Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The action of some drugs on the eye may lead to the occurrence of unforeseen ocular and extraocular reactions. Vincaleukoblastin (Velbe) provokes serious corneal lesions with a healing time of two weeks and a half. The local application of Neo-Synephrine eye drops (10%) and Mydrial-Atropine ointment may lead in the case of a pharmacogenetic disposition to disagreeable systemic effects. In one case of preparation for a cataract operation by akinesis and retrobulbar injection, Novocain was changed by mistake with Pilocarpinum hydrochloricum by the error of a pharmaceutical firm. This led to severe complications, which could by successfully treated with Chlorpromazine (Largactil). The knowledge of these clinical observations may be of greater usefulness in the preventation of untoward drug reactions.
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PMID:[Ophthalmic-pharmacological complications (author's transl)]. 96 10

Chlorpromazine and several other phenothiazine neuroleptic drugs appear to induce cataract formation. However, the newer generation of antipsychotic agents has shown no evidence of an etiologic relationship with cataract occurrence. Research did reveal cataract occurrence in dogs who received quetiapine, which prompted concern despite there being no known causal link between quetiapine and lens opacities in humans. Nevertheless, quetiapine's manufacturer issued formal recommendations for ophthalmological follow-up examinations with the use of this drug. Infrequent occurrences of cataract development have been documented in people taking olanzapine but, again, without established causative association; a similar situation is seen with ziprasidone. Periodic ocular examinations of the lens are suggested for patients prescribed long-term treatment with phenothiazines or quetiapine.
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PMID:Cataract occurrence with antipsychotic drugs. 1229 3

Chlorpromazine is known to deposit in ocular tissues when taken at high doses for prolonged periods. Chlorpromazine therapy in a 59-year-old schizophrenic man with a cumulative dosage exceeding 2500 g resulted in multiple white deposits in both corneas especially in the endothelium. Confocal microscopy revealed significant pleomorphism and polymegethism of endothelial cells. The anterior lens capsules opacities were star-shaped and concentrated in the centre. Because of cataract and chronic angle closure glaucoma our high-myopic patient underwent surgery, and light microscopic evaluation of the obtained anterior lens capsule during cataract surgery showed golden brown cytoplasmic deposits in the central epithelial cells and capsule. The peripheral epithelial cells of the removed capsule had no deposit. There were no sign of retinal deposits in the fundoscopy, optical coherence tomography and fluorescein angiography. In this patient chlorpromazine deposited mainly in the corneal endothelium, central anterior lens capsule and epithelial cells.
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PMID:In vivo observations of chlorpromazine ocular deposits in a patient on long-term chlorpromazine therapy. 1895 20

A 55-year-old woman who was treated with long-term, high-dose clozapine for schizophrenia presented with bilateral decreased visual acuity. She had pigmentary changes affecting the cornea and the retina, as well as stellate cataract. Chlorpromazine use is known to produce similar changes, but this is the first report to our knowledge of pigmentation associated with clozapine use.
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PMID:Ocular pigmentation associated with clozapine. 1922 Jan 77

All psychotropic medications have the potential to induce numerous and diverse unwanted ocular effects. Visual adverse effects can be divided into seven major categories: eyelid and keratoconjunctival disorders; uveal tract disorders; accommodation interference; angle-closure glaucoma; cataract/pigmentary deposits in the lens and cornea; retinopathy; and other disorders. The disorders of the eyelid and of the keratoconjunctiva are mainly related to phenothiazines and lithium. Chlorpromazine, at high dosages, can commonly cause abnormal pigmentation of the eyelids, interpalpebral conjunctiva and cornea. It can also cause a more worrisome but rarer visual impairment, namely corneal oedema. Lithium can rarely lead to a bothersome eye irritation by affecting sodium transport. Uveal tract problems are mainly associated with tricyclic antidepressants (TCAs), typical antipsychotics, topiramate and selective serotonin reuptake inhibitors (SSRIs). TCAs, typical antipsychotics and SSRIs can all cause mydriasis that is often transient and with no major consequences, but that can promote closure of angles in susceptible patients. Topiramate has been frequently associated with a number of significant ocular symptoms including acquired myopia and angle-closure glaucoma. Problems with accommodation are related to TCAs and to low-potency antipsychotics. TCAs cause transient blurred vision in up to one-third of patients. Angle-closure glaucoma is a serious condition that has been mainly associated with TCAs, low-potency antipsychotics, topiramate and, to a lesser extent, SSRIs. When patients with narrow angles are given TCAs, they all appear to experience induction of glaucomatous attacks. Antipsychotics and SSRIs may lead to an added risk of developing angle-closure glaucoma, but only in predisposed eyes. Topiramate can lead to an allergic-type reaction whereby structures of the lens and ciliary body are displaced, which results in angle-closure glaucoma. Cataractous changes can result from antipsychotics, mainly from high dosages of chlorpromazine or thioridazine. These two drugs, when used at high dosages and for prolonged periods, frequently cause lenticular opacifications. Retinopathy has been shown to be related to high dosages of typical antipsychotics, mainly chlorpromazine and thioridazine. The frequency of occurrence of retinal effects seems to be proportional to the total amount of drug used over a long period of time. Other visual problems of special concern are the ocular dystonias, other eye movement disorders, and decreased ability to perceive colours and to discriminate contrast. Ocular dystonias can occur with antipsychotics (especially high-potency ones), carbamazepine (especially in polytherapy), topiramate and, rarely, with SSRIs. Disturbance in various eye movements is frequently seen with benzodiazepines, antiepileptic drugs and lithium. Impairment in the perception of colours and the discrimination of contrasts has been shown to occur not uncommonly with carbamazepine and lorazepam. Thus, typical antipsychotics, TCAs, lithium, benzodiazepines, carbamazepine, topiramate and SSRIs appear to produce most of the currently recognized ocular problems. Psychiatrists, ophthalmologists and patients need to be aware of and prepared for any medication-induced adverse effect. Early prevention and intervention can avoid most of the serious and potentially irreversible ocular toxicities.
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PMID:Ocular adverse effects of common psychotropic agents: a review. 2093 68

There is resurgence of first generation antipsychotics use due to the metabolic side effects associated with the use of second generation antipsychotics. Lenticular and corneal abnormalities were reported earlier with Chlorpromazine. However, there has not been much interest in the recent past. Nonetheless it is important for clinicians to be aware of this side effect as chlorpromazine is a commonly used antipsychotic in developing countries like India. We report a patient who developed cataract possibly due to chlorpromazine and reviewed the relevant literature.
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PMID:Chlorpromazine induced cataract in a young patient with schizophrenia. 2179 65