Eye disease treatments

Category: Medicines

Type

Involuntary

Introduction and description

As this is the medicine section, treatments involving eye surgery are excluded from this page, instead it deals with medications that are generally delivered as eye drops.

Eye drops are saline-containing drops that are used to deliver other medications.  On the whole they produce very few hallucinations simply because eye drops have less of a risk of side effects than do oral medicines.  Furthermore, the risk can be minimized by ‘occluding the lacrimal punctum’, which in layman’s terms means you press on the inner corner of the eye for a short while after administering the drops.  In this way the drops stay in the eye.

The nasolacrimal duct (sometimes called the tear duct) carries tears from the lacrimal sac into the nasal cavity. Excess tears flow through the nasolacrimal duct into the inferior nasal meatus. In effect, tears go through this duct, down the nose and into the mouth.  This is the reason the nose starts to run when a person is crying, and why one can sometimes taste eye drops. 

This is not good news. 

If the eye drops enter the mouth and we swallow them, we are getting a dose of a medicine that was not intended to be ingested.  Secondly the nose is the one area which is a weak spot when it comes to fluid entering the brain.

The olfactory bulb transmits smell information from the nose to the brain, and is thus necessary for a proper sense of smell.  But it is a very weak spot as it provides access to some key areas of the brain. 

This is why cocaine sniffers sniff cocaine – they dose is immediate and straight to the brain with no involvement of the blood brain barrier.

Thus is we don’t press that tear duct hard to stop the eye drops from entering the nose, and if we should be so unwise as to swallow and sniff instead of blowing out the gunge, we have provided a route for the contents of the eye drops to get into the brain and body.

The advice is thus BLOW IT OUT and SPIT IT OUT, if any should leak into your nose.

Types of drugs

Depending on the condition being treated, eye drops may contain steroids, antihistamines, beta receptor blockers, prostaglandins, non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antifungal, or topical anaesthetics. All these could in the long term do us no good at all if they leak into the brain.

Another group of drugs are associated with the neurotransmitters that affect the nervous system.  When the parasympathetic nervous system is invoked we become relaxed. 

During relaxation, we have no need to strain our eyes and see and the pupil narrows to give our eyes a rest from any light.   This narrowing has therapeutic uses and the drugs are called cholinergics.  But when the sympathetic nervous system is invoked, this is our flight and fight response and the pupil widens enormously so that we are better able to face the perceived threat.  Again this property is exploited in some of the drugs which are called anticholinergics.

As there are so many types we have split this section into two.  This section deals with:

• Drugs to help with eye examinations
• Drugs to help with surgery
• Myopia treatments
• Dry eye treatments
• Pink eye or conjunctivitis eye drops
• Steroid eye drops
• Allergy eye relief and pain relief eye drops

Another page is devoted to

• Glaucoma eye drops

•  Macular degeneration eye drops or medication

 

We have grouped all the figures by the classes of drug so that it is easier to see the effects.  All the figures for both hallucinations and deaths come from the eHealthme website and are a summary of the Adverse Drug Reports submitted by doctors to the FDA and SEDA.  Thus US figures only and not the rest of the world.  This is why some drugs cannot be included – no figures exist because they are sold outside the USA.

Drugs to help with eye examinations

There are a group of drugs that act just on the eye to widen the pupil so that the eye and the interior of the eye can be better examined, and all these are called anticholinergic agents.  Anticholinergic agents block the neurotransmitter acetylcholine and acetycholine – put crudely - is the neurotransmitter governing relaxation.  Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.

Atropine is possibly the best known anticholinergic, and there are observations we have found that show it has caused hallucinations, but there are other drugs that can be used in the eye in this category.

The correct name for these is Mydriatic eye drops, meaning they make the eye's pupil widen to maximum, to let an optician or doctor have the best view inside the eyeball behind the iris. Afterwards in sunny weather they can cause dazzling and photophobia until the effect of the mydriasis has worn off.

Topical atropine is used as a cycloplegic, to temporarily paralyze the accommodation reflex, and as a mydriatic, to dilate the pupils. Atropine degrades slowly, typically wearing off in 7 to 14 days, so it is generally used as a ‘therapeutic mydriatic’, whereas tropicamide (a shorter-acting cholinergic antagonist) or phenylephrine (an α-adrenergic agonist) is preferred as an aid to ophthalmic examination.

Drug	No of hallucinations
Tropicamide	1
Atropine	16 ++
Cyclopentolate / Cyclogyl, Cylate, & Pentolair	5
Phenylephrine	-

 ++ Atropine has multiple uses, not all these hallucinations may be caused by eye drops

Atropine

• On Aug, 13, 2015: 3,780 people reported to have side effects when taking Atropine. Among them, 142 people (3.76%) have Death
• On Aug, 28, 2015: 1,438 people reported to have side effects when taking Atropine sulfate. Among them, 22 people (1.53%) have Death

Cyclopentolate

• On Sep, 1, 2015: 131 people reported to have side effects when taking Cyclopentolate hydrochloride. Among them, 1 people (0.76%) has Death

 

Drugs to help with surgery

In contrast to the anticholinergics there are also drugs that do the opposite called cholinomimetics.  They behave like acetylcholine and are also called cholinergic agonists.

They are used during ophthalmic surgery. In topical ocular and intraocular administration its principal effects are miosis.  Miosis means constriction of the pupil.  The opposite condition, mydriasis, is the dilation of the pupil as we saw above.  Intraocular administration is used to produce miosis after lens implantation during cataract surgery.

Drug	No of hallucinations
Isopto Carpine / Pilocarpine HCl	3
Carbachol (Carbastat, Carboptic, Isopto Carbachol, Miostat)	3
Acetylcholine chloride [Miochol]	0

 If we now take an example like Carbachol, the most common side effects by gender according to the eHealthme web site are as follows :

Female	Male
Pyrexia	Blood Pressure Decreased
Pneumonia	Nausea
Hypersensitivity	Heart Rate Decreased
Throat Irritation	Eye Inflammation
Dyspnoea	Hallucination
Skin Odour Abnormal	Hyperhidrosis
Dysphonia	Loss Of Consciousness
Epistaxis	Oedema Peripheral
Nausea	Orthostatic Hypotension
Hair Texture Abnormal	Post Procedural Complication

 Epistaxis means nosebleeds.  Dysphonia is the medical term for disorders of the voice: an impairment in the ability to produce voice sounds using the vocal organs.  Dyspnea means shortness of breath or breathlessness.  Pyrexia is fever.  Hyperhidrosis is excessive sweating.

• Pilocarpine - On Sep, 1, 2015: 350 people reported to have side effects when taking Pilocarpine hydrochloride. Among them, 11 people (3.14%) have Death

All of these symptoms appear to indicate that the eye drops [or injection] have leaked into the system – the lungs, the brain and the blood stream.

Myopia treatments

Myopia is commonly known as near-sightedness or short-sightedness.  If you are myopic the light that comes in does not directly focus on the retina but in front of it, causing the image that one sees when looking at a distant object to be out of focus, but in focus when looking at a close object.

It is often caused by too much close work.  Being in school all day and doing homework, or playing computer games in leisure hours, is all close focus work and it affects the muscles of the eye over time so that they can no longer relax.  The cure is fairly obvious – less close work and more getting out in the fresh air and looking in the far distance.  Giving our eyes a rest.

In more dangerous cases, it may be due to pathogens in the brain causing small undetected tumours that are squashing the eye-ball.  This really needs to be investigated, especially if one eye is worse than the other.

Difficult births can also cause distortion of the eye.  If your ears are at different levels you had  a difficult birth and your eyes may have suffered.

The ‘cure’ is glasses or contact lenses.  I, for example, wear glasses and I am quite happy wearing glasses.  I have had no side effects from wearing glasses and consider them a godsend.  My brother wears contact lenses.  He has had more problems. 

But in the USA, there are researchers who have proposed the use of eye-drops to treat myopia in children and two they have proposed is atropine or pirenzepine.  Both are anticholinergics.  I quote:

I would have thought death and hallucinations ought to be counted as a risk, but clearly our researchers consider this par for the course [see above for the anticholergens].  We continue:

We may find we need to add to this section in the future.

 Dry eye treatments

Dry eye treatments are a form of artificial tear eye drops. Artificial tears are lubricant eye drops used to treat the dryness and irritation associated with deficient tear production in keratoconjunctivitis sicca (dry eyes).  This has a cause and is more often than not a pathogen attacking the tear duct.  It can also be caused by poor surgery where the tear duct is damaged and by problems during the gestation of a baby.  One pal of mine for example became pregnant whilst still on the pill and didn’t stop taking the pill until several months into gestation, when she suddenly realised that all the sickness might have a cause.  Sophie was a perfect baby – apart from the fact she couldn’t cry.

Artificial tears are also used to moisten contact lenses and in eye examinations and are available over-the-counter, simply because they only contain water, salts and polymers.

Tears are quite complex and provide natural pathogen resisting compounds whereas artificial tears do not, thus there is a risk of infection.  This is why contact lens users are told to give their eyes a rest from the lenses on a frequent basis – thus allowing natural tears to get to the eyeball.

Examples of Artificial tear products include Systane Lubricant eye drops, Nature’s tears, Refresh, Thera tears etc etc  They all act differently, but there are no records of hallucinations from these on eHealthme.  There are more examples on forums, for example

Thus the link appears to be contact lenses and contact lens fluid.  The fluid gives the person an eye disease and this disease then results in the hallucinations.  Another different example.

Pink eye or conjunctivitis eye drops

Antibiotic eye drops are prescribed when conjunctivitis is caused by bacteria but not when it is caused by a virus.  Chloramphenicol, for example is still widely used in topical preparations (ointments and eye drops) for the treatment of bacterial conjunctivitis and if we glance down the most common Chloramphenicol side effects, we can see that in this case the hallucinations are probably caused by the distortion of the eyes rather than the leaking of the antibiotic into the brain or body:

Visual Acuity Reduced (31 reports)
Parophthalmia (26 reports)
Eyes - Bulging (22 reports)
Conjunctival Oedema (21 reports)
Eye Pain (17 reports)
Intraocular Pressure Increased (17 reports)
Erythema Multiforme (13 reports)
Drug Hypersensitivity (13 reports)
Post Procedural Complication (11 reports)
Sepsis (9 reports)

Parophthalmia is inflammation of the connective tissue around the eye.  Erythema multiforme is a skin condition that usually follows an infection or drug exposure.

Drug	No of hallucinations
Chloramphenicol	6
Moxifloxacin - Vigamox, Moxeza	9
Levofloxacin - trade names Levaquin (US), Tavanic (EU)	*

*No specific trade name is used for Levaquin when used as eye drops. 

Moxifloxacin - Vigamox and Moxeza are the names for Moxifloxacin based eye drops

• On Aug, 7, 2015: 811 people reported to have side effects when taking Vigamox. Among them, 20 people (2.47%) have Death.
• On Sep, 1, 2015: 525 people reported to have side effects when taking Moxifloxacin hydrochloride. Among them, 12 people (2.29%) have Death

Levofloxacin -  As it is used frequently for other infections and ingested, any figures for hallucinations and deaths are more likely to derive from ingestion.  Nevertheless the figures below do show the risks of ingestion

• On Aug, 18, 2015: 5,455 people reported to have side effects when taking Levofloxacin. Among them, 63 people (1.15%) have Death
• On Aug, 8, 2015: 27,865 people reported to have side effects when taking Levaquin. Among them, 719 people (2.58%) have Death

Antibiotic eye drops are also used to prevent infections after eye surgeries, particularly cataract removal.  Steroid eye drops [see below] are used to reduce any inflammation after the cataract has been removed and the new lens fitted.  By reducing redness itching and soreness, it helps prevent damage to the delicate tissue of the eye.  But by suppressing the immune system there is a danger that infection my take hold, thus antibiotic drops are used to counter any risk of infection.  In both cases the amount given is tiny and the risks low as long as you hold that tear duct!

Steroid eye drops

Steroid anti-inflammatory eye drops are used after surgery, for example, after cataract surgery to reduce the pressure on the eye caused by the inflammation often experienced after surgery.  It is a logical consequence of the surgery that the body should inflame the eye to enable the immune system to send protection whilst the eye heals.  But where a cataract has been removed and a new lens put in, this could compromise the effects of the surgery.  Thus immunosuppressants are occasionally used to very temporarily slow down the reaction.

Drug	No of hallucinations
Ciclosporin trade name Restasis	34
Betnesol / Betamethasone sodium phosphate ++	1
Dexamethasone	245
Fluoremethalone +++	-
Prednisolone acetate [minims]	1
Rimexolone and Vexol	1

 ++ The one hallucination may not necessarily have been caused by eye drops, as this product is used for eyes, ears and nose drops

+++ Fluorometholone is a corticosteroid, most often used after laser-based refractive surgery. It is marketed under the brand names FML and Flarex

• Restasis - On Aug, 5, 2015: 4,356 people reported to have side effects when taking Restasis. Among them, 15 people (0.34%) have Death.
• Betnesol - On Sep, 1, 2015: 543 people reported to have side effects when taking Betamethasone valerate. Among them, 3 people (0.55%) have Death
• Dexamethasone  - On Aug, 12, 2015: 53,192 people reported to have side effects when taking Dexamethasone. Among them, 2,458 people (4.62%) have Death.
• Prednisolone acetate  - On Sep, 1, 2015: 1,360 people reported to have side effects when taking Prednisolone acetate. Among them, 16 people (1.18%) have Death

 

Allergy eye relief and pain relief eye drops

Some eye drops may contain histamine antagonists or non-steroidal anti-inflammatory drugs, which suppress the optical mast cell responses to allergens including (but not limited to) aerosolized dust particles.

Drug	No of hallucinations
Acular and Ketorolac	21
Bromfenac, Prolensa and Bromday	-
Loteprednol and Lotemax	1
Nepafenac and Nevanac	0
Ocufen	0

 Acular

• On Aug, 31, 2015: 528 people reported to have side effects when taking Acular. Among them, 9 people (1.70%) have Death.
• On Aug, 25, 2015: 58 people reported to have side effects when taking Acular ls. Among them, 1 people (1.72%) has Death
• On Aug, 26, 2015: 1,615 people reported to have side effects when taking Ketorolac tromethamine. Among them, 22 people (1.36%) have Death

Bromfenac - On Aug, 19, 2015: 84 people reported to have side effects when taking Bromfenac sodium. Among them, 2 people (2.38%) have Death

Lotemax - On Sep, 1, 2015: 717 people reported to have side effects when taking Lotemax. Among them, 5 people (0.70%) have Death.

Nevanac - On Sep, 1, 2015: 472 people reported to have side effects when taking Nevanac. Among them, 2 people (0.42%) have Death

Ocufen - On Aug, 15, 2015: 114 people reported to have side effects when taking Ocufen. Among them, 2 people (1.75%) have Death.

 

Related observations

Healing observations

• Assessment of eyebright (euphrasia officinalis L.) extract activity in relation to human corneal cells using in vitro tests 019934
• Berberine 019950
• Culpepper's Complete Herbal on Eyebright 019932
• Culpepper's Complete Herbal on White Willow 020521
• Dr Duke's list of activity for Vitamin C 017762
• Dr Duke's list of Chemicals and their Biological Activities in Pilocarpus racemosus 018159
• Dr Duke's list of Eye disease treatment activity for the Dog Rose 018093
• Dr Duke's list of Plants with Anticonjunctivitic Activity 019935
• Dr Duke's list of Plants with Antiglaucomic activity 019952
• Dr Duke's list of Plants with Antikeratitic Activity 019936
• Dr Duke's list of Plants with Antitrachomic Activity 019949
• Dr Duke's list of Plants with Antitrachomic Activity 019937
• Eyebright - The Healing power of herbs – Ceres Esplan 019931
• Fortified extract of red berry, Ginkgo biloba, and white willow bark in experimental early diabetic retinopathy 020529
• Is low dose of estrogen beneficial for prevention of glaucoma? 017894
• Mrs Grieve on Eyebright 019933
• Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis 019947
• Oestrogen, ocular function and low-level vision: a review 017933
• Riboflavin and corneal repair 027369
• Riboflavin Deficiency as a cause of disease 027370
• Standardised antibacterial Manuka honey in the management of persistent post-operative corneal oedema: a case series 020932
• The ocular benefits of estrogen replacement therapy: a population-based study in postmenopausal Korean women 017932
• Vitamin A and cancer 007246

Hallucination

• Acetazolamide and Diamox 005059
• Acular and Ketorolac 017601
• Alrex 017982
• Ansaid 018002
• Avastin hallucinations 023918
• Betnesol and Betamethasone 017600
• Blocadren 018049
• Botox 018051
• Brain injury associated with widely abused amphetamines: neuroinflammation, neurogenesis and blood-brain barrier 023922
• Carbachol 017547
• Chloramphenicol 017593
• Cyclopentolate 017545
• Dexamethasone 017603
• EHealthme - Atropine 017544
• Epinastine hydrochloride 018953
• Eye drops 005237
• Eye drops 005265
• Eye drops 005264
• Floxin 018994
• Fluorescite 019064
• Lotemax and Loteprednol 017604
• Macugen 019489
• Moxifloxacin 001144
• Neptazane 019678
• Ocuflox [Ofloxacin] 019729
• Olopatadine Hydrochloride 019801
• Optivar 019813
• Patanol 019833
• Pilocarpine 017548
• Pilocarpine Hydrochloride and Pilopine Hs 019847
• Polysporin 019850
• Prednisolone [eye drops] 017605
• Restatis 015697
• Rimexolone and Vexol 017608
• Salagen 020016
• Systemic toxicity from ocular homatropine 019938
• Tequin 020196
• Terra-cortril 020199
• Tilade 020207
• Timoptic & Timoptic-xe 020210
• Tobradex 020211
• Triamcinolone 015759
• Tropicamide 017546
• Tussionex Pennkinetic 020244
• Vigamox and Moxeza 017598
• Visual hallucinations in ophthalmology 025261
• Visudyne 020372
• Zymar 020474

In time

Synaesthesia, Pure or enhanced perception, Inter composer communication, Vision, Dream, Perception recall, Exploring group perception

• Danielou, Alain – On drugs you are possessed by the spirit being of the drug 022582
• Eye drops 005237

Other observations

• Bromfenac, Prolensa and Bromday 017602
• Nepafenac and Nevanac 017606
• Ocufen 017607