Ophthalmologic Side Effects
Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish in Retinoids in Dermatology, 2019
Some patients may experience decreased dark adaptation and night blindness during retinoid treatment, but this is reversible. Isotretinoin can cause reversible abnormalities in the function of rod cells in rats that can be documented with electroretinography (27). Administration of high dose isotretinoin to rats (40 mg/kg) slows recovery of rod signaling after bleaching by slowing down the regeneration of rhodopsin (a complex protein sensitive to light that contains another vitamin A derivative, 11-cis retinal, as cofactor) in the visual cycle; however, rod functions become normal after dark adaptation, when enough time is allowed for the delayed recovery of rhodopsin and no histological damage occurs at the retinal tissue (28). Decreased color vision may occur during isotretinoin treatment but this is also reversible (4). The incidence of this adverse effect is very low and could not be repeated in some studies (27,29). Both isotretinoin and acitretin treatments are also associated with a reduction in contrast sensitivity (5,30). There is no detailed study on the influence of acitretin, bexarotene, and alitretinoin on dark adaptation; however, package inserts of acitretin and alitretinoin also list night blindness among the adverse events (22,25).
Visual changes with aging
Pablo Artal in Handbook of Visual Optics, 2017
Dark adaptation represents the ability of the visual system to adjust sensitivity when ambient light levels change from bright light (photopic) to low light (scotopic) conditions. Measurement of dark adaptation is therefore an important clinical tool for the assessment of change in visual sensitivity over time in the dark and is commonly used to assess retinal photoreceptor function. A variety of techniques are available to measure dark adaptation, but the most common approach is to assess sensitivity over time following an initial photobleach exposure, using an achromatic stimulus, either at the fovea or around 5°–12° from the fovea (Jackson et al. 1999, Dimitrov et al. 2008, Owsley et al. 2014).
Ophthalmic drugs
Mary E. Shaw, Agnes Lee in Ophthalmic Nursing, 2018
This is a natural compound from the Pilocarpus tree found in South America. It is a parasympathomimetic. Onset – 30 minutes.Duration – 10–12 hours.Dosage – Two, three or four times a day, or intensively for acute glaucoma.Disadvantages: G. pilocarpine can cause headaches.The eye is fixed at accommodation.The pupil remains permanently miosed, increasing the risk of accidents especially at night as light adaptation is restricted.Care must be taken when used intensively as overdose can cause vomiting.G. pilocarpine may cause an allergic reaction.G. pilocarpine can sting on instillation.Single use – Available in minims, which are preservative free, only in 2% strength.
Depth perception, dark adaptation, vigilance and accident proneness of Chinese coal mine workers
Published in International Journal of Occupational Safety and Ergonomics, 2018
Mingming Deng, Alan H. S. Chan, Feng Wu, Linyan Sun
Dark adaptation is the ability of the eye to recover its sensitivity in the dark after exposure to bright lights.[15] Kowalski-Trakoxer et al. [16] pointed out that, in general, older people suffer a loss of contrast sensitivity, a decrease in dark adaptation ability and a decline in color sensitivity. Maija et al. [17] indicated that abnormalities in binocularity and depth perception, dark adaptation, contrast sensitivity, glare sensitivity or color vision are all problems that could possibly increase the risk of traffic accidents. Zhang et al. [18] studied a technical test of dark adaptation for drivers and showed significant differences of dark adaptation ability between accident and non-accident groups. In the coal mine environment, the dark adaptation ability is very important to reading information; in particular the warning signs which are usually printed in red-colored words.[7] However, no studies have reported the relationship between the dark adaptation ability of coal mine workers and work safety.
Comparing Rod-Mediated Dark Adaptation in Older Adults before and after Cataract Surgery
Published in Current Eye Research, 2023
Tarushi Tanaya, Thomas A. Swain, Mark E. Clark, Jason C. Swanner, Virginia R. Lolley, Michael A. Callahan, Gerald McGwin, Cynthia Owsley
A parsimonious explanation for our data may be that age-related cataract is serving as a filter to reduce the photo-bleach magnitude, and then after cataract removal and IOL insertion, the bleach is increased, thus generating a longer RIT (meaning slower dark adaptation). As mentioned, this effect is modest in moderate cataracts, but with greater opacity in more severe cataract, this has a more marked impact on the slowing of dark adaptation. An optical consequence of age-related cataract is to reduce shorter wavelength light particularly in the region of 400–500 nm, but transmission is also reduced as high as 600 nm in some eyes as noted by Artigas et al.25 However, we simply do know the individual spectral characteristics of the cataracts in our sample. Another potential explanation for our results may be that cataract generates forward light scatter, which may have reduced the localized intensity of the bleach.
Ocular side effects of systemic isotretinoin – a systematic review and summary of case reports
Published in Journal of Dermatological Treatment, 2023
Olivia Lamberg, Arianna Strome, Foster Jones, Julia Mleczek, Adrienne Jarocki, Jonathon P. Troost, Yolanda Helfrich
While isotretinoin is a very effective treatment option for patients with recalcitrant acne vulgaris, its clinical use is associated with a variety of adverse events ranging in severity and implications. It is well recognized that the most serious potential adverse event of isotretinoin use is teratogenicity. Yet, there are many other more common side effects, including mucocutaneous effects such as cheilitis and xerosis, and neurologic effects such as headaches (3). There are also several reported ophthalmologic side effects that also range in severity. These include less severe effects such as ocular surface alterations, dry eye diseases, ocular irritation, visual field defects, and abnormalities in dark adaptation. More serious and extremely rare adverse effects include retinal toxicity, corneal opacities, and optic neuritis, which may lead to permanent ocular damage if unrecognized (4,5). These ocular adverse events have been reported within days to years of isotretinoin therapy initiation (6). In some reported cases, these ocular side effects are suspected to be dose dependent and become tolerable with a change in dosing and symptomatic management (2).
Related Knowledge Centers
- Cone Cell
- Contrast
- Eye
- Photopigment
- Physiology
- Retina
- Rod Cell
- Visual Perception
- Night Vision
- Scotopic Vision