Archive for the ‘Medications Review’ Category

Medication Side Effects Review: Accutane

Tuesday, February 7th, 2012

Medications Review Logo e1312299174236 Medication Side Effects Review:   AccutaneAccutane or isotretinoin is a medication that is used to treat certain, severe cases of acne that do not respond to other forms of treatment.     The medication is widely known to cause birth defects, and the medical community does a good job educating women they should not take Accutane while pregnant or when they believe they may become pregnant.    But Accutane also results in some significant ocular side effects.

The most common ocular side effect of Accutane is Dry Eye Syndrome.   In most cases, the ocular dryness is severe and can cause very significant discomfort or pain for the patient.    When dryness results, it may be so significant that artificial tears are not effective.   In these situations, a person may benefit from a prescription eye drop called Restasis, which would cause the eyes to produce more moisture.   Restasis does require 4-6 weeks of continual use before relief may be felt.   Given this, punctal plugs or “tear savers” may be a preferred and more immediate way to provide accutane patients with relief.   These tear savers prevent moisture from leaving the eye through the natural tear ducts and they can be removed if necessary.      When a person discontinues accutane, the Dry Eye Syndrome tends to slowly improve over a period of up to several months and may still require monitoring during this time.

Another potential ocular side effect of Accutane is decreased night vision.    Accutane is actually a form of vitamin A, which plays a direct role in the function of certain elements in your retina.    Disrupting the delicate balance of Vitamin A and other chemicals in the body may cause patients to notice significant decreased vision in dark rooms or while driving at night.   Discontinuation of the medication, unfortunately, may not always improve night vision to its original state.    Some case reports have shown this to be a much longer lasting side effect than the Dry Eye Syndrome.

Research also indicates other potential side effects of the medication may include:   blurred vision, fluctuating vision, corneal deposits, cataracts,  sensitivity to light, and color deficiencies.

While Accutane may not be as widely used as it once was, it does have its place in certain situations.    Be sure to visit your optometrist once you start the medication, and it may be necessary to monitor your eyes frequently while you remain on the medication.

As always, I’d love to hear your comments or questions.  Give us a shout over on Facebook or on Google+.    And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach

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Medication Side Effects Review: Tamoxifen

Tuesday, August 2nd, 2011

Medications Review Logo 300x130 Medication Side Effects Review:   Tamoxifen Tamoxifen is a common and effective drug used in the treatment of breast cancer.   But like many medications, it does have the potential to adversely affect the eyes and vision.    Although the incidence of these ocular side effects may be uncommon, some studies indicate that as many as 6 to 12% of patients using Tamoxifen may have side effects.

Tamoxifen has the potential to effect several areas of the eye.    It can potentially create an opacity or cloudy spot in the cornea, which is the front part of the eye that needs to remain clear in order to create good vision.   The medication can also create deposits in the retina near the macula, which is the portion of the retina responsible for fine-detailed central vision.    Tamoxifen may also affect the optic nerve’s ability to communicate vision completely and accurately to the visual centers of the brain.   Finally, cataracts have also been reported in patients using Tamoxifen.

The really good news is that most of these side effects are reversible once the medication can be stopped in accordance with Oncologist’s intended breast cancer treatment plan.   If cataracts develop, cataract surgery very effectively improves vision.45200034 tamoxifen226spl Medication Side Effects Review:   Tamoxifen

If you are taking Tamoxifen, I highly recommend annual dilated eye exams and letting your Optometrist know that you are taking the medication.    Also, between exams, be sure to let your Optometrist know if you experience any changes in your vision or other eye-related symptoms.

As always, I hope you find these posts helpful and  I’d  love to hear your questions or comments over on our Facebook Fan Page.

Best wishes,

Dr. Beach.

 

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Medications Side Effects Review: Antihistamines and Glaucoma

Sunday, March 27th, 2011

Why do Antihistamine Medications come with Warnings about Glaucoma?Medications Review Logo 300x130 Medications Side Effects Review:  Antihistamines and Glaucoma

It’s official.  Allergy season is back!  As cars around Hampton Roads are being blanketed with pollen, we’ll also be bombarded with commercials for antihistamine medications treating symptoms related to seasonal allergies.   Ever wonder why these medications come with the warning, “ask your doctor before you take this medication if you have glaucoma?”

Zyrtec D Medications Side Effects Review:  Antihistamines and GlaucomaFor  most people with glaucoma, antihistamines pose no risks.   That’s because the most common form of glaucoma is ‘open-angle glaucoma,” meaning the drainage structure inside the eye, or angle, is open.   However, there is a less common type of glaucoma called “narrow-angle glaucoma,” in which the structures bordering the drainage angle form a very narrow opening for fluid to exit the inside portion of the eye.     Antihistamines, very rarely, may cause this narrow angle to close.  When this happens, fluid inside the eye can’t exit and the pressure within the eye can drastically increase.  Symptoms of an angle closure will include significant pain and blurred or distorted vision.

The good news, comprehensive eye health examinations can detect the presence of narrow angles and help identify the small number of people with the risk for ocular side effects with antihistamine medications.

As always, I’d love to hear your comments or questions.  Give us a shout over on Facebook or on Google+.    And, remember, you can now request an appointment for your annual eye exam  at our office by clicking here.

Best wishes,

Dr. Beach.

 

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Medication Side Effects Review: Amiodarone

Monday, March 1st, 2010

Amiodarone Medications Review Logo 300x130 Medication Side Effects Review:  Amiodarone

Last week, a patient requested that I bring up this medication for my next ‘Medications Review.’  Amiodarone is given to treat cardiac arrhythmia, often when other medications have proved ineffective in controlling the condition.

Patients taking amiodarone are advised to have annual, and sometimes more frequent eye exams, because of several side effects the medication may have on the eyes.

For example, amiodarone may cause “vortex keratopathy.”   This side effect is secorverticillatab 300x226 Medication Side Effects Review:  Amiodaroneen as a swirling pattern of white deposits in the cornea.   This finding may or may not effect vision, and has been shown to resolve when the medication is stopped.

Another potential side effect is cataracts, which may cause a blurriness in vision as well as glare or halo effects when looking at lights.

Some patients taking amiodarone also experience changes in their perception of color.    This may be the result of the drug’s effect on the optic nerve.

Frequent eye examinations will allow your optometrist to diagnose these side effects and communicate with your primary care physician.   From there, the severity of the ocular side effects can be weighed against the cardiac benefits of taking amiodarone.    If you are someone you know is taking amiodarone for arrhythmia, please see your optometrist and let them know you are taking this medication.

As always, I’d love to hear your comments or questions.  Give us a shout over on Facebook or on Google+.    And, remember, you can now request an appointment for your annual eye exam  at our office by clicking here.

Best wishes,

Dr. Beach.

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Medication Side Effects Review: Steroids

Tuesday, January 26th, 2010

Steroids (Corticosteroids)

Medications Review Logo 300x130 Medication Side Effects Review:  Steroids

Ever wonder why an optometrist wants you to list all of your medications?  Ever wonder what a medicine for arthritis, lupus, or any other condition has to do with a comprehensive eye health exam?

In this series of blog entries I’ll be talking about potential ocular side effects of  common medicines that are used to treat diseases throughout the body.  In fact, most common systemic medications have the potential to affect your eyes.    The incidence and degree of ocular side effects depends on the medicine, but letting the optometrist know your medications list will allow for special attention to  specific potential side effects during your  exam.

First up:  Steroids.    We’re not talking body-building,  Mark McGuire steroids.  Those are anabolic steroids.  We are talking corticosteroids.   This group of oral medications help control over-active responses from your immune system during a whole host of conditions.  Examples of conditions in which corticosteroids may be used include arthritis, lupus, dermatitis, severe allergies, Crohn’s disease, hepatitis, sarcoidosis, and many other conditions.   Two of the most common corticosteroids used are Prednisone and Dexamethosone.

Corticosteroids are one of the groups of oral medicines most likely to have ocular side effects.  Long term use of these medicines may lead to cataracts.    Steroid-induced cataract formation varies in its incidence and severity based on the individual and the dose and duration of the steroid use.   Eye exams, with pupil dilation, are indicated at regular intervals during long-term steroid use.  This way the optometrist can notify the primary care physician of this side effect.    If the cataracts become severe, cataract surgery may be indicated.

Another potential side effect of oral corticosteroids is an increase in eye pressure.  This increase in eye pressure has the potential to develop into glaucoma, which is an irreversible damage to the optic nerve resulting in permanent vision loss.   Again, regular examinations by the optometrist during the use of these medicines will allow for close monitoring of eye pressures. When pressure changes are caught early and treated with topical pressure lowering eye drops,  glaucoma may be prevented from occurring.

As always, if you have any questions, please feel free to email me at doctor@clearvieweye.net

Take Care,

Dr. Beach.

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