Effects of Drugs on Vision
| antidepressants | antimanics | antispasmodics | caffeine | cocaine | marijuana | methamphetamines | narcotics and painkillers | steroids |
Antidepressants
Cyclic antidepressants can cause dry mouth and blurred vision.
As part of their action on many different brain systems, the cyclics act on histamine receptors, flicking on the body's "fight or flight" response, speeding up the heart, and shunting energy away from bodily functions, such as waste removal. The result: you get dry mouth, blurred vision, constipation, and urinary problems. These side effects may be especially annoying if you're taking amitriptyline, clomipramine, doxepin, imipramine, or protriptyline.
Per WebMD
Antimanics
Lithium:
Adverse reactions that suggest lithium toxicity include: anorexia; visual impairment or disturbance; drowsiness; muscular weakness; fasciculations, or myoclonia; ataxia; slurred speech; stupor or coma; tremor; confusion; seizures; and arrhythmias. Serum lithium concentrations should not be allowed to rise above 2.0 mEq/L during the acute treatment phase. Serum concentrations above 3.0mEq/L can produce adverse effects involving multiple organ systems.
Per Clinical Pharmacology 2000
Antispasmodics
Barbiturates:
Ocular adverse reactions with barbiturates occur most commonly after chronic use or toxic doses. Miosis is seen most frequently, but mydriasis predominates during toxic states. Disturbances in ocular movement may be seen with weakness of the extraocular muscles and nystagmus. Ptosis has been reported after chronic use.
Per Clinical Pharmacology 2000
Caffeine
No visual effects are listed for caffeine
Cocaine
CNS toxicity is extremely common with cocaine use, and initially patients present with symptoms of CNS stimulation such as agitation; excitement; anxiety; restlessness; apprehension; irritability; confusion; dizziness; lightheadedness; hallucinations (may be auditory, gustatory, olfactory, or visual); formication (especially during withdrawal); headache; mood lability; psychosis; pressured speech; generalized tics; preconvulsive movements; exophthalmos; urinary incontinence; fecal incontinence; and/or mydriasis. Advanced CNS effects include seizures, status epilepticus, delirium, psychosis, hyperreflexia, and CNS hemorrhage. Late depressive effects include hyporeflexia, muscle paralysis, mydriasis, and death. Long-term use can result in agnosia and ageusia. Concurrent use of cocaine with CNS stimulants can cause excessive anxiety, irritability, seizures, and/or cardiac arrhythmias.
Per Clinical Pharmacology 2000
Marijuana
No visual effects are listed for marijuana. (Does lower intraocular pressure, however.)
Methamphetamines
No listed effects for methamphetamines. However, precaution must be taken for patients with glaucoma, since methamphetamines can exacerbate glaucoma.
Per Clinical Pharmacology 2000
Narcotics / Painkillers
Morphine -
Anticholinergic effects occur infrequently with morphine. Patients can experience xerostomia (dry mouth), blurred vision, or urinary retention. Following epidural or intrathecal administration of morphine, the incidence of urinary retention is 40-100%. While this may not be a problem for some post-operative patients who have an indwelling urinary catheter, ambulatory and chronic pain patients may have significant problems.
Morphine and its congeners cause miosis. Severe overdose can cause mydriasis once brain anoxia develops. Therapeutic doses can increase accommodation and sensitivity to light reflex and decrease intraocular tension in both normal and glaucomatous eyes.
Per Clinical Pharmacology 2000
Demerol -
Anticholinergic effects occur with meperidine but are infrequent. Patients can experience xerostomia (dry mouth), blurred vision, or urinary retention. Tolerance does not develop to these effects. In high doses, meperidine may produce mydriasis rather than miosis.
Per Clinical Pharmacology 2000
Steroids
Corticosteroids should be used cautiously in patients with glaucoma or other visual disturbance. Corticosteroids are well known to cause cataracts and can exacerbate glaucoma during long-term administration. Patients receiving topical or systemic corticosteroids chronically should be periodically assessed for cataract formation.
Per Clinical Pharmacology 2000