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Visual disorders: sometimes drug-related

Visual disorders, such as myopia, hypermetropia and loss of the accommodation faculty (presbytia), are often caused by anatomical anomalies or ageing. However, they can sometimes be caused by medication, and in these cases are reversible when treatment stops.

Myopia, hypermetropia and loss of the accommodation faculty are common visual disorders, often due to anatomical anomalies or to physiological ageing. Some drugs are implicated in the occurrence or the aggravation of these disorders.

Certain drugs act on the autonomous nervous system, modifying the pupils’ diameter and ability to accommodate: atropinic drugs (atropine, antispasmodics, urinary incontinence treatments, drugs used in neuropsychiatry, bronchodilators, antihistamines H1); cholinergic drugs used for various ailments (Alzheimer’s disease, smoking cessation treatments).

Other drugs have an unpredictable effect or an unknown mechanism: diuretics, antibiotics, antiepileptics, oestrogen/progestogen.

The role of a drug treatment should be questioned when a sudden change of vision that is both transient and bilateral takes place. The disorders soon subside after the drug treatment ceases.

©Prescrire June 2010

"Drug-induced myopia, hyperopia and accommodation disorders" Prescrire Int 2010; 19 (107): 116-119 (pdf, subscribers only).

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