Associations of selected medications and visual function: the Beaver Dam Eye Study

Klein, Barbara E.K.; Klein, Ronald; Knudtson, Michael D.; Lee, Kathryn E.; Danforth, Lorraine G.; Reinke, Jennifer O.; Adler, Anna

doi:10.1136/bjo.87.4.403

Cited by 24 publications

(12 citation statements)

References 15 publications

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“…It was found that several reviewed studies had shown a global loss of contrast sensitivity with benzodiazepines. [124,125] Furthermore, this trial's specific findings were that long-term lorazepam recipients exhibited impaired contrast Continued next page sensitivity (and exophoria), and this was independent of the sedative effects of the benzodiazepine. This was seen to be concomitant with a normal visual acuity.…”

Section: Benzodiazepinesmentioning

confidence: 96%

Ocular Adverse Effects of Common Psychotropic Agents

Richa¹,

Yazbek²

2010

CNS Drugs

178

143

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All psychotropic medications have the potential to induce numerous and diverse unwanted ocular effects. Visual adverse effects can be divided into seven major categories: eyelid and keratoconjunctival disorders; uveal tract disorders; accommodation interference; angle-closure glaucoma; cataract/pigmentary deposits in the lens and cornea; retinopathy; and other disorders. The disorders of the eyelid and of the keratoconjunctiva are mainly related to phenothiazines and lithium. Chlorpromazine, at high dosages, can commonly cause abnormal pigmentation of the eyelids, interpalpebral conjunctiva and cornea. It can also cause a more worrisome but rarer visual impairment, namely corneal oedema. Lithium can rarely lead to a bothersome eye irritation by affecting sodium transport. Uveal tract problems are mainly associated with tricyclic antidepressants (TCAs), typical antipsychotics, topiramate and selective serotonin reuptake inhibitors (SSRIs). TCAs, typical antipsychotics and SSRIs can all cause mydriasis that is often transient and with no major consequences, but that can promote closure of angles in susceptible patients. Topiramate has been frequently associated with a number of significant ocular symptoms including acquired myopia and angle-closure glaucoma. Problems with accommodation are related to TCAs and to low-potency antipsychotics. TCAs cause transient blurred vision in up to one-third of patients. Angle-closure glaucoma is a serious condition that has been mainly associated with TCAs, low-potency antipsychotics, topiramate and, to a lesser extent, SSRIs. When patients with narrow angles are given TCAs, they all appear to experience induction of glaucomatous attacks. Antipsychotics and SSRIs may lead to an added risk of developing angle-closure glaucoma, but only in predisposed eyes. Topiramate can lead to an allergic-type reaction whereby structures of the lens and ciliary body are displaced, which results in angle-closure glaucoma. Cataractous changes can result from antipsychotics, mainly from high dosages of chlorpromazine or thioridazine. These two drugs, when used at high dosages and for prolonged periods, frequently cause lenticular opacifications. Retinopathy has been shown to be related to high dosages of typical antipsychotics, mainly chlorpromazine and thioridazine. The frequency of occurrence of retinal effects seems to be proportional to the total amount of drug used over a long period of time. Other visual problems of special concern are the ocular dystonias, other eye movement disorders, and decreased ability to perceive colours and to discriminate contrast. Ocular dystonias can occur with antipsychotics (especially high-potency ones), carbamazepine (especially in polytherapy), topiramate and, rarely, with SSRIs. Disturbance in various eye movements is frequently seen with benzodiazepines, antiepileptic drugs and lithium. Impairment in the perception of colours and the discrimination of contrasts has been shown to occur not uncommonly with carbamazepine and lorazepam. Thus, typical antipsycho...

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Section: Benzodiazepinesmentioning

confidence: 96%

Ocular Adverse Effects of Common Psychotropic Agents

Richa¹,

Yazbek²

2010

CNS Drugs

178

143

View full text Add to dashboard Cite

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“…In addition to the general physiologic changes often seen with increasing age and disease, the high incidence of polypharmacy (ie, 4 or more medications) 56 (also see the article by Peron and colleagues elsewhere in this issue) is another major risk factor for falls, [57][58][59] one that needs to be addressed to lower the risk. Research has shown that a simple reduction of psychotropic medications and polypharmacy can result in a significantly reduced fall rate.…”

Section: The Problem Of Polypharmacymentioning

confidence: 97%

Falls Risk in Older Adults with Type 2 Diabetes

Vinik

Colberg

et al. 2015

Clinics in Geriatric Medicine

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“…[1][2][3][4][5] Frailty is characterised by observable functional declines in the body, particularly weight loss, exhaustion, low energy expenditure, slowness and weakness, 1,6,7 and has been linked to visual impairment in recent population studies. [8][9][10] Glaucoma is a leading cause of irreversible visual impairment among older adults, leading to visual field loss, and in the later stages of the disease, to loss of central vision. As locomotion has been shown to be highly visually dependent, 11,12 it is expected that mobility would become increasingly difficult with greater visual impairment.…”

Section: Introductionmentioning

confidence: 99%

Inferior visual field reductions are associated with poorer functional status among older adults with glaucoma

Black

Wood

Lovie‐Kitchin

2011

Ophthalmic Physiologic Optic

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Purpose: To examine the relationship between visual impairment and functional status in a community-dwelling sample of older adults with glaucoma. Methods: This study included 74 community-dwelling older adults with openangle glaucoma (aged 74 ± 6 years). Assessment of central vision included high-contrast visual acuity and Pelli-Robson contrast sensitivity. Binocular integrated visual fields were derived from merged monocular Humphrey Field Analyser visual field plots. Functional status outcome measures included physical performance tests (6-min walk test, timed up and go test and lower limb strength), a physical activity questionnaire (Physical Activity Scale for the Elderly) and an overall functional status score. Correlation and linear regression analyses, adjusting for age and gender, examined the association between visual impairment and functional status outcomes. Results: Greater levels of visual impairment were significantly associated with lower levels of functional status among community-dwelling older adults with glaucoma, independent of age and gender. Specifically, lower levels of visual function were associated with slower timed up and go performance, weaker lower limb strength, lower self-reported physical activity, and lower overall functional status scores. Of the components of vision examined, the inferior visual field and contrast factors were the strongest predictors of these functional outcomes, whereas the superior visual field factor was not related to functional status. Conclusions: Greater visual impairment, particularly in the inferior visual field and loss of contrast sensitivity, was associated with poorer functional status among older adults with glaucoma. The findings of this study highlight the potential links between visual impairment and the onset of functional decline. Interventions which promote physical activity among older adults with glaucoma may assist in preventing functional decline, frailty and falls, and improve overall health and well-being.

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Associations of selected medications and visual function: the Beaver Dam Eye Study

Cited by 24 publications

References 15 publications

Ocular Adverse Effects of Common Psychotropic Agents

Ocular Adverse Effects of Common Psychotropic Agents

Falls Risk in Older Adults with Type 2 Diabetes

Inferior visual field reductions are associated with poorer functional status among older adults with glaucoma

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