Drugs Which Can Affect Near Vision: A Useful List

Drugs Which Can Affect Near Vision: A Useful List

Joanne L. Smith B.Sc., Ph.Phm.*

J. Raymond Buncic, M.D., F.R.C.S.(C)t

ABSTRACT

This paper documents a list of drugs that cause problems with near vision, by virtue of effects on accommodation, occasionally refractive error and diplopia. It is meant as a reference aid to the clinician when confronted with problems of focusing on near objects or print.

There are many drugs that have been reported to interfere with near or reading vision, producing blurring, decreased accommodation and diplopia. This paper lists the drugs that have been reported in the literature to produce symptoms which interfere with near vision. Case reports for the listed drugs vary greatly from many to few. The drugs have been divided into the following categories: those causing (A) blurring at near, (B) diplopia and (C) induced myopia. Those drugs which only rarely cause these symptoms have been omitted.

From the Departments of Pharmacy* and Ophthalmologyt, The Hospital For Sick Children, Toronto, Ontario, Canada Requests for reprints should be addressed to: Dr. J. Raymond Buncic, Department of Ophthalmology, The Hospital For Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G lX8

TABLE 1 DRUGS COMMONLY CAUSING DIFFICULTY WITH FOCUSING AT NEAR OR BLURRED VISION.

DRUG Antipsychotics Chlorpromazine Clozapine Fluphenazine Haloperidol Loxapine Perphenazine Pimozide Risperidone Thioridazine Thiothixene Trifluoperazine Antidepressants Bupropion Doxepin MAOls, for example:

Phenelzine Tranylcypromine Maprotiline Nefazodone SSRls, for example: Fluoxetine Fluvoxamine Paroxetine Sertraline Tricyclic Antidepressants, for example: Amitriptyline Clomipramine Desipramine Imipramine Nortriptyline Trimipramine

INCIDENCE

14-23 5 1.2-4.3 6.8-16

7.4-17.8 20 1-2%, >/= 10% 0.6-18 20 4-10

5.3-15% 20

1.5-17%) 9%(2-10%) 4% 9%

3-4.5% 6.3% 4% 4%

7.5-35% 18-20% adults 2-6 1.2-17% 5.5% 6%

REFERENCE

8 8,14

8 8 12,14 8 8 11 8 8 8 8,9 11 8

8 8 11 11

8,11 14 11 11

8 8 8 8 8 8

Venlafaxine Anticholinergics Atropine Belladonna Benztropine Dicyclomine Donepezil Hyoscyamine Propantheline Scopolamine Trihexyphenidyl Other Drugs Amiodarone Buspirone Calcium channel blockers Carbamazepine Chloroquine Chlorpheniramine Clomiphene Cyclophosphamide Cytarabine Digoxin Fludarabine Gabapentin Guanethedine Hydroxychloroquine Indinavir Lamotrigine Lithium Mexilitine Piroxicam Quinidine Ritonavir Trimethadione Zidovudine

DRUG Acetazolamide Acetylcholine Alprazolam Amantadine Ambutonium Amodiaquine Amoxapine Amphetamine Amphotericin Antazoline Baclofen Bendroflumethiazide Betamethasone Bethanechol Biperiden Captopril Carbachol Carisoprodol Cetirizine Chloramphenicol Chlordiazepoxide Chlorothiazide, Chlorthalidone Cinchocaine (dibucaine) Cimetidine Clemastine Clonazepam Clonidine Clorazepate Cocaine Cortisone

6%

20% 1-2%

12 (high doses) 2% (high doses) -1% -5-10%

4.2% (amblyopia) 17% ................
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