Acute Transient Myopia Associated With Use of Acetazolamide (Diamox)

Binder, Samuel S.; Steele, Willard H.

doi:10.1001/jama.1957.72980200006009c

Cited by 14 publications

(5 citation statements)

References 4 publications

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“…A uveal effusion was observed in about half of the patients. When acetazolamide was stopped, all cases recovered completely after a median of 5 days (2 – 14), with the aid of additional cycloplegia, anti-glaucomatous agents, and/or steroid treatment in about a quarter, a third, and more than half of the patients, respectively 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Behandlungsoptionen umfassen systematisches Absetzen des Medikaments in Verbindung mit Zykloplegie, antiglaukomatösen Medikamenten und/oder Kortikosteroiden. Eine vollständige Auflösung tritt in etwa 5 Tagen ein (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Aufgrund der weit verbreiteten Anwendung von Acetazolamid ist das Wissen über diese idiosynkratische Reaktion entscheidend, um Komplikationen eines Winkelblockglaukoms zu vermeiden.…”

Section: Therapy and Outcomeunclassified

“…Treatment options include systematic drug withdrawal associated with cycloplegia, anti-glaucomatous agents, and/or corticosteroids. Full recovery is achieved within about 5 days (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Given the widespread use of acetazolamide, awareness of this idiosyncratic reaction is crucial to avoid complications of acute angle-closure glaucoma.…”

mentioning

confidence: 99%

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Acute Myopic Shift after a Single Dose of Acetazolamide: A Case Report and Review of the Literature

Kaisari,

Abouzeid,

Magnin

et al. 2024

Klin Monbl Augenheilkd

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We report the case of a 32-year-old male who presented with an acute myopic shift as a result of uveal effusion following a single administration of 250 mg acetazolamide. The drug was discontinued and following cycloplegia and topical steroid therapy, we observed progressive deepening of the anterior chamber, reopening of the iridocorneal angle, and complete resolution of the myopic shift after 5 days. A literature review since 1956 identified 23 cases, including ours, which developed a myopic shift after a median time of 24 h (3 – 24) following a median dose of 500 mg (125 – 1000) acetazolamide, with about a third complicated by angle closure ocular hypertension. This presumed idiosyncratic reaction can occur without prior drug exposure and independent of the phakic status. Treatment options include systematic drug withdrawal associated with cycloplegia, anti-glaucomatous agents, and/or corticosteroids. Full recovery is achieved within about 5 days (2 – 14). Given the widespread use of acetazolamide, awareness of this idiosyncratic reaction is crucial to avoid complications of acute angle-closure glaucoma.

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Section: Discussionmentioning

confidence: 99%

Section: Therapy and Outcomeunclassified

mentioning

confidence: 99%

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Acute Myopic Shift after a Single Dose of Acetazolamide: A Case Report and Review of the Literature

Kaisari,

Abouzeid,

Magnin

et al. 2024

Klin Monbl Augenheilkd

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“…A search of PubMed reveals that medical literature regarding transient myopia related to the use of acetazolamide is limited and consists mainly of case reports from the 1950s and 1960s. [4][5][6][7] Although it is a documented side effect listed on the package insert 1 as well as in popular medical references, such as UpToDate (UpToDate, Inc.) and Epocrates (athenahealth, Inc.), it is not one that is commonly discussed among medical experts providing care or advice to individuals utilizing the drug for prevention or treatment of AMS. There has been a case report of a trekker in Nepal experiencing visual changes while taking acetazolamide for the treatment of AMS at doses of 250 mg, but in that situation the dosage of acetazolamide was higher than described here; myopia began after the patient was at high altitude and already experiencing AMS.…”

Section: Discussionmentioning

confidence: 99%

Myopic Changes in a Climber after Taking Acetazolamide and the Use of Corrective Lenses to Temporize Symptoms: A Case Report from Mount Kilimanjaro

Hill

2016

Wilderness & Environmental Medicine

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When performing detailed tasks related to climbing or hiking, accurate vision is important for safety. Acetazolamide is a medication commonly used to prevent acute mountain sickness, but it has an uncommon side effect of transient myopia. Reports of this side effect are mainly associated with its use in obstetrics, where it is often prescribed in higher doses than used in acute mountain sickness prophylaxis. We describe the case of a climber taking low-dose acetazolamide who developed transient myopia. We further describe potential mechanisms of this rare side effect as well as a novel approach of field management utilizing possible materials at hand.

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“…Transient myopia has been reported with a wide variety of medications, including aspirin, 3 quinine, 4 tetracyclines, 5 metronidazole, 6 sulphamethoxazole/trimethoprim, 7,8 dapsone, 9 topiramate, 10 –12 triamterene, 13 and carbonic anhydrase inhibitors, and in particular acetazolamide. 14 –17 The mechanism proposed involves allergic-type reaction localized to the ciliary body. 18 The resolution of symptoms is usually longer than the half-life of the drug would suggest, and although cessation of medication is probably adequate treatment, cycloplegia may be tried.…”

mentioning

confidence: 99%