconstriction
  Conjunctivitis
  Decreased vision
  Mydriasis
  Narrow-angle glaucoma
  Rebound miosis
 Adrenergic agonist (topical ophthalmic)Conjunctival vasoconstriction
  Conjunctivitis
  Decreased vision
  Mydriasis
  Narrow-angle glaucoma
  Punctate keratitis
  Rebound miosis
PhenylpropanolamineAnorexiantRetinal vascular disorders
PhenytoinAnticonvUlsantColor vision defects
  Decreased vision
  Diplopia
  Fetal phenytoin syndrome
  Mydriasis
  Nystagmus
  Ocular pain
  Paralysis of extraocular muscles
  Ptosis
PhysostigmineMioticSee Neostigmine
PilocarpineMioticDecreased accommodation
  Follicular conjunctivitis
  Miosis
  Narrowing or occlusion of lacrimal puncta.
  Retinal detachment
PiperazineAnthelminticAbnormal color vision
  Decreased vision
  Miosis
  Nystagmus
  Paralysis of accommodation
  Visual hallucinations
PiperocaineTopical local anestheticSee Benoxinate
Polymyxin BAntibioticAllergic reactions
  Conjunctivitis
  Ocular pain
Polysaccharide-iron complexAgent used to treat deficiency anemiasSee Ferrocholinate
PrednisoloneAdrenal corticosteroidSee Betamethasone
PrednisoneAdrenal corticosteroidSee Betamethasone
PrilocaineLocal anestheticSee Bupivacaine
PrimidoneSedative and hypnoticSee Amobarbital
ProcaineLocal anestheticSee Bupivacaine
ProchlorperazineAntipsychotic agentSee Chlorpromazine
PromethazineAntipsychotic agentSee Chlorpromazine
ProparacaineTopical local anestheticSee Benoxinate
PropoxycaineLocal anestheticSee Bupivacaine
PropranololAntiarrhythmic agentDecreased vision
  Diplopia
  Toxic amblyopia
  Visual hallucinations
ProtriptylineAntidepressantSee Amitriptyline
QuinacrineAntiprotozoal agentAbnormal visual sensations
  Corneal edema
  Corneal opacity
  Decreased vision
  Retinopathy
QuinidineAntiarrhythmic agentAbnormal color vision
  Decreased vision
  Diplopia
  Mydriasis
  Night blindness
  Photophobia
  Visual field defects
QuinineAntimalarial agentDecreased vision
  Optic atrophy
  Papilledema.
  Retinopathy
  Toxic amblyopia
  Visual field defects
ReserpineAntihypertensive agentConjunctivitis
  Decreased vision
  Oculogyric crises
  Optic atrophy
  Paralysis of extraocular muscles
  Ptosis
  Uveitis
RifampinAntitubercular agentDiscolored tears
  Exudative conjunctivitis
SildenafilErectile agentBlurred vision
  Colored vision (blue, green, yellow, pink)
  Conjunctival hyperemia
  Dazzle visual sensation
  Subconjunctival hemorrhages
ScopolamineAdjunct to anesthesiaDecreased lacrimation
  Decreased vision
  Decrease or paralysis of accommodation
  Diplopia
  Mydriasis
  Narrow-angle glaucoma
  Decreased vision
 MydriaticDecrease or paralysis of accommodation
  Mydriasis
Secobarbital.Sedative and hypnoticSee Amobarbital
Silver nitrateOphthalmic antibacterial agentSee Colloidal silver
Silver proteinOphthalmic antibacterial agentSee Colloidal silver
Sodium salicylateMild analgesicSee Aspirin
StreptomycinAntibioticNystagmus
  Optic neuritis
  Ptosis
  Toxic amblyopia
  Visual field defects
SuccinylcholineAdjunct to anesthesiaExtraocular muscle contractions
  Elevated intraocular pressure
  Conjunctivitis
  Decreased vision
  Myopia
SulindacAntirheumatic agentKeratitis
  Stevens-Johnson syndrome
SuraminAntiprotozoal agentCorneal deposits
TalbutalSedative and hypnoticSee Amobarbizal
TamoxifenAntineoplastic agentCataracts
  Color vision defects
  Corneal opacities
  Decreased vision
  Optic neuritis
  Papiltedema
  Retinal and macular change
  Visual field abnormalities
TetracaineTopical local anestheticSee Betaxolol
TetracyclineAntibioticSee Chlortetracycline
TetraethylammoniumAntihypertensive agentSee Chlorisondamine
TetrahydrocannabinolPsychedelic agentSee Cannabis
ThiopentalSedative and hypnoticSee Amobarbiral
ThioridazineAntipsychotic agentSee Chlorpromazine
ThiothixeneAntipsychotic agentSee Chloprothixene
Timolol?-Adrenergic blockerSee Betaxolol
TolazamideAgent used to treat hyperglycemiaSee Acetohexamide
TolbutamideAgent used to treat hyperglycemiaSee Acetoltexamide
TranylcypromineAntidepressantSee Isocarboxazid
TriamcinoloneAdrenal corticosteroidSee Betamethasone
ThchlorethyleneGeneral anestheticdecreased vision
  Diplopia
  Paralysis of accommodation
  Paralysis of extraocular muscles
  Photophobia
  Ptosis
  Visual field defects
TrifluoperazineAntipsychotic agentSee Chlorpromazine
TrifluperidolAntipsychotic agentSee Droperidol
TrifluridineAntiviral agentSee Idoxuridine
TrimethadioneAnticonvulsantSee Paramethadione
Trimethaphan.Antihypertensive agentSee Chlorisondamine
TrimethidinitimAntihypertensive agentSee Chlorisondamine
TropicarnideMydriatic and cycloplegicSee Cyclopentolate
TryparsamideAntiprotozoal agentAbnormal visual sensations
  Decreased vision
  Optic atrophy
  Optic neuritis
  Visual field defects
TubarineAdjunct to anesthesiaSee Metubine iodide
UreaOsmoticRebound glaucoma
  Subconjunctival or retinal hemorrhages
  Visual hallucinations
UrokinaseProteolytic enzymeHypopyon
  Increase or decrease in intraocular pressure
  Uveitis
Valproate sodiumAnticonvulsantsAbnormal visual sensations
 Valproic acid Diplopia
  Nystagmus
Valproic acidAnticonvulsantSee Valproate sodium
VeratrumAntihypertensive agentDecreased vision
  Extraocular myotonia
  Mydriasis
  Narrow-angle glaucoma
VidarabineAntiviral agentSee Idoxiaidine
 Vigabatrin  
VinblastineAntineoplastic agentsBlephartis
 Vincristine Cortical blindness
  Diplopia
  Paralysis of extraocular muscles
  Ptosis
VincristineAntineoplastic agentSee Vinblastine
Vitamin AVitaminDiplopia
  Loss of eyelashes or eyebrows
  Papilledema
  Paralysis of extraocular muscles
Vitamin DVitaminCorneal opacity
  Papilledema

 

 

TABLE 2. Adverse Systemic Reactions of Drugs Commonly Used in Ophthabnology


DrugRoute of AdministrationPharmacologic ActionAdverse Systemic Reactions
AcetazolamideIntramuscularCarbonic anhydrase inhibitorsAnorexia
 DicblorphenamideIntravenous  
 EthoxzolamideOral  
 MethazolamideTopical ocular  
AcetylcholineIntraocularIntraocular mioticBradycardia
   Hypotension
AmoxicillinIntramuscularAntibioticsAnemia
 AmpicillinIntravenous Angioneurotic edema
 CarbenicillinOral Exfoliative dermatitis
 Cloxacillin  Stevens-Johnson syndrome
 Dicloxacillin  Urticaria
 Hetacillin   
 Methicillin   
 Nafcillin   
 Oxacillin   
AmpicillinIntramuscularAntibioticSee Amoxicillin
 Intravenous  
 Oral  
Amphotericin BTopical ophthalmicAntibioticAllergic reactions
   Diarrhea
AtropineTopical ophthalmicAnticholinergicsConfusion
 Homatropme  Dermatitis
 Scopolamine  Dryness of mouth
   Excitement
   Fever
   Flushed skin
   Hallucinations
   Psychosis
   Tachycardia
   Thirst
   Urinary retention
BacitracinTopical ophthalmicAntibioticAllergic reactions
   Erythemia
   Urticaria
BenoxinateTopical ophthalmicTopical local anestheticsAllergic reactions
 Proparacame  Anaphylactic reactions
 Tetracaine Convulsion 
   Faintness
   Hypotension
   Syncope
BetaxololTopical ophthalmicb-Adrenergic blockersAggravates chronic pulmonary
 Levobunolol   obstructive disease
 Timolol  Alopecia
   Asthma
   Bradycardia
   Bronchospasm
   Cardiac arrhythmia
   Confusion
   Dizziness
   Dyspnea
   Erythema
   Finger and toe nail pigmentation
   Headache
   Heart block
   Hypotension
   Increase in high density
    lipoprotein
   Nausea
   Skin rashes
   Urticaria.
BupivacaineRetrobulbar injectionLocal anestheticsBradycardia
 Lidocaine  Cardiac arrest
 Procaine  Convulsion
   Hypotension
CarbacholTopical ophthalmicParasympathomimeticsAbdominal cramps
 Pilocarpine  Diarrhea
   Hypotension
   Increased salivation
   Muscle tremors
   Nausea
   Respiratory distress
   Rhinorrhea.
   Slurred speech
   Sweating
   Vomiting
   Weakness
CarbenicillinIntramuscularAntibioticSee Amoxicillin
 Intravenous  
 Oral  
ChloramphenicolTopical ophthalmicAntibioticAllergic reactions
   Bone marrow depression including aplastic anemia
   Contact dermatitis
   Depigmentation
   Gastrointestinal symptoms
ChlortetracyclineTopical ophthalmicAntibioticsAllergic reactions
 Tetracycline  Discoloration of skin
   Erythema
   Photosensitivity
CloxacillinOralAntibioticSee Amoxicillin
CyclopentolateTopical ophthalmicAnticholinergicsAmnesia
 Tropicamide  Ataxia
   Convulsion
   Disorientation
   Dysarthria
   Fever
   Hallucinations
   Psychosis
DemecariumTopical ophthalmicAnticholinesterase,Abdominal cramps
 Echothiophate  long-actingDiarrhea
 Isoflurophate  Fatigue
   Nausea
   Rhinorrhea
   Weight loss
DichlorphenamideOralCarbonic anhydrase inhibitorSee Acetazolamide
DicloxacillinIntramuscularAntibioticSee Amoxicillin
 Oral  
EchothiophateTopical ophthalmicAnticholinesterases, long-actingSee Demecarium
EphedrineTopical ophthalmicSympathomimeticsCardiac arrhythmia.
 Epinephrine  Hypertension
 Hydroxyamphetamine  Palpitations
 Phenylephrine  Subarachnoid hemorrhage
   Tachycardia
EpinephrineTopical ophthalmicSympathomimeticSee Ephedrine
ErythromycinTopical ophthalmicAntibioticAllergic reactions
EthoxzolamideOralCarbonic anhydrase inhibitorSee Acetazolamide
FluoresceinIntravenousOphthalmic dyeAnaphylactic reactions
   Dizziness
   Hypotension
   Nausea
   Pruritus
   Syncope
   Urticaria
   Vomiting
GentamicinTopical ophthalmicAntibioticAllergic reactions
   Depigmentation
   Erythema,
GlycerinIntravenousOsmotic agentsBack pain
 IsosorbideOral Congestive heart failure
 Mannitol  Dehydration
 Urea  Headache
   Mental confusion
   Nausea
   Vomiting
HetacillinIntramuscularAntibioticSee Antoxicillin
  Intravenous 
  Oral 
HomatropineTopical ophthalmicAnticholinergicSee Atropine
HydroxyamphetamineTopical ophthalmicSympathomimeticSee Ephedrine
IdoxuridineTopical ophthalmicAntiviralsAllergic reactions
 Trifluridine  Contact dermatitis
 Vidarabine   
IsoflurophateTopical ophthalmicAnticholinesterase, long-actingSee Dernecarium
IsosorbideIntravenousOsmotic agentSee Glycerin
 Oral  
LevobunololTopical ophthalmicft-Adrenergic blockerSee Betaxolol
LidocaineRetrobulbar injectionLocal anestheticSee Bupivacaine
MannitolIntravenousOsmotic agentSee Glycerin
MethazolamideOralCarbonic anhydrase inhibitorSee Aceurzolamide
MethicillinIntramuscularAntibioticSee Antoxicillin
 Intravenous  
NafcillinIntramuscularAntibioticSee Antoxicillin
 Intravenous  
 Oral  
NeomycinTopical ophthalmicAntibioticAllergic reactions
   Contact dermatitis
   Erythema
   Urticaria
NeostigmineTopical ophthalmicAnticholinesterases, short-actingAbdominal cramps
 Physostigmine  Depigmentation
   Diarrhea
   Nausea
   Vomiting
OxacillinIntramuscularAntibioticSee Antoxicillin
 Intravenous  
 Oral  
PhenylephrineTopical ophthalmicSympathomimeticSee Ephedrine
PhysostigmineTopical ophthalmicAnticholinesterase, short-actingSee Neostigmine
Pilocarpine,Topical ophthalmicParasympathomimeticSee Carbachol
PiperocaineTopical ophthalmicTopical local anestheticSee Benoxinate
Polymyxin BTopical ophthalmicAntibioticAllergic reactions
   Erythema
ProcaineRetrobulbar injectionLocal anestheticSee Bupivacaine
ProparacaineTopical ophthalmicTopical local anestheticSee Benoxinate
ScopolamineTopical ophthalmicAnticholinergicSee Atropine
SulfacetamideTopical ophthalmicAntibioticsAllergic reactions
 Sulfamethizole  Contact dermatitis
 Sulfisoxazole  Exfoliative dermatitis
   Photosensitivity
   Stevens-Johnson syndrome
SulfamethizoleTopical ophthalmicAntibioticSee Sulfacetandde
SulfisoxazoleTopical ophthalmicAntibioticSee Sulfacetandde
TetracaineTopical ophthalmicTopical local anestheticSee Benoxinate
TetracyclineTopical ophthalmicAntibioticSee Chlortefracycline
TimololTopical ophthalmic)S-Adrenergic blockerSee Betaxolol
TrifluridineTopical ophthalmicAntiviralSee Idoxurtdine
TropicamideTopical ophthalmicAnticholinergicSee Cyclopentolate
UreaIntravenousOsmotic agentSee Glycerin
Vidarabine,Topical ophthalmicAntiviralSee Idoxuridine

 

 

TABLE 3. Agents Affecting Specific Ocular Areas


ConjunctivaBusulfanQuinacrine
AcetaminophenCarbamazepineQuinine
AcetanilidChlorat hydrateTamoxifen
AcetohexamideChlordiazepoxideThioridazine
AmobarbitalChloroformTrifluoperazine
AspirinChloroprocaineUrea.
AtropineChlorpromazine 
AurothioglucoseChlorpropamideOptic Nerve
AurothioglycanideChlorprothixeneAlcohol
BarbitalChlortetracyclineAntipyrine
BenoxinateColloidal silverBroxyquinoline
BenzalkoniumCycloserineCarmustine
BetaxololDerneclocyclineChloramphenicol
BromideDiazeparnChlortetracycline
ButacaineDiazoxideCisplatin.
CannabisDoxycyclineCycloserine
CarbamazepineDroperidolDeferoxamine
ChlorisondamineEpinephrineDemeclocycline
ChlorpropamideErgonovineDoxycycline
ChrysarobinErgotamineEthambutol
CocaineEthchlorvynolGentamicin
Colloidal silverFloxuridineGriseofulvin
CyclopentolateFluorouracil.Ibuprofen
DemecariumFlurazepamlodochlorhydroxyqum.
Diatrizoate meglumine/sodiumGold Au-198lodoquinol.
DiazoxideGold sodium thiomalateIsoniazid
DibucaineGriseofulvinMethacycline
DipivefrinGuanethidineMinocychne
DyclonineHaloperidolNalidixic acid
EchothiophateIdoxuridineNitrofurantoin
EpinephrineImipramineOral contraceptives
Etretinatelothalamate meglumine/sodiurnOxyphenbutazone
FloxuridineIsocarboxazidOxytetracycline
FluorouracilIsoniazidPhenylbutazone
GlycerinKetaminePropranolol.
Gold Au-198LevallorphanQuinine
Gold sodium thiomalateLevobunololReserpine
GuanethidineLidocaineStreptomycin
HashishLithium carbonateTetracycline
HomatropineMepivacaineTryparsamide
IdoxuridineMeprobamateVitamin A
lothalamate meglumine/sodiumMesoridazineVitamin D
IsoffurophateMethacyclineUvea (ChoroK Ciliary body, Iris, Pupils)
IsotretinoinMethaqualone 
LevobunolotMethylergonovineAlcohol
MarihuanaMethylpentynol.Amitriptyline
MecamylamineMethysergideAmphetamme
MeprobamateMetrizamideAmyt nitrite
MethylpentynolMetubine iodideAtropine
NeomycinMinocyclineBelladonna
NeostigmineMorphineBenoxinate
NitrofurantoinNalorphineBromide
OxprenololNaloxoneBupivacaine
OxyphenbutazoneNialamideButacaine
PentobarbitalNitrofurantoinCannabis
PentoliniumNortriptylineCarbamazepine
PhenacaineOpiumCarbon dioxide
PhenacetinOxyphenbutazoneChloral hydrate
PhenobarbitalOxytetracyclineChlorisondamine,
PhenoxybenzaminPentobarbitalChloroprocaine,
PhenylbutazonePerphenazineChlorphentermine
PhenylephrinePhencyclidineChlorpromazine
PhysostigminePhenelzineChlorprothixene
PilocarpinePhenobarbitalChymotrypsin
PiperocainePhenoxybenzamineCimetidine
Polymyxin BPhenylbutazoneClomiphene
PractololPhenytoinCocaine
PrimidonePilocarpineDemecarium
ProparacainePiperazineDextroamphetamme
PropranololPrilocaineDibucaine
ReserpinePrimidoneDiethylpropion
RifampinProcaineDipivefrin
SecobarbitalProchlorperazineDroperidol
Silver nitratePromethazineDyclonine
Silver proteinPropoxycaineEchothiophate
Sodium salicylateProtriptylineEphedrine
SulfonamidesReserpine,Epinephrine
SulindacRifampinErgonovine
TalbutalScopolamineErgotamine
TetracaineSecobarbitalGuanethidine,
TetraethylammoniumSilver nitrateHaloperidol.
TetrahydrocannabinolSilver proteinHashish
ThiopentalSodium SalicylateHexamethonium
TimololStreptomycin.Homatropine
TolazamideSuccinylcholineHydromorphone
TolbutamideTalbutalImipramine
TrifluridineTetracyclineIsocarboxazid
TrimethaphanThiopentalIsollurophate
TrimethidiniumThioridazineIsoniazid
TropicamideThiothixene,Levallorphan
UreaTimolotLidocaine
VidarabineTolazamideMarihuana
Cornea and ScleraTolbutamideMecamylarnine
AcetohexamideTranylcypromineMepivacaine
AmiodaroneTrichlorethyleneMeprobamate
AmodiaquineTrifluoperazineMesoridazine
AntipyrineTrifluperidol.Methamphetamine
AurothioglucoseTrifluridineMethaqualone
AurothioglycanideTubafineMethylergonovine,
BenoxinateValproate sodiumMethysergide
BenzalkoniumValproic acidMetubine iodide
BetamethasoneVeratrurnMorphine
BetaxololVidarabineNalorphine
BusulfanVinblastine,Naloxone
ButacaineVincristineNeostigmine
ChlordiazepoxideVitamin ANialamide,
ChloroquineLensNortriptyline
ChlorpromazineAllopurinolOpium
ChlorpropamideAurothioglucoseOxymorphone
ChlorprothixeneAurothioglycanideParaldehyde
ChrysarobinBetamethasonePentolinium.
CocaineBusulfanPerphenazine
Colloidal silverChlorpromazinePhenacaine
CortisoneChlorprothixenePhenelzine
DexamethasoneCobaltPhenmetrazine
Diatrizoate meglumine/sodiumColloidal silverPhenoxybenzamine
DiazepamCortisonePhentermine
DibucaineDemecariumPhenylephrine
DyclonineDexamethasonePhenytoin
ErgonovineDiazoxidePhysostigmine
ErgotamineEchothiophatePilocarpine
EtretinateFludrocortisone,Piperazine
FerrocholinateFluorometholonePiperocaine
Ferrous fumarateFluprednisolonePrilocaine
Ferrous gluconateGold Au-198Procaine
Ferrous succinateGold sodium thiomalateProchlorperazine,
Ferrous sulfateHydrocortisonePromethazine
FludrocortisoneIsoffurophateProparacaine
FluorometholoneMesoridazinePropoxycaine
FluprednisoloneMethylprednisoloneProtriptyline
FlurazepamParamethasoneQuinidine
Gold Au-198PerphenazineReserpine
Gold sodium thiomalatePrednisoloneScopolammie
GuanethidinePrednisoneTetracame
HydrocortisoneProchlorperazineTetraethylammonium
HydroxychloroquinePromethazineTetrahydrocannabinol
IdoxuridineSilver nitrateThioridazine
IndomethacinSilver proteinThiothixene
Iron dextranThioridazineTranylcypromine
Iron sorbitexThiothixeneTrichlorethylene
IsotretinoinTriamcinoloneTrifluoperazine
LevobunololTrifluoperazineTrifluperidol.
MeprobamateMacula. and RetinaTrimethaphan
MesoridazineAllopurinolTrimethidinium
MethylergonovineAluminum nicotinateTubarine
MethylprednisoloneAmodiaquineUrokinase
MethysergideAmyl nitriteVeratrum
NaproxenBroxyquinoline 
NeomycinCarbon dioxide 
Oral contraceptivesCarmustine 
OxprenololChloroquine 
ParaldehydeChlorpromazine 
ParamethasoneDeferoxamine 
PerphenazineDemecarium 
PhenacaineDiatrizoate meglumine/sodium. 
PhenylephrineEchothiophate 
PiperocaineEpinephrine 
Polysaccharide-iron complexErgonovine 
PractololErgotamine 
PrednisoloneEtretinate 
PrednisoneFerrocholinate 
ProchlorperazineFerrous fumarate 
PromethazineFerrous gluconate 
ProparacaineFerrous succinate. 
QuinacrineFerrous sulfate 
Silver nitrateGlycerin 
Silver proteinGriseoftdvin 
SulindacHydroxychloroquine 
Suraminlodochlorhydroxyquin 
Tamoxifenlodoquinol 
Tetracainelothalamate meglumine/sodium 
ThioridazineIron dextran 
ThiothixeneIron sorbitex 
TimololIsofturophate 
TolazamideIsotretinoin 
TolbutamideMeprobamate 
TriamcinoloneMesoridazine 
TrifluoperazineMethylergonovine 
TrifluridineMethysergide 
VidarabineNeostigmine 
Vitamin DNiacin 
Eye Appendages (Eyelashes, Eyelids, Extraocular Muscles, Lacrimal Apparatus)Niacinamide 
 Nicotinyl alcohol 
 Nitroglycerin 
AcetohexamideOral contraceptives 
AlcoholOxygen 
AmiodaroneOxyphenbutazone 
AmitriptylinePerphenazine 
AmobarbitalPhenylbutazone 
AspirinPhenylpropanolamme 
AurothioglucosePhysostigmine 
AurothioglycanidePilocarpine 
BarbitalPolysaccharide-iron complex 
BetaxololProchlorperazine 
BromidePromethazine 
BupivacaineSildenafil 

 

 

TABLE 4. Visual Tests Helpful in Monitoring for Ocular Drug Toxicity


Bionticroscopic EvaluationlodochlorhydroxyquinHydrocortisone
AcetohexamidelodoquinolHydromorphone
AllopurinolIothalamate meglumine/sodiumHydroxychloroquine
AmiodaroneMethylergonovinelbuprofen
AmodiaquineMethysergideImipramine
AurothioglucoseNiacinIndomethacin
AurothioglycanideNiacinamideIron dextran
BenoxinateNicotinyl alcoholIron sorbitex
BetamethasoneNitroglycerinIsocarboxazid
BusulfanOral contraceptivesIsollurophate
ButacaineOxygenIsoniazid
ChloroquinePhenylpropanolamineKetamine
ChlorpromazineIntraoadar PressureLevallorphan
ChlorpropamideAmitriptylineLevobunolol
Chlorprothixene,AmphetamineLidocaine
CobaltAtropineLithium carbonate
CocaineBelladonnaLysergide (LSD)
Colloidal silverBetamethasoneMecamylamine
CortisoneCarmustineMepivacaine
Demecarium.ChlorphentermineMeprobamate
DexamethasoneChymotrypsinMesoridazine
Diatrizoate meglumine/sodiumCimetidineMethacycline
DiazoxideCortisoneMethamphetamine
Dibucaine,CyclopentolateMethaqualone
Dyclonine Methylergonovine
EchothiophateDexamethasoneMethylprednisolone
ErgonovineDextroamphetamineMethysergide
ErgotamineDiethylpropionMetrizamide
EtretinateDipivefrinMinocycline
FerrocholinateEphedrineMorphine
Ferrous fumarateEpinephrineNalorphine
Ferrous gluconateFludrocortisoneNaloxone
Ferrous succinateFluorometholoneNeostigmine
Ferrous sulfateFluprednisoloneNiacin
FludrocortisoneHomatropineNiacinamide
FluorometholoneHydrocortisoneNialamide
FluprednisoloneImipramineNicotinyl alcohol
Gold Au-198KetamineNitroglycerin
Gold sodium thiomalateMethamphetamineNortriptyline
HydrocortisoneMethylprednisoloneOpium
HydroxychloroquineNortriptylineOral contraceptives
Idoxuridine,ParamethasoneOxprenolol
IndomethacinPhenylephrineOxygen
Iron dextranPhenmetrazineOxymorphone
Iron sorbitex.PhentermineOxyphenbutazone
IsoflurophatePrednisoloneOxytetracycline
IsotretinoinPrednisoneParaldehyde
MesoridazineProtriptylineParamethasone
MethylergonovineScopolaminePentolinium
MethylprednisoloneSucciny1cholineperphenazine
MethysergideTriamcinolonePhenacetin
NaproxenTropicamidePhenelzine
ParamethasoneUreaPhenmetrazine
Perphe ineVeratrumPhentermine
Phenacaine Phenylbutazone
PiperocaineOphthalmoscopyPhenylephrine
Polysaccharide-iron complexAllopurinolPhenytoin
PractololAmodiaquinePhysostigmine
PrednisoloneBroxyquinolinePiperazine
PrednisoneCarmustine,Polysaccharide-iron complex
ProchlorperazineChloramphenicolPractolol
PromethazineChloroquinePrednisolone
Proparacaine,,ChlorpromazinePrednisone
QuinacrineChlortetracyclinePrilocaine
Silver nitrateCisplatinProcaine
Silver proteinCycloserineprochlorperazine
SuraminDanazolPromethazine
TamoxifenDeferoxaminePropoxycaine
TetracaineDemecariumPropranolol
ThioridazineDemeclocyclineProtriptyline
ThiothixeneDiatrizoate meglumine/sodiumQuinacrine
TolazamideDoxycychneQuinidine
TolbutamideEchothiophateQuinine
TriamcinoloneEthambutolReserpine
TrifluoperazineEtretinateScopolamine
TrifturidineFerrocholinateSodium salicylate
VidarabineFerrous fumarateSulfonamides
VigabatrinFerrous gIuconateTetracycline
Vitamin DFerrous succinateTetraethylammonium
Color VisionFerrous sulfateThioridazine
Amyl nitriteGentamicinThiothixene
AspirinGriseofulvinTimolol
BromideHydroxychloroquineTolazamide
ChlorpromazinelbuprofenTolbutamide
DigitalisIodochlorhydroxyquinTranylcypromine
DigitoxinlodoquinolTriamcinolone
Digoxinlothalamate meglumine/sodiumTrichlorethylene
EthambutolIron dextranTrifluoperazine
lbuprofenIron sorbitexTrifluperidol
IndomethacinIsoflurophateTrimethaphan
IsocarboxazidIsoniazidTrimethidinium
MesoridazineIsotretinoinTropicamide
MethaqualoneMesoridazineTryparsamide
Nalidixic acidMethacyclineVeratrum
Nialamidehfinocychne 
OuabainNalidixic acidVisual Fields
ParamethadioneNeostigmineAlcohol
PerphenazineNitrofurantoinAmodiaquine
PhenacetinOral contraceptivesBetamethasone
PhenelzineOxyphenbutazoneChloramphenicol
PiperazineOxytetracyclineChloroqume
ProchlorperazinePerphenazineCortisone
PromethazinePhenylbutazoneDexamethasone
QuinidinePhenylpropanolamineDiazoidde
Sodium salicylatePhysostigmineEpinephrine
ThioridazinePilocarpineEthambutol
TranylcyprominePolysaccharide-iron complexFludrocortisone
 ProchlorperazineFluorometholone
TrifluoperazinePromethazineFluprednisolone
TrimethadioneQuinacrineHydrocortisone
Dark AdaptationQuinineHydroxychloroquine
AlcoholStreptomycinIbuprofen.
ParamethadioneTamoxifenlothalamate meglumine/sodium
Quinidine,TetracyclineIsoniazid
TrimethadioneThioridazineLithium carbonate
 TrifluoperazineMethylprednisolone
Extraocular MotilityTYyparsamideOral contraceptives
AcetohexamideVitamin AOxygen
AlcoholVitamin DOxyphenbutazone
Amitriptyline Paramethasone
AmobarbitalSicca ExaminationPhenylbutawne
AspirinBetaxololPrednisolone
BarbitalBusulfanPrednisone
BetaxololLevobunololQuinidine
BromideOral contraceptivesQuinine
BupivacaineOxprenololStreptomycin
CarbamazepinePractololTriamcinolone
ChlordiazepoxideTImololTrichlorethylene
Chloroform Tryparsamide
ChloroprocaineVisual Acuity Measurements 
ChlorpromazineAcetaminophen 
Chlorpropamide,Acetanilid 
DiazepamAcetohexamide 
EthchlorvynolAlcohol (ethanol) 
FloxuridineAllopurinol 
FluorouracilAluminum nicotinate 
FlurazepamAmiodarone 
GuanethidineAmitriptyline 
ImipramineAmodiaquine 
IsoniazidAmphetamine 
KetamineAmyl nitrite 
LevobunololAntipyrine, 
UdocaineAspirin 
Lithium carbonateAtropine 
MepivacaineBelladonna 
MeprobamateBetamethasone 
MesoridazineBetaxolol 
MethaqualoneBromide 
MethylpentynolBupivacaine 
MetrizamideBusulfan 
Metubine iodideCarbamazepine 
NitrofurantoinCarbon dioxide 
NortriptylineChloramphenicol 
OxyphenbutazoneChlordiazepoxide 
PentobarbitalChlorisondamine 
PerphenazineChloroform 
PhenobarbitalChloroprocame 
PhencyclidineChloroquine 
PhenylbutazoneChlorphentermie 
PhenytoinChlorpromazine 
PiperazineChlorpropamide 
PrilocaineChlorprothixene 
PrimidoneChlortetracycline 
ProcaineCisplatin 
ProchlorperazineClomiphene 
PromethazineCobalt 
PropoxycaineCortisone 
ProtriptylineCyclopentolate 
ReserpineCycloserine 
SecobarbitalDemecarium 
Sodium salicylateDemeclocycline 
StreptomycinDexamethasone 
Succiny1cholineDextroamphetamine 
TalbutalDiazepam 
ThiopentalDiazoxide 
ThioridazineDiethylpropion, 
TimololDipivehin 
TolazamideDoxycychne 
TolbutamideDroperidol 
TrichlorethyleneEchothiophate 
TrifluoperazineEpinephrine 
TubarineErgonovine 
Valproate sodiumErgotamine 
Valproic acidEthambutol 
VeratrumEthchlorvynol 
VinblastineFerrocholinate 
Vincristine  
Vitamin AFerrous fumarate 
 Ferrous gluconate 
Fluorescein AnglographyFerrous succinate 
Aluminum nicotinateFerrous sulfate 
Amyl nitriteFludrocortisone 
Broxyquinoline,Fluorometholone 
Carbon dioxideFluprednisolone 
CarmustineFlurazepam 
Diatrizoate megluminelsodium.Gentamicin 
EpinephrineGriseofulvin 
ErgonovineGuanethidine 
ErgotamineHaloperidol 
Griseofulvin.Hexamethonium 
 Homatropine 

 

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BIBLIOGRAPHY

Dukes MNG, ed. Meyler's Side Effects of Drugs. 11th ed. Amsterdam: Excerpta Medica, 1988

Fraunfelder FT, Fraunfelder FW. Drug-Induced Ocular Side Effects. 5th ed. Woburn, MA: Butterworth-Heinemann, 2001

Grant WM. Toxicology of the Eye. 4th ed. Springfield, IL: Charles C Thomas, 1993

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