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Drug-induced corneal damage

FEATURED REVIEW A wide variety of drugs can damage the cornea, with effects ranging from simple asymptomatic deposits to irreversible, sight-threatening damage.
Full review (4 pages) available for download by subscribers.

Key points

  • Corneal damage can have a variety of causes, including infections, chemical splashes, environmental factors (radiation, trauma, contact lenses, etc.), and systemic diseases (genetic, autoimmune, inflammatory, metabolic, etc.). A wide range of drugs can also damage the cornea.

  • The severity of drug-induced corneal changes can range from simple asymptomatic deposits to irreversible, sight-threatening damage. Several factors can influence the onset of corneal lesions. Some factors, such as the dose, are treatment-related, while others such as contact lenses, are patient-related. A variety of mechanisms may be involved, including corneal dryness, changes in the corneal epithelium, impaired wound healing and deposits.

  • Many drugs can damage the cornea through direct contact, after intraocular injection or instillation, including VEGF inhibitors, anti-inflammatory drugs, local anaesthetics, glaucoma drugs, fluoroquinolones, and preservatives.
     
  • Some systemically administered drugs can also damage the cornea, notably cancer drugs, amiodarone and isotretinoin. 
     
  • Vulnerable patients should be informed of this risk if they are prescribed a drug with the potential to damage the cornea so that they can identify problems in a timely manner. It may be necessary to discontinue the suspect drug when signs and symptoms of corneal damage occur.

©Prescrire 1 April 2014

"Drug-induced corneal damage" Prescrire Int 2014; 23 (148): 97-100. (Pdf, subscribers only)

Download the full review.
Pdf, subscribers only

See also:

Drug-induced colour
vision disorders
(May 2012)
Free

Visual disorders:
sometimes drug-related
(June 2010)
Free

Drug-induced cataracts
Prescrire Int 2011
20 (113): 41-43
Pdf, subscribers only