In e na ional Jou nal o Clinical Science and Medical Resea ch
ISSN(p in ): 2770-5803, ISSN(online): 2770-582X
Volume 05 Issue 11 No embe 2025
DOI: h ps://doi.o g/10.55677/IJCSMR/V5I11-08/2025, Impac Fac o : 8.005
Page No : 306-308
306 A ailable a : h ps://jou nalo medical.o g/
Ocula Ad e se E ec s o Psycho opic D ugs: A Clinical S udy o 20 Cases
(2023–2025)
Z. Filali1*, H. Boui2, H. Lazaa 1, L.O. Che kaoui1
1Depa men o Oph halmology, Special y Hospi al o Raba , Mohammed V Uni e si y – Facul y o Medicine and Pha macy,
Raba , Mo occo
2Depa men o Oph halmology, Hassan II Mili a y Hospi al, Facul y o Medicine and Pha macy, Ibn Zoh Uni e si y, Laâyoune,
Mo occo
ABSTRACT Published Online: No embe 21, 2025
Pu pose: To analyze he ocula ad e se e ec s induced by psycho opic medica ions
and desc ibe hei mechanisms acco ding o d ug classes.
Me hods: A e ospec i e desc ip i e s udy in ol ing 20 pa ien s ollowed be ween
Janua y 2023 and June 2025 o ocula mani es a ions seconda y o psycho opic
he apy.
Resul s: The mean age was 49 yea s (18–72), wi h a emale p edominance (60%).
Neu olep ics accoun ed o 40% o p esc ip ions, an idep essan s o 30%, anxioly ics
o 20%, and mood s abilize s o 10%. The mos equen ocula e ec s we e d y eye
(45%), accommoda i e diso de s (25%), ocula hype ension o acu e glaucoma (15%),
co neal deposi s (10%), and e inal changes (5%).
Conclusion: Psycho opic d ugs may cause a wide ange o ocula side e ec s. Ea ly
de ec ion and collabo a ion be ween psychia is s and oph halmologis s a e essen ial o
p e en isual complica ions.
KEYWORDS:
Psycho opics; Ad e se e ec s;
Eye; Glaucoma; D y eye; Vision..
INTRODUCTION
Psycho opic d ugs a e widely used in he managemen o
ch onic psychia ic diso de s, bu hei sys emic and ocula
oxici y emains unde ecognized [1,2]. These agen s can
a ec he ocula su ace, accommoda ion, in aocula
p essu e, and e en he e ina. The mechanisms di e among
pha macological classes: an icholine gic and neu olep ic
agen s induce accommoda ion diso de s and d y eye;
an idep essan s can igge myd iasis and acu e glaucoma;
pheno hiazines lead o co neal deposi s and e inal
pigmen a ion; and mood s abilize s such as li hium may
cause diplopia o nys agmus [3–5]. This s udy aims o
desc ibe he spec um o ocula ad e se e ec s ela ed o
psycho opic d ugs and o emphasize he need o sys ema ic
oph halmologic su eillance.
Co esponding Au ho : D . Zineb Filali
*Ci e his A icle: Z. Filali, H. Boui, H. Lazaa , L.O.
Che kaoui (2025). Ocula Ad e se E ec s o Psycho opic
D ugs: A Clinical S udy o 20 Cases (2023–2025).
In e na ional Jou nal o Clinical Science and Medical
Resea ch, 5(11), 306-308
PATIENTS AND METHODS
A e ospec i e desc ip i e s udy was conduc ed be ween
Janua y 2023 and June 2025 in he oph halmology
depa men s o Raba and Laâyoune. Twen y pa ien s
e e ed o ocula symp oms ollowing psycho opic
medica ion we e included. Inclusion c i e ia we e use o
psycho opics o a leas h ee mon hs, onse o new o
wo sening ocula signs, and comple e medical eco ds.
Exclusion c i e ia we e p e-exis ing ocula disease o
concu en exposu e o o he ocula ly oxic d ugs.
Collec ed da a included age, sex, du a ion o ea men , d ug
class, unc ional symp oms (blu ed ision, pho ophobia,
d yness, diplopia), and clinical indings (IOP, co neal s a us,
undus, OCT).
RESULTS
The mean age was 49 yea s (18–72); he e we e 12 women
(60%) and 8 men (40%). The mean exposu e du a ion was
18 mon hs. Poly he apy wi h mul iple psycho opics was
obse ed in 20% o cases.
D . Zineb Filali e al, Ocula Ad e se E ec s o Psycho opic D ugs: A Clinical S udy o 20 Cases (2023–2025)
307 A ailable a : h ps://jou nalo medical.o g/
Dis ibu ion by pha macological class:
- Neu olep ics (chlo p omazine, halope idol, ispe idone): 8
cases (40%) – co neal deposi s, accommoda i e
dys unc ion, e inal pigmen a ion.
- An idep essan s (ami ip yline, luoxe ine, se aline): 6
cases (30%) – d y eye, myd iasis, glaucoma exace ba ion.
- Anxioly ics (benzodiazepines): 4 cases (20%) – blu ed
ision, ansien diplopia.
- Mood s abilize s (li hium, alp oa e): 2 cases (10%) –
emo , nys agmus, pho ophobia.
Main ocula mani es a ions:
- D y eye: 9 cases (45%)
- Accommoda ion diso de s / blu ed ision: 5 cases (25%)
- Ocula hype ension / acu e glaucoma: 3 cases (15%)
- Co neal deposi s: 2 cases (10%)
- Re inal pigmen a ion: 1 case (5%)
Re e sibili y:
- Comple e eco e y a e ea men wi hd awal: 70%
- Pa ial imp o emen : 20%
- Pe sis en sequelae ( e inal damage): 10%.
DISCUSSION
Psycho opic medica ions ep esen a equen ly o e looked
cause o ocula oxici y. In ou se ies, neu olep ics and
an idep essan s we e mos commonly implica ed, e lec ing
hei widesp ead and ch onic use [3,4]. Ou indings a e
consis en wi h hose o Biousse and Newman [5] and
Zengin e al. [6], who emphasized he impo ance o
mul idisciplina y igilance.
Neu olep ics, pa icula ly pheno hiazines, demons a e a
ma ked co neal and e inal opism. Co neal deposi s occu
due o accumula ion o lipophilic me aboli es wi hin he
an e io s oma. While o en asymp oma ic, hese may cause
pho ophobia o mild isual impai men o e ime. Re inal
pigmen a y changes associa ed wi h chlo p omazine and
hio idazine a e dose-dependen and may be i e e sible,
wa an ing long- e m moni o ing e en a e d ug cessa ion
[7].
An idep essan s expose pa ien s o unc ional dis u bances
linked o an icholine gic and sympa homime ic ac i i y,
including myd iasis, d y eye, and occasionally acu e angle-
closu e glaucoma. Such cases a e pa icula ly obse ed in
hype me opic pa ien s wi h na ow i idoco neal angles [8].
Selec i e se o onin eup ake inhibi o s (SSRIs), al hough
conside ed sa e , can s ill al e in aocula p essu e
egula ion in glaucoma pa ien s [9].
Anxioly ics such as benzodiazepines mainly cause ansien
isual symp oms—blu ed ision, diplopia, pho ophobia—
which ypically esol e upon discon inua ion [10]. Mood
s abilize s (li hium, alp oa e) end o p oduce neu o-
oph halmic e ec s— ine emo , nys agmus, o diplopia—
e lec ing sys emic neu o oxici y a he han di ec ocula
damage [11].
F om a pa hophysiological s andpoin , se e al mechanisms
con ibu e o psycho opic ocula oxici y: dopamine gic
blockade and an icholine gic ac i i y educing lac imal
sec e ion, lipophilic accumula ion wi hin ocula issues,
dys egula ion o pupilla y one and aqueous humo
dynamics causing glaucoma, and oxida i e s ess wi h
mic oci cula o y dis u bance a he e inal le el [12,13].
Clinically, hese ad e se e ec s can signi ican ly a ec
isual unc ion, especially in elde ly o polymedica ed
pa ien s. A coo dina ed app oach in ol ing psychia is s,
neu ologis s, and oph halmologis s is essen ial o ea ly
de ec ion. Baseline and pe iodic eye examina ions should
include in aocula p essu e measu emen , ea ilm
e alua ion, and e inal imaging when indica ed [14].
Implemen ing a s anda dized oph halmic ollow-up shee o
long- e m psycho opic use s could imp o e sa e y and
p e en i e e sible ision loss [15].
CONCLUSION
Ocula ad e se e ec s o psycho opic d ugs a e di e se and
o en unde es ima ed. They p ima ily in ol e he ocula
su ace, accommoda ion, and in aocula p essu e. Ea ly
ecogni ion and in e disciplina y managemen a e c ucial o
a oid pe manen damage. Sys ema ic oph halmologic
sc eening is s ongly ecommended o high- isk pa ien s,
pa icula ly hose on long- e m he apy o wi h p e-exis ing
ocula condi ions.
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