The Influence of Systemic Medications on Accommodation

I don’t regard my latest edition of Clinical Ocular Pharmacology handy (Bartlett & Jaanus 2008), but in the line of progress of looking for something else came over this nice (if somewhat outdated) particular from the American Orthoptic Journal adhering drugs which can affect near chimera:

Smith JL, Buncic JR: Drugs Which Can Affect Near Vision: A Useful List, Am Orthopt J 1999; 49:180-190.


This early part of the day, an article in press (no calembourg intended) in the Canadian Journal of Ophthalmology came to my watch courtesy of Dr. Kathy Freeman in prepping on the side of our weekly conference to select items in favor of Elsevier’s Practice Update for Eyecare.

Topiramate and privilege: Does topiramate cause accommodative dysfunction?
Eren Çerman, Semra Akkaya Turhan, Muhsin Eraslan, Pınar Kahraman Koytak, Özden Kilinç, Tülin Tanrıdağ.  Published online: November 25, 2016.

You’re additional likely to recognize Topiramate by its mark name Topomax, a drug commonly used to bargain seizures and also used to gratification migraines.  Visual disturbances in migraine are well documented by regard to light sensitivity as well similar to auras.  Lesser known is the certainty that Topomax can inhibit the reply to accommodative stimuli, resulting in a significant  accommodative lag, which is the subject of this quantifying adjective.  The study used the Grand Seiko Open View Auto-Refractor, what one. we’re very fond of in our employment to objectively measure accommodative responses.

You obviously don’t be in actual possession of to get this fancy, and be able to simply pull out your retinoscope while history reveals that your patient is seizing Topamax and is having any affectionate of near point symptomology or consummation issues.  And although the head didn’t mention it specifically, these patients are furthermore candidates for experiencing pseudo convergence deficiency secondary to induced accommodative lag (diocese the clinical pearl here).

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