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  • image The eye is highly susceptible to drug toxicity due to its extensive vasculature.

  • image When ophthalmic disorders occur, all medications and biologic agents, irrespective of route of administration, are potential causes.

  • image It is difficult to fully quantify the incidence of drug-induced ophthalmic disorders due to the variety of causative factors and side-effect reporting behaviors of clinicians.

  • image The most common drug-induced ophthalmic disorders include dry eye, cataract, intraoperative floppy iris syndrome, optic neuropathy, and retinopathy.

  • image The severity of drug-induced ophthalmic disorders varies and depends on dose, pharmacokinetics, genetic predisposition, age, extremes of body weight, and/or duration of exposure.

  • image Health professionals and patients should discuss potential drug-induced ophthalmic disorders to ensure awareness, prompt identification, management, and treatment.


Preclass Engaged Learning Activity

Watch the following videos available from the US National Library of Medicine MedlinePlus for a brief overview of the anatomy and function of the eye. These videos provide necessary foundation and will assist in understanding the mechanisms of drug-induced ophthalmic disorders.


image The eye is an important, complex organ of the nervous system. It is composed of specialized tissues and complex structures that collectively contribute to the body’s ability to visually process the environment (Fig. e112-1).1–3 The sequence for normal, functioning eyes begins with the eyelid, which opens to allow exposure to light, bathes the eye with tear film, and helps remove waste. The eye receives light through the cornea, a clear tissue at the front of the eye. The light then proceeds through the aqueous humor and enters the pupil. The light continues through the pupil, which regulates the amount of light entering the eye to the lens. The lens changes thickness and shape to bend the received light and send it through the vitreous humor to the retina at the back of the eye.1–3 The retina then transforms the light into electrical impulses, which travel through the optic nerve to the brain. The brain then translates these impulses into the image that is seen. The function of each structure of the eye is summarized in Table e112-1.2,3

Figure e112-1

Anatomy of the eye.

TABLE e112-1Summary of the Structures and Function of the Eye

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