Urologic medications and ophthalmologic side effects: a review

Authors

  • Johan Gani Division of Urology, Toronto Western Hospital, University Health Network, Toronto, ON
  • Nathan Perlis Division of Urology, Toronto Western Hospital, University Health Network, Toronto, ON
  • Sidney B. Radomski Division of Urology, Toronto Western Hospital, University Health Network, Toronto, ON

DOI:

https://doi.org/10.5489/cuaj.371

Abstract

Commonly prescribed urologic medications can have significant
ophthalmologic side effects. The existing information can be conflicting. We looked at alpha-blockers and intraoperative floppy iris syndrome (IFIS), phosphodiesterase type 5 (PDE5) inhibitors and non-arteritic ischemic optic neuropathy (NAION) and lastly anticholinergic medications and glaucoma. There is no conclusive scientific data on what to do if the risk of urinary retention is low to moderate, however, we recommend that patients having cataract surgery should stop alpha-blocker medications preoperatively. If there is a high risk of urinary retention, the alpha-blocker should not be withheld, with the active involvement of the ophthalmologist. The role of using 5 alpha-reductase inhibitors (5ARIs) can be considered. There is no convincing evidence that PDE5 inhibitors cause non-arteritic anterior ischemic optic neuropathy (NAION), but patients should be advised of the possible risk of visual loss, especially in patients with risk factors of ischemic heart disease. Acute angle closure glaucoma (AACG or closed angle glaucoma) is very rarely caused by anticholinergic medications in patients with
narrow angle anterior eye chambers. However, these medications are safe in patients with open angle glaucoma or treated closed angle glaucoma. Urologists should inquire about the patient’s glaucoma history from his/her ophthalmologist before starting an anticholinergic medication.

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Author Biographies

Johan Gani, Division of Urology, Toronto Western Hospital, University Health Network, Toronto, ON

Nathan Perlis, Division of Urology, Toronto Western Hospital, University Health Network, Toronto, ON

Sidney B. Radomski, Division of Urology, Toronto Western Hospital, University Health Network, Toronto, ON

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Published

2013-02-26

How to Cite

Gani, J., Perlis, N., & Radomski, S. B. (2013). Urologic medications and ophthalmologic side effects: a review. Canadian Urological Association Journal, 6(1), 53–8. https://doi.org/10.5489/cuaj.371

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