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What Are Common Glaucoma Contraindications?

By L. Whitaker
Updated Feb 13, 2024
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Certain types of systemic medications, particularly corticosteroids and some antidepressants, are commonly named as glaucoma contraindications because they can cause an increase in intraocular pressure (IOP). These drugs can have dangerous effects for individuals with glaucoma or those who might be genetically predisposed to develop this condition. Patients should be monitored for their reactions to certain medications with glaucoma contraindications, while those at high risk for developing glaucoma should use caution in using medicines that can precipitate the condition.

Many steroid medications, especially in the form of eye drops, are known to increase IOP and thereby increase the likelihood of developing glaucoma. Individuals who are engaged in long-term use of corticosteroids to address system conditions are at a greater risk of glaucoma induced by steroid use. Close monitoring by a physician is encouraged for those at high risk of glaucoma who use steroids.

Medications for high blood pressure can influence the development or exacerbation of glaucoma. These drugs can include ACE inhibitors, such as catapril, as well as beta blockers such as atenolol. Anyone with glaucoma is urged to avoid developing hypertension or to manage it effectively with the help of a physician.

Drugs used in the treatment of epilepsy or Parkinson's disease are sometimes referenced as glaucoma contraindications. Topiramate is an example of an antispasmodic medication that can cause problems with eye pressure. Medicines containing sulfa or sulfonamides can sometimes also induce glaucoma.

Some anticholergenic medicines for the management of mental health problems are labeled with glaucoma contraindications. A few of these medications are haloperidol and other antipsychotic drugs, amitryptiline and other tricyclic antidepressants, lithium, and paroxetine. Certain antihistamines also fall into this category due to their action of blocking neurotransmitters. Other antidepressants that are associated with glaucoma contraindications are imipramine and some selective serotonin reuptake inhibitors, or SSRIs, such as citalopram.

Glaucoma is a vision-damaging condition in which the IOP becomes increased, sometimes without obvious pain or other symptoms. Increased IOP can cause damage to the optic nerve that, if untreated, results in blindness. Open-angle or wide-angle glaucoma is the most common type, with narrow-angle or angle-closure glaucoma being a rare but acute form of the disease. Individuals at higher risk of developing glaucoma include those with vision problems, diabetes, rheumatoid arthritis or a genetic history of glaucoma; anyone who is over 40 years old; and people who are taking steroid medications. Another high-risk category includes those whose heritage is Irish, Hispanic, Scandinavian, African-American, Russian, Japanese or Inuit.

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Discussion Comments
By turquoise — On Feb 06, 2013

There is a drug used for some psychological conditions as well as Parkinson's disease that contains L-DOPA. This is a chemical that's found in nature so I thought that it wouldn't contradict glaucoma. I started using it.

A week later, I started experiencing severe eye pain, migraines and changes in my vision. It turns out this is one of the drugs that is not allowed for glaucoma patients. The doctor who had prescribed it for me was not aware that I have glaucoma. The symptoms disappeared when I stopped using it.

By burcinc — On Feb 05, 2013

@anamur-- Absolutely! Those who have glaucoma or who are predisposed to it should steer clear of atropine (atropine sulfate), especially atropine eye drops.

Atropine increases pressure inside the eye and can lead to narrow-angle/acute-angle glaucoma. If someone already suffers from glaucoma and uses atropine, the condition will worsen.

There are several other medications that have the same pressure increasing effect on the eyes. They are glycopyrrolate, isopropamide and propantheline.

By serenesurface — On Feb 05, 2013

Is there contraindication between atropine and glaucoma?

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