Ocular Manifestations of Systemic Medications (F)

Question 1

How will all ocular effects from systemic meds present?

Answer 1

bilateral

Question 2

What are the medication types that decrease tear production?

Answer 2

1. oral anticholinergics
2. oral antihistamines
3. oral decongestants
4. oral B-blockers
   5, oral contraceptives
5. Isotretinoin (acne med)
6. Oxsoralen (psoriasis)

Question 3

What are the medication types that increase tear production?

Answer 3

Salagen and Evoxac (Sjogrens)

Question 4

What is the condition in which there are corneal deposits that are absorbed into the limbal stem cells that then migrate into the central corneal position in a whorl-like pattern?

Answer 4

vortex keratopathy

Question 5

What are the drugs that affect the cornea?

Answer 5

1. Cordarone, Amiodarone (arrhythmia)
2. Myochrysine, Gold Salts (RA)
3. Plaquenil, Hydroxychloroquine (antimalarial, RA, Lupus)
4. Thorazine (chlorpromazine), Seroquel (antipsychotic)

Question 6

What are the drugs that affect the lens?

Answer 6

corticosteroids (posterior subcapsular)

Question 7

What are the drugs that affect the iris with the condition it makes?

Answer 7

1. Flomax, tamsulosin (BPH) = floppy iris syndrome (problem for cataract surgery)
2. Anticholinesterase = pupillary miosis
   3, opiates = pupillary miosis
3. anticholinergics = pupillary dilation
4. Antianxiety meds, antihistamines, tricyclic antidepressants = pupillary dilation
5. amphetamines, cocaine, ADD/ADHD meds, oral decongestants = pupillary dilation

Question 8

What are the drugs that increase myopia?

Answer 8

1. sulfonamides
2. carbonic anhydrase inhibitors
3. diuretics
4. topamax (antiseizure)

Question 9

What are the drugs that increase IOP?

Answer 9

1. anticholinergics
2. antihistamines
3. decongestants
4. phenothiazides
5. tricyclic antidepressants
6. corticosteroids

Question 10

What are the drugs that decrease IOP?

Answer 10

1. systemic B-blockers
2. cannabinoids
3. cardiac glycosides
4. ethyl alcohol

Question 11

What are the drugs that can induce maculopathies?

Answer 11

1. Plaquenil (RA, Lupus)

2. Tamoxifen (breast cancer)

Question 12

What are the drugs that induce effects on cone receptor function?

Answer 12

1. Lanoxin (digoxin) (cardiac arrhythmias and CHF) = snow vision

Question 13

What are the drugs that can induce peripheral retinotoxicity?

Answer 13

1. thioridazine (anti-psychosis) = RPE loss with hyperplasia

Question 14

What are the drugs that can affect retinal vasculature?

Answer 14

1. drug abusers = talc retinopathy

2. viagra, levitra, cialis = blue vision and NAION

Question 15

What are the drugs that can induce optic neuritis/neuropathy?

Answer 15

1. amiodarone

2. topamax

Question 16

What are the drugs that can induce idiopathic intacranial hypertension that can cause papilledema?

Answer 16

1. high dose Vit A
2. tetracyclines
3. nalidixic acid (1st gen fluoroquinolone)
4. birth control
5. isotretinoin
6. withdrawal of systemic steroids

Question 17

What is useful in differentiating papilledema from pseudopapilledema from ONH drusen?

Answer 17

OCT