Dry eye | Alpha-1 antagonists (alfuzosin, tamsulosin, terazosin) Alpha-2 agonists (apraclonidine, brimonidine) Anticholinergics (atropine, homatropine, hyoscine, ipratropium, tolterodine) Anticonvulsants (valproic acid) Antihistamines (cetirizine, chlorpheniramine, diphenhydramine, doxylamine) Antimalarials (chloroquine, hydroxychloroquine) Antineoplastics (busulfan, cyclophosphamide) Antipsychotics (thioridazine) Anxiolytics (lorazepam) Beta agonists (acebutolol) Beta blockers (atenolol, propranolol) Benzalkonium chloride Bisphosphonates Cannabinoids (dronabinol) Systemic decongestants (pseudoephedrine) Diuretics (furosemide, indapamide, metolazone) Oral contraceptives Retinoids (isotretinoin) Topical decongestants (naphazoline) Tricyclic antidepressants (amitriptyline) | Nonpharmacologic therapy: (1) warm compresses, (2) increase fluid intake, (3) use humidifier Increase tear volume: (1) consider artificial tears or other topical lubricants, (2) punctal occlusion Decrease inflammation: (1) 0.05% cyclosporine ophthalmic drugs, (2) LFA-1 antagonist ophthalmic drops, (3) short-term ophthalmic glucocorticoids Medication changes: (1) discontinue medication, (2) use preservative-free ophthalmic drops |
Floppy iris syndrome | Alpha-1 antagonists Benzodiazepines Chlorpromazine Donepezil Duloxetine Finasteride Quetiapine | Preoperative screening for previous and/or current use of causative agents Consider cataract surgery before initiation of alpha-1 antagonist therapy Intracameral alpha-adrenergic agonists (epinephrine, phenylephrine) Intraoperative devices: (1) iris retractors, (2) OVDs, (3) pupil expanders |
Optic neuropathy | Amiodarone Ethambutol Linezolid PDE-5 inhibitors (avanafil, sildenafil, tadalafil, vardenafil) | Discontinuation of causative drug as medically appropriate Regular ophthalmic examinations |
Retinopathy | Aminoquinolines (hydroxychloroquine, chloroquine) Antiestrogens (tamoxifen) Phenothiazines (chlorpromazine, thioridazine) Retinoids (isotretinoin) | Monitor via regular ophthalmic examinations, patient-reported signs and symptoms Vision loss is irreversible |