Quick Reference to Ocular Manifestations of Commonly Prescribed Systemic Medications

Disease/Condition Generic Name (Brand Name) of Medication Potential Ocular Complications/Adverse Reactions
Acne (vulgaris/ rosacea) tetracycline hydrochloride (Achromycin)

doxycycline (Vibramycin)

minocycline hydrochloride (Minocin)

Blurred vision (associated with pseudotumor cerebri), diplopia, color vision defects, photosensitivity

Allergies (rhinitis, uticaria) loratidine (Claritin)

cetirizine (Zyrtec)

Keratoconjunctivitis, photosensitivity, dry eye, contact lens discomfort
Angina nifedipine (Procardia, Adalat)

nitroglycerine (Nitrobid, Nitrostat)

Blurred vision, ocular irritation, periorbital edema

Anxiety/panic disorders alprazolam (Xanax)

diazepam (Valium)

Blurred vision, photosensitivity, blepharospasm, subconjunctival hemorrhages, retinal hemorrhages, oculomotor dysfunctions, decreased accommodation, diplopia, visual hallucinations

Arthritis (rheumatoid)

ibuprofen (Advil, Motrin)

indomethacin (Indocin)

prednisone (Deltasone)

hydroxychloroquinine sulfate (Plaquenil)

Blurred vision, toxic maculopathy, corneal deposits, color vision defects, visual field loss, nystagmus, photosensitivity
Blood clots, atrial fib prophylaxis warfarin sodium (Coumadin) Subconjunctival and retinal hemorrhages
Bronchospasm albuterol sulfate (Proventil, Ventolyn)

ipratropium bromide (Atrovent)

Pupillary dilation, visual hallucinations, elevated intraocular pressure
Cancer (breast) tamoxifen citrate (Nalvadex) Retinopathy, color vision defect, visual acuity and visual field loss

Cardiac arrhythmias (atrial fib and tachycardia)

digoxin (Lanoxin)

propranolol (Inderal)

amiodarone hydrochloride (Cordarone)

corneal and lenticular deposits, papillitis, pseudotumor cerebri (rare), photosensitivity, dry eyes, color anomalies

Congestive heart failure

digoxin (Lanoxin)

captopril (Capoten)

Blurred vision, color vision (blue/green) defect, retinal entopic phenomena
Contraception estrogen and progesterone (Ovcon, Ovral, Ortho-Novum) Contact lens intolerance, decreased color perception
Depression fluoxetine hydrochloride (Prozac)

paroxetine hydrochloride (Paxil)

sertraline hydrochloride (Zoloft)

amitryptoline (hydrochloride Elavil, Enpep)

Blurred vision, diplopia, ptosis, nystagmus, dilated pupils, dry eye, eye pain

Diabetes mellitus

glyburide (DiaBeta, Micronase)

glipizide (Glucotrol)

insulin (Humulin N)

metformine (Glucophage)

Blurred vision, transient lenticular changes, photosensitivity

Ear infections (acute otitis media) amoxicillin trihydrate (Amoxil, Polymox, Trimox)

cefaclor (Ceclor)

cephalexin (Keflex)

Allergic reaction of eyelids or conjunctiva, photosensitivity, ptosis, diplopia
Epilepsy/seizures clonazepam (Klonopin)

phenytoin sodium (Dilantin)

carbamazepine (Tegratol, Atretol)

divalproex (Depakote)

Nystagmus, diplopia, photosensitivity
Gonorrhea tetracycline hydrochloride (Achromycin)

amoxicillin trihydrate (Amoxil)

Blurred vision (associated with pseudotumor cerebri), allergic reaction of eyelids or conjunctiva
Herpes Simplex acyclovir (Zovirax) Periocular edema, visual hallucinations

Hyperthyroidism/

goiter

levothyroxine sodium (Synthroid)

Blurred vision, photosensitivity, papilledema (related to pseudotumor cerebri), diplopia, ptosis, blepharospasm
HIV infection (AIDS) Dideoxynucleoside reverse transcriptase inhibitors:

didanosine (Videx)

zalcitabine (Hivid)

lamivudine (Epivir)

zidovudine (Retrovir)

stavudine (Zerit)

HIV protease inhibitors:

indinavir (Crixivan)

nelfinavir (Viracept)

ritonavir (Norvir)

saquinavir (Fortovase)

Non-nucleoside reverse transcriptase inhibitors:

delavirdine (Rescriptor)

nevirapine (Viramune)

Cystoid macular edema, hyperpigmentation of eyelids, diplopia, visual hallucinations
Hypertension furosemide (Lasix)

hydralazine hydrochloride (Apresoline)

enalapril maleate (Vasotec)

captopril (Capoten)

nifedipine (Adalat, Procardia)

triamterene (Diazide)

lisinopril (Zestril)

amlodipine (Norvasc)

Blurred vision, conjunctivitis, photosensitivity, visual hallucinations, tearing, nystagmus, retinal hemorrhages

Hypercholesterolemia

atorvastatin (Lipitor)

simvastatin (Zocor)

pravastatin (Provachol)

lens opacities, decreased visual
Impotence/erectile dysfunction sildenafil (Viagra)

impairment of color vision (blue/green), photophobia

Leg cramps (nocturnal) quinine sulfate Blurred vision, diplopia, photosensitivity, toxic retinopathy
Menopause (hormone replacement) estrogen (Premarin) contact lens intolerance
Nausea/vomiting (severe) prochlorperazine (Compazine) Blurred vision, pigmentary deposits on lens, retinopathy
Pain (low to moderate) propoxyphene hydrochloride (Darvon) Blurred vision, miosis, reduced lacrimation

Pain (moderate to severe)

acetaminophen with codeine (Tylenol with Codeine)

tramadol (Ultram)

oxycodone with acetaminophen (Percocet)

Visual disturbances, pupillary changes

Psoriasis (vitiligo) methoxsalen (Oxsoralen) keratitis, photosensitivity, dry eyes

Psychotic disorders

chlorpromazine hydrochloride (Thorazine)

trifluoperazine hydrochloride (Stelazine)

thioridazine hydrochloride (Mellaril)

prochlorperazine (Compazine)

Retinopathy, corneal and lenticular deposits, accommodative dysfunction, color vision defects, visual acuity and visual field loss

Respiratory infection

amoxicillin trihydrate (Amoxil, Polymox, Trimox)

cephalexin (Keflex)

cefaclor (Ceclor)

tetracycline hydrochloride (Achromycin)

Allergic reaction of eyelids or conjunctiva, photosensitivity, ptosis, diplopia

Sinus infection (acute sinusitis)

amoxicillin trihydrate (Amoxil, Polymox, Trimox)

cefaclor (Ceclor)

Allergic reaction of eyelids or conjunctiva, photosensitivity, ptosis, diplopia

Skin infection

cefaclor (Ceclor)

ciprofloxacin hydrochloride (Cipro)

Allergic reaction of eyelids or conjunctiva, photosensitivity, peripheral corneal edema

Tuberculosis

rifampin (Rifadin)

ethambutol hydrochloride (Myambutol)

prednisone (Deltasone)

Optic neuritis, color vision defects, visual acuity and visual field loss

Ulcers (duodenal/gastric)

cimetidine (Tagamet)

ranitidine hydrochloride (Zantac)

famotidine (Pepcid)

omeprazole (Prilosec)

Blurred vision, visual hallucinations, photosensitivity, decreased accommodation, dilated pupils

Urinary tract infection (UTI)

amoxicillin trihydrate (Amoxil, Polymox, Trimox)

cephalexin (Keflex)

cefaclor (Ceclor)

tetracycline hydrochloride (Achromycin)

ciprofloxacin hydrochloride (Cipro)

Allergic reaction of eyelids or conjunctiva, photosensitivity, ptosis, diplopia

References:

  1. Physician's Desk Reference. Montvale, NJ: Medical Economics, 1999.
  2. Drug Facts and Comparisons. St. Louis: Facts and Comparisons, 1999.
  3. American Hospital Formulary Service Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1999.
  4. http://www.Drugtopics.com

This Quick Reference is a partial listing of commonly prescribed systemic medications and their ocular manifestations.

Prepared by the Primary Care Committee, Clinical Care Group, American Optometric Association.

Approved by the AOA Board of Trustees, August 26, 1999

Cross References to Quick Reference to Ocular Manifestations of Commonly Prescribed Systemic Medications - Brand Name (generic name) – Disease/Condition

  • Achromycin (tetracycline hydrochloride) – Acne (vulgaris/rosacea); Gonorrhea; Respiratory infection; Urinary tract infection (UTI)
  • Adalat (nifedipine) – Angina; Hypertension
  • Advil (ibuprofen) - Arthritis (rheumatoid)
  • Amoxil (amoxicillin trihydrate) – Ear infections (acute otitis media); Gonorrhea; Respiratory infection; Sinus infection (acute sinusitis); Urinary tract infection (UTI)
  • Apresoline (hydralazine hydrochloride) – Hypertension; Respiratory infection; Urinary tract infection (UTI)
  • Atretol (carbamazepine) – Epilepsy/seizures
  • Atrovent (ipratropium bromide) – Bronchospasm
  • Capoten (captopril) - Congestive heart failure
  • Capoten (captopril) – Hypertension
  • Ceclor (cefaclor) – Ear infections (acute otitis media); Respiratory infection; Skin infection; Urinary tract infection (UTI)
  • Cipro (ciprofloxacin hydrochloride) - Skin infection; Urinary tract infection (UTI)
  • Claritin (loratidine) - Allergies (rhinitis, uticaria)
  • Compazine (prochlorperazine) - Nausea/vomiting (severe); Psychotic disorders
  • Cordarone (amiodarone hydrochloride) – Cardiac arrhythmias (atrial fib and tachycardia)
  • Coumadin (warfarin sodium) - Blood clots; atrial fib prophylaxis
  • Crixivan (indinavir) – HIV infection (AIDS)
  • Darvon (propoxyphene hydrochloride) - Pain (low - moderate)
  • Deltasone (prednisone) - Arthritis (rheumatoid)
  • Deltasone (prednisone) – Tuberculosis
  • Depakote (divalproex) - Epilepsy/seizures
  • DiaBeta (glyburide) – Diabetes mellitus
  • Diazide (triamterene) – Hypertension
  • Dilantin (phenytoin sodium) – Epilepsy/seizures
  • Elavil (amitryptoline hydrochloride) – Depression
  • Enpep (amitryptoline hydrochloride) – Depression
  • Epivir (lamivudine) – HIV infection (AIDS)
  • Fortovase (saquinavir) – HIV infection (AIDS)
  • Glucophage (metformine) - Diabetes mellitus
  • Glucotrol (glipizide) – Diabetes mellitus
  • Hivid (zalcitabine) – HIV infection (AIDS)
  • Humulin N (insulin) – Diabetes mellitus
  • Inderal (propranolol) – Cardiac arrhythmias (atrial fib and tachycardia)
  • Indocin (indomethacin) - Arthritis (rheumatoid)
  • Keflex (cephalexin) - Ear infections (acute otitis media);
  • Klonopin (clonazepam) – Epilepsy/seizures
  • Lanoxin (digoxin) – Cardiac arrhythmias (atrial fib and tachycardia); Congestive heart failure
  • Lasix (furosemide) – Hypertension
  • Lipitor (atorvastatin) – Hypercholesterolemia
  • Mellaril (thioridazine hydrochloride) – Psychotic disorders
  • Micronase (glyburide) – Diabetes mellitus
  • Minocin (minocycline hydrochloride) - Acne (vulgaris/rosacea)
  • Motrin (ibuprofen) - Acne (vulgaris/rosacea)
  • Myambutol (ethambutol hydrochloride) – Tuberculosis
  • Nalvadex (tamoxifen citrate) - Cancer (breast)
  • Nitrobid; Nitrostat (nitroglycerine) – Angina
  • Norvasc (amlodipine) – Hypertension
  • Norvir (ritonavir) – HIV infection (AIDS)
  • Ortho-Novum (estrogen and progesterone) – Contraception
  • Ovcon; Ovral (estrogen and progesterone) – Contraception
  • Oxsoralen (methoxsalen) - Psoriasis (vitiligo)
  • Paxil (paroxetine hydrochloride) – Depression
  • Pepcid (famotidine) – Ulcers (duodenal/gastric)
  • Percocet (oxycodone with acetaminophen) - Pain (moderate to severe)
  • Plaquenil (hydroxychloroquinine sulfate - Arthritis (rheumatoid)
  • Polymox (amoxicillin trihydrate) – Ear infections (acute otitis media); Respiratory infection; Sinus infection (acute sinusitis); Urinary tract infection (UTI)
  • Premarin (estrogen) - Menopause (hormone replacement)
  • Prilosec (omeprazole) – Ulcers (duodenal/gastric)
  • Procardia (nifedipine) - Angina
  • Procardia (nifedipine) – Hypertension
  • Provachol (pravastatin) – Hypercholesterolemia
  • Proventil (albuterol sulfate) – Bronchospasm
  • Prozac (fluoxetine hydrochloride) – Depression
  • Quinine sulfate - Leg cramps (nocturnal)
  • Rescriptor (delavirdine) – HIV infection (AIDS)
  • Retrovir (zidovudine) – HIV infection (AIDS)
  • Rifadin (rifampin) – Tuberculosis
  • Stelazine (trifluoperazine hydrochloride) – Psychotic disorders
  • Synthroid (levothyroxine sodium) - Hyperthyroidism/goiter
  • Tagamet (cimetidine) – Ulcers (duodenal/gastric)
  • Tegratol (carbamazepine) – Epilepsy/seizures
  • Thorazine (chlorpromazine hydrochloride) – Psychotic disorders
  • Trimox (amoxicillin trihydrate) – Ear infections (acute otitis media); Respiratory infection; Sinus infection (acute sinusitis); Urinary tract infection (UTI)
  • Tylenol with Codeine (acetaminophen with codeine) – Pain(moderate to severe)
  • Ultram (tramadol) – Pain (moderate to severe)
  • Valium (diazepam) - Anxiety/panic disorders
  • Vasotec (enalapril maleate) – Hypertension
  • Ventolyn (albuterol sulfate) – Bronchospasm
  • Viagra (sildenafil) - Impotence /erectile dysfunction
  • Vibramycin (doxycycline) - Acne (vulgaris/rosacea)
  • Videx (didanosine) - HIV infection (AIDS)
  • Viracept (nelfinavir) – HIV infection (AIDS)
  • Viramune (nevirapine) - HIV infection (AIDS)
  • Xanax (alprazolam) - Anxiety/panic disorders
  • Zantac (ranitidine hydrochloride) – Ulcers (duodenal/gastric)
  • Zerit (stavudine) – HIV infection (AIDS)
  • Zestril (lisinopril) – Hypertension
  • Zocor (simvastatin) – Hypercholesterolemia
  • Zovirax (acyclovir) - Herpes Simplex
  • Zyrtec (cetirizine) - Allergies (rhinitis, uticaria)