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DESCRIPTION
Two of the most complex organs of the body, the eyes provide us with instantaneous visual feedback of the world around us. We have all experienced eye trouble at one time or another - eyes that are tired, bloodshot, burning, dry, infected, irritated, itchy, sensitive to light, ulcerated, or watery, to name just a few. While some eye disorders, such as nearsightedness or cataracts, for example, are localized problems, eye disturbances are often a sign of disease elsewhere in the body. Watery eyes are a symptom of the common cold, a thyroid problem may be indicated by protruding or bulging eyes and reading difficulties; dark circles under the eyes and eyes that are red, swollen, and/or watery may indicate allergies; yellowing of the eyes from jaundice can be a sign of hepatitis, gallbladder disease, or gallstone blockage; droopy eyes are often an early sign of myasthenia gravis, a disorder in which the muscles of the eye weaken. A drastic difference in the sizes of the pupils can indicate a tumor somewhere in the body, whereas high blood pressure and diabetes may manifest themselves in periodic blurring of vision.
The eyeball is a sphere about an inch in diameter that is covered by a tough outer layer called the sclera, the "white of the eye." Underneath the sclera is the middle layer of the eye, the choroid, which contains the blood vessels that serve the eye. The front of the eye is covered by a transparent membrane called the cornea. Behind the cornea is a fluid-filled chamber called the anterior chamber; behind that - in the center of the sclera, on the front of the eyeball - is the highly pigmented iris, and in the center of the iris is the pupil. Behind the iris is the transparent lens. Inside, at the back of the eye, is the retina, a delicate light-sensitive membrane that is connected to the brain by the optic nerve.
The eye also contains two important fluids. The ciliary body, whose muscles are responsible for focusing the lens of the eye, also produces a waterlike substance called the aqueous humor, which fills the space between the cornea and the lens. The aqueous humor contains all of the constituents of blood except for red blood cells. The other fluid is the vitreous humor, a jellylike substance that fills the back of the eyeball, the space between the lens and the retina.
On the outside of the eyeball are six muscles that move the eyes. Under the upper eyelids are the lacrimal glands, which secrete tears. At the inner corners of the eyelids are the tear ducts, small openings through which the tears drain into the nose and the back of the throat. At the edges of the eyelids, where the eyelashes are, are glands that produce oils, sweat, and other secretions.
What we think of as the simple act of seeing is actually a complex, multi step process that goes on continuously and at breathtaking speed. Light enters the eye through the pupil, which changes size depending on the amount of light entering it. When there is very little light, the pupil dilates; in bright light, the pupil constricts. As light enters the eye, it is focussed by the lens, which adjusts the shape by means of the action of the muscles and ligaments of the ciliary body. The lens become fatter or flatter depending upon the distance to the object being focused on. The lens projects light onto the retina, where special pigment absorbs the light and forms a corresponding image. Finally, this image is transmitted by means of the optic nerve to the brain, which interprets the image. Anything that interferes with any link in this chain of events can result in impaired vision.
Many cases of eye damage and vision loss are linked to underlying diseases of one type or another. Diabetes often leads to hemorrhages in the retina and the vitreous. eventually producing blindness. Early cataracts also may be related to diabetes. High blood pressure produces a gradual thickening of the blood vessels inside the eyes that can result in visual impairment and even blindness. Other factors linked to declining eyesight include too much sun exposure, poor nutrition, exposure to tobacco smoke or other pollutants, and dehydration.
One major contributor to eye trouble is poor diet, especially the denatured, chemical- and preservative-laden foods that most Americans consume daily. A deficiency of just one vitamin can lead to various eye problems. Supplementation with the correct vitamins and minerals can help prevent or correct eye trouble. Some of these supplements also protect against the formation of free radicals, which can damage the eyes. Specific eye problems that can be helped by supplementing the diet with vitamins and other nutrients are discussed at the below links.
DRUGS HARMFUL TO THE EYES
The human body is an organic unit with its tissues and organs interrelated and mutually dependent. Therefore, the health of the eyes, being the optical organ of the body, can influence, and be influenced by, any and every other organ in the body. Therefore when medications are taken for conditions of the body, they often have visual side effects.
For all drugs that make you more sensitive to light, a good pair of sunglasses is a must to be used that blocks out 100 per cent of the ultra-violet rays. In addition, you should be such taking antioxidants as vitamin C, vitamin E, vitamin A, selenium, alpha lipoic acid and lutein, which are important in helping reduce the possible side effects of the medications.
The following is a review of the most common medications taken in the United States and their potential effects on the eyes:
THESE DRUGS CAN ALSO DAMAGE THE RETINA:
- Plaquenil (hydroxchloriquine sulfate) is a drug routinely prescribed by rheumatologists for rheumatoid arthritis. It has caused irreversible retinal damage.
- Clonidine (brand name catapres) - is used to lower blood pressure.
- Thioridazine - fights infections but can cause pigmentary retinopathy.
- The whole family of NSAIDS (non-steroidal anti-inflammatory drugs) can cause visual side effects such as cataracts, dry eyes, and retinal hemorrhages that may result from long-term use. These include aspirin, ibuprofen (Advil, Motrin, Bayer, Aleve), flurbiprofen, ketoprofen and naproxen sodium. Also Tylenol (acetaminophen), though not an NSAID, can be harmful.
DRUGS THAT CAN CAUSE EYE HEMORRHAGE:
- NSAIDS including over-the-counter pain relievers.
- Venlafaxine - an antidepressant.
- Amphotericin B - an antibiotic.
- Cholesterase inhibitors - often used for Alzheimer's.
- Pentoxifylline - for blood clotting.
- Heparin, coumadin, anisidione, oral anti-coagulants.
DRUGS THAT CAN CAUSE GLAUCOMA AND/OR DAMAGE THE OPTIC NERVE:
- NSAID's
- Venlafaxine
- Steroids - cortisone prescriptions such as Prednisone are the most damaging drugs to the eyes of any prescription drugs. If you must take any of these drugs, be sure to supplement your diet with anti-oxidants such as vitamins E and C, and beta-carotene. Ask your health care provider if you can replace Prednisone with a natural cortisone such as hydrocortisone.
- Simvastatin
- Fenfluramine
- Mirtazapine
- Gastic antispasmodics
- Antidepressants
THESE DRUGS CAN CAUSE OR WORSEN CATARACTS:
Photosensitizing drugs (drugs that make you more sensitive to the sun) are drugs that absorb light energy and undergo a photochemical reaction resulting in chemical modification of tissue. They can make you more susceptible to cataracts and macular degeneration. The following is a list of those drugs:
- Antihistamines
- Birth control pills
- Tranquilizers
- Sulfa drugs
- Oral anti-diabetic drugs
- Antidepressants
- NSAIDS (for example aspirin, ibuprofen, advil, meclofen).
- Steroids - may produce posterior subcapsular cataracts. Steroids work by mimicking the action of the body's own hormones to help control inflammation. They are usually prescribed for diseases such as rheumatoid arthritis, Crohn's Disease,and lupus. Long-term steroid use can cause posterior subcapsular cataracts and increases in intraocular pressure. These cataracts will develop in up to 50 per cent of people taking 10 to 15 milligrams of prednisone daily for one to two years. These cataracts are very dense and can cause a rapid loss of vision. They will not go away even after you stop the medication and will have to be surgically removed. Though not as common as cataracts, sustained treatment of steroids can cause a rise in intraocular pressure leading to glaucoma, though after the steroid use is stopped the intraocular pressure will return to normal. The bad news is any damage done by the rise in pressure will remain. Steroid use can also indirectly damage the eye by causing an increase in blood sugar therefore causing diabetes. If you must take steroids make sure you take high doses of antioxidants such as alpha lipoic acid, vitamin C, vitamin E , and lutein to help prevent cataract formation.
- Fluroquinone, terbinafine, mefloquine type antibiotics
- Glucocorticoids (Prednisone)
- Eretinate, isoretinoin
DRUGS THAT CAN CAUSE DRY EYE SYMPTOMS:
(See further down on page for more details on how each of these drugs effect the body.)
- Antibiotics
- Blood pressure medications
- Antidepressants
- Antihistamines
- Birth control pills
- Appetite suppressants
DRUGS THAT CAN CAUSE LIGHT SENSITIVITY:
(See further down on page for more details on how each of these drugs effect the body.)
- Certain antibiotics
- Anti-malarial drugs
- Antihistamines
- Blood pressure medications
- Digoxin - is used for heart failure or heart irregularity.
- Photosensitizing drugs - see "Drugs that cause cataracts" above.
DRUGS THAT CAN CAUSE ALLERGIC CONJUNCTIVITIS:
- Antibiotics - when antibiotics are given for eye problems topically they may have the side effect of causing an allergic conjunctivitis (red eye). Systemic antibiotics taken orally, intramuscularly, or intravenously to help with bacterial infections may cause some visual symptoms. For example:
1. Synthetic penicillins (amoxicillin and ampicillin)- a person taking these may experience some mild redness of the eyes, itching and dry eyes. In rare cases they have been shown to cause hemorrhages of the blood vessels in the conjunctiva and in the retina.
2. Tetracycline - similar to the above plus light sensitivity and blurred vision.
3. Sulfonamides - many people are allergic to "sulfa drugs". This can cause blurred vision, light sensitivity and hemorrhages in the eye.
Note: Whenever taking antibiotics make sure you take probiotics such as acidophilus or bifidus and vitamin C to help ward off some of the side effects of the antibiotics.
DRUGS THAT CAN CAUSE BLOOD CLOTTING AND HARM THE BLOOD FLOW TO THE EYES:
- Androgen replacement with synthetic hormones.
- Estrogen
DRUGS THAT CAN CAUSE CHANGES TO THE CORNEA:
- Anti-malarial drugs including Chloroquine, quinacrine, and hydroxychloroquine can cause changes in the cornea. Symptoms such as halos around lights, glare and light sensitivity may occur. There is no change in the person's visual acuity. Once drug therapy is stopped both subjective symptoms and objective corneal signs disappear.
OTHER DRUGS THAT CAN CAUSE A VARIETY OF EYE PROBLEMS:
- Blood pressure medications - causes your body to excrete excess fluid. What this means for your blood vessels is less fluid. But in the eyes less fluid means dry eyes, light sensitivity, possible blurred and/or double vision in some people. Beta-blockers are sometimes used to reduce high blood pressure. They can reduce blood pressure by slowing the kidney's production of a protein called renin. Renin normally causes the release of a powerful blood vessel constrictor called angiotensin II , which makes it harder for blood to flow through the arteries (thus raising blood pressure) and also causes secretion of hormones that cause water retention (which increases the amount of fluid in the blood). The names of common beta-blockers are Inderal and Tenormin.
- Digoxin - is used for heart failure or heart irregularity. Common visual side effects are color vision changes You may experience light flashes, blind spots and light sensitivity.
- Antidepressants - these type of medications change how information is processed in the nerves in the brain. Therefore any medication that affects neurological function can affect vision. For example:
1. Prozac - may cause dilated pupils, double vision, blurred vision and dry eyes. It can also cause eye pain, eye lid infection (blepharitis), cataracts, glaucoma, ptosis (eyelid droop) and an inflammation of the iris (iritis). These side effects can only be avoided by discontinuing the medication, so if your taking Prozac be aware that these visual symptoms are normal when taking this drug.
2. Tricyclic antidepressants (amitriptyline, desipramine,imipramine, and nortriptyline) - these drugs may cause such visual effects as loss of the ability to focus up close, dilated pupils, double vision, and dry eyes.
3. Valium - may cause red eyes, involuntary eye twitching and some paralysis of the eye muscles.
4. Zoloft - has very few visual side effects.
- Antihistamines - just as these medications have a drying effect on your nose, it does that to the eyes also. This gives you the visual symptoms of light sensitivity and dry eyes. In rare instances it may make your pupils dilate or become unequal in size. If so report this to your health care provider.
- Appetite suppressants (amphetamines, dextroamphetamines, methaamphetamines, and phenmetrazine compounds) - these may give the following visual side effects: dilated pupils, difficulty focusing the eyes, difficulty converging the eyes when reading.
- Birth Control Pills - women taking birth control pills have a higher incidence of migraine headaches, problems with contact lenses due to dry eyes, and color vision disturbances.
NOTE: Any time a side effect of dilated pupils is found that can increase your susceptibility to narrow angle glaucoma.
Overuse of what is considered "harmless" drugs can be harmful to the body and eyes. When these are used excessively, they can produce photosensitivity, dry eyes, corneal deposits, gastrointestinal tract damage and even cataracts.
Two other classes of drugs that are over prescribed and overused are antibiotics and diuretics, which can disrupt that natural chemistry & fluid balance of the eyes.
Note: Do not change your schedule of taking any prescribed medications before discussing this with your health care provider first.
TYPES OF EYE PROBLEMS & DISORDERS
Maintaining Healthy Eyes
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You are having problems with your vision and/or suspect an infection of your eye or a vitamin A deficiency.
You have allergies that may be causing visual problems.
You have any increase of symptoms.
You have been exposed to toxic substances that are affecting your eyesight.
You have any unexpected or unusual symptoms. There may be underlying health issues that need to be addressed.
You should have your eyesight checked regularly by your health care provider to rule out any problems and to receive a prescription for contacts or eyeglasses, if they are needed. Preserve you vision... it is very important.
HELPFUL RELATED LINKS
MoonDragon's Health & Wellness: Nutrition Basics - Vitamin A
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