These 17 Medications May Cause Double Vision or Harm Your Eyes

When people take medications for certain conditions, like blood pressure or allergies, they don’t often think about eye side effects. But some medications can cause side effects that affect the eyes, from mild dryness to severe inflammation. Your eyes are relatively small but have a rich blood supply, and that combination makes them vulnerable to side effects from medications.

These side effects vary — and may involve any part of the eye, from the cornea in the front of your eye to the retina and optic nerve in the back of your eye. Let’s take a look at some commonly prescribed medications that can affect your eye health.

1. Alendronate (Fosamax)

Alendronate (Fosamax) belongs to a class of medications called “bisphosphonates.” Alendronate can treat osteoporosis, and it can lead to inflammation in the front, middle, and back part of the eye. Symptoms of inflammation in the eye include:

• Blurred vision

• Light sensitivity (photophobia)

• Eye pain

• Eye redness

2. Topiramate (Topamax)

Topiramate (Topamax) can treat many conditions, including seizures, migraine headaches, and mood disorders.Topiramate can trigger acute glaucoma, an eye condition that damages the optic nerve. People often experience eye pain, headache, and blurred vision. There are also reports of mydriasis (dilated pupil), acute myopia (sudden nearsightedness), and other rare eye complications.

3. Isotretinoin (Accutane)

Isotretinoin (Accutane, Absorica) is an oral pill that treats acne. A common side effect of isotretinoin is dry eye. Isotretinoin can also cause:

• Inflammation of the conjunctiva and eyelid (blepharoconjunctivitis)

• Light sensitivity (photophobia)

• Swelling of the optic nerve (papilledema)

4. Amiodarone (Cordarone)

Amiodarone (Cordarone) is a medication that treats irregular heartbeats, like atrial fibrillation. The risk of developing an eye condition goes up if you’re taking a higher dose of amiodarone. Eye complications are very common, even at lower doses, so people who take amiodarone should get regular eye exams. 

Amiodarone can also trigger vortex keratopathy. More than 70% of people experience this side effect. Vortex keratopathy causes a swirl-like pattern to appear on the cornea (the clear, front part of the eye). Most people don’t experience vision changes from it, while a few notice halos around lights. 

A more serious side effect from amiodarone is optic nerve damage. The optic nerve connects the eye and the brain so you can see. Damage to the optic nerve can lead to permanent vision loss.

5. Tamsulosin (Flomax)

Tamsulosin (Flomax) helps people urinate if they have an enlarged prostate (benign prostatic hypertrophy) or prostate cancer. Tamsulosin puts you at risk of developing intraoperative floppy iris syndrome (IFIS), a condition that can make it harder to treat cataracts. 

In one study, more than half of people taking tamsulosin developed IFIS during cataract surgery. It’s not clear why, but even if you stop taking tamsulosin before surgery, you’re still at high risk of developing IFIS. So you and your eye doctor will need to plan cataract surgery with this in mind.

6. Sildenafil (Viagra)

Sildenafil (Viagra) treats erectile dysfunction (ED). Some people experience changes in color perception after starting sildenafil. You may notice that things look like they’re tinted blue. This does go away if you stop taking the medication.

Another rare, serious side effect is optic nerve damage. This can cause permanent vision loss. The risk of developing optic nerve damage goes up if you’re taking a higher dose of sildenafil. 

Tadalafil (Cialis) and vardenafil (Levitra) can also cause these eye symptoms.

7. Tamoxifen

Tamoxifen is an anti-estrogen medication that can treat ovarian and breast cancer. It can lead to several eye problems, including:

• Retinal deposits

• Cornea clouding

• Swelling of the macula (macular edema)

Since these symptoms can lead to permanent vision loss, people who take tamoxifen should get regular eye exams.

8.  Chlorpromazine (Thorazine)

Chlorpromazine (Thorazine) is an antipsychotic medication that can treat hallucinations and paranoia. Chlorpromazine can cause:

• Pigment changes of the cornea, eyelids, and conjunctiva (white part of the eye)

• Dry eye 

• Blurry vision

• Retinal damage (retinal degeneration)

Thioridazine (Mellaril) is a similar antipsychotic that can also cause these symptoms.

9. Ethambutol (Myambutol or EMB)

Ethambutol (Myambutol or EMB) is a medication that treats tuberculosis. It can cause:

• Changes in color perception

• Decreased peripheral vision

• Inflammation and damage of the optic nerve

10. Hydroxychloroquine (Plaquenil)

Hydroxychloroquine (Plaquenil) treats rheumatoid arthritis, lupus, and other autoimmune disorders. 

Hydroxychloroquine can damage the retina, specifically the macula, causing permanent vision loss. The risk of developing retinal damage is higher for people taking higher doses of hydroxychloroquine. People who have been taking the medication for a long time are also at higher risk. Your eye doctor will perform specific tests during the exam to check for drug toxicity.

11. Prednisone

Prednisone and other steroids can treat many medical conditions, including eye conditions like uveitis. But some people can develop steroid-induced glaucoma, which can lead to permanent vision loss over time. But, if caught early, steroid-induced glaucoma can be reversed. Steroids can also cause cataracts to develop quickly and earlier. So be sure to see an eye doctor right away if you develop blurred vision or eye pain while taking steroids.

12. Diphenhydramine (Benadryl)

Diphenhydramine (Benadryl) is an over-the-counter (OTC) antihistamine that relieves seasonal allergy symptoms. Benadryl can cause dry eye and trouble seeing up close (because it makes your pupils get bigger). 

A serious side effect some people develop is acute angle-closure glaucoma, which is a medical emergency. Acute angle-closure glaucoma causes permanent vision loss if it’s not treated right away. When taking diphenhydramine, get emergency medical care if you develop: 

• Blurry vision

• Headache

• Intense eye pain

• Vomiting

• Halos in your vision

13. Cidofovir (Vistide)

Cidofovir (Vistide) treats cytomegaloviral (CMV) retinitis, a viral infection of the retina. Even though it treats a serious eye condition, it can also cause a different problem in the eye — uveitis. Uveitis causes eye pain, redness, and vision changes. If you take cidofovir, be sure to get regular eye exams to make sure you’re not developing uveitis.

14. Digoxin/digitalis (Lanoxin)

Digoxin (Lanoxin), or digitalis, helps treat many heart conditions. But it can cause vision changes, including: 

• Double vision

• Blurry vision

• Light sensitivity

• Changes in color perception (yellow tint to vision) 

These vision changes usually go away when you stop taking the medication. 

15. Fingolimod (Gilenya)

Fingolimod (Gilenya) is a newer medication that treats multiple sclerosis. It can cause macular edema, or swelling in the back of the eye. Symptoms of macular edema include:

• Blurred central vision

• Shadows in vision

• Blank spots in the vision

• Changes in color perception (colors may look washed out or muted, making them harder to tell apart)

People taking fingolimod should get regular eye exams.

16. Rifampin (Rifadin)

Rifampin (Rifadin) is another medication that treats tuberculosis and other infections. Rifampin makes all bodily fluids look orange-red, including tears. While this won’t affect vision, it will stain contact lenses, which will make everything look orange.

The color of your tears will go back to normal once you stop taking the medication. But you might want to switch to daily, disposable lenses or glasses while taking rifampin. 

17. Doxycycline (Vibramycin)

Doxycycline (Vibramycin) is an antibiotic that treats many types of infections and helps treat other medical conditions, like acne. People who take doxycycline for a long time can develop secondary intracranial hypertension also known as pseudotumor cerebri. This causes an increase in the pressure inside the brain, which leads to:

• Blurred vision

• Double vision

• Headaches

Tetracycline and minocycline are similar antibiotics that can also cause intracranial hypertension. 

Medications that can affect your vision without harming your eyes

The medications above can directly affect your eye health. But some medications can indirectly affect your vision changes. They don’t affect the eyes directly. Instead, they can cause other side effects and those side effects can affect your vision. Here are some examples.

What should you do if you develop vision changes or double vision while taking one of these medications?

If you’re taking any of these medications and you develop vision changes, double vision, or other eye symptoms — call an eye doctor right away. Early treatment can protect your vision. Your eye doctor will also help you safely taper or stop your medication.

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Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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