Medications and Vision Cheat Sheet (DRAFT) by [deleted]

The use of all five senses­—vi­sion, hearing, taste, smell, and touch—­allows humans to process everything occurring in the world around them.1 However, with increased age, sensory changes that can negatively impact an indivi­dual's quality of life often occur. Additi­onally, the use of certain medica­tions can further impair senses, which can be especially troubl­esome for aging adults who generally have high rates of polyph­armacy and increasing frailty

The risk of low vision (ie, where some usable vision remains) and blindness increases signif­icantly with age, partic­ularly in those over the age of 65.2,3 The most common age-re­lated eye diseases include the follow­ing4:

 glaucoma, which leads to peripheral vision loss;
 age-re­lated macular degene­ration, which leads to central vision loss;
 diabetic retino­pathy, which leads to a spotty field of vision;
 cataracts, which lead to blurring, clouding of images, sensit­ivity to light, and decreased contrast differ­ent­iation; and
 dry eye, which creates insuff­icient tear produc­tion, making vision­-re­lated activities more difficult.

A number of factors, including disease and medication use, can result in vision impairment and impact the overall health and well-being of older adults. Some of the potential negative impacts include the following:

 increased risk of falls and fractures, leading to hospital or nursing home placement, increased disabi­lity, and premature death;
 increased risk of depres­sion;
 increased difficulty identi­fying medica­tions, which can lead to medica­tio­n-r­elated adverse events; and
 declines in activities of daily living.

Medica­tions can impact vision in various ways, including the following:

 Antich­oli­nergic side effects that lead to blurred vision or changes in perception (eg, antihi­sta­mines, gastro­int­estinal medica­tions, certain antide­pre­ssants, antips­ych­otics, and others­)3-6;
 Worsening glaucoma (eg, steroids, antich­oli­ner­gics, and medica­tions with antich­oli­nergic side effects, sulfa-­based medica­tions, and others­)3,6;
 Contri­buting to or worsening macular degene­ration (eg, phenyl­eph­rine, long-term NSAID use, niacin, quinine, and others­)3,4;
 Increasing cataract formation (eg, steroids, long-term NSAID use, antips­ych­otics, glaucoma medica­tions, and others­)3,4; and
 Causing visual distur­bances such as visual halluc­ina­tions (eg, as may occur with antich­oli­nergic syndrome,5 benzod­iaz­epines, and others6).