Drug-induced Toxic Reactions in the Eye

Abstract

Every drug can produce untoward consequences, even when used according to standard or recommended methods of administration. Adverse drug reactions can involve every organ and system of the body, even the eye, and frequently are mistaken for signs of underlying disease. Reactions in the eye may involve the eyelids, periorbital tissues, lacrimal apparatus, conjunctiva, cornea, lens, iris, ciliary body, intraocular pressure, retina, optic nerve, and ocular movement. In addition, fetal abnormalities can be caused by the use of eye drugs during pregnancy. Topical ophthalmic therapies or the use of ophthalmic dyes may cause systemic reactions. This article reviews drugs used systemically or topically that may cause adverse effects in the eye and related structures. Adverse ocular reactions to medications create an important health problem, and nursing professionals in close contact with patients inside and outside the hospital must assume a role in detecting them early, identifying them, educating the patient about them, and treating them.

Systemic low‐molecular weight drug delivery to pre‐selected neuronal regions

“…In terms of the safety profile of using barrier‐modulating technology, we have seen very few differentially regulated genes in neuronal tissues when claudin‐5 is suppressed (Campbell et al, 2009). It must also be considered that a relatively small number of drugs can cause ocular complications when administered systemically and, therefore, modulation of the barriers could exacerbate such complications (Abdollahi et al, 2004). However, it must be stressed that these agents are relatively few in number, are extremely well documented and could easily be avoided by individuals receiving a sub‐retinal or stereotaxic inoculation of CLDN5 AAV‐2/9.…”

Bilateral retrobulbar neuritis following cessation of ethambutol

“…Antitubercular drugs produce unwanted side effects, especially when used at high dosages and usually for periods of more than two months [5,6]. Retrobulbar neuritis, optic neuropathy and chiasmopathy due to ethambutol is a known neurotoxic complication.…”

Fixed drug eruption induced by topical olopatadine ophthalmic solution

“…Drug molecules present in the system may become selectively deposited in specialized ocular tissues such as the cornea, lens and retina, which may therefore show individual sensitivities to drug toxicity. 6 Olopatadine hydrochloride, a mast cell stabilizer and histamine receptor antagonist, has been shown to inhibit mast cell activation in an in vitro model of human mast cell culture, reducing histamine and TNF-α release and upregulating proinflammatory mediators in conjunctival epithelial cells. 7 Olopatadine is the first dual-function antiallergic agent approved by the Food and Drug Administration for the treatment of the signs and symptoms of allergic conjunctivitis.…”