Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 26, 2026 55 minutes ago
Medical News: Many people never imagine that a pill taken for migraines, depression, allergies, bladder problems, or even a common cold could trigger a sudden eye emergency. However, a new review by researchers from the Department of Ophthalmology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, warns that several widely prescribed medications have been repeatedly linked to acute angle-closure glaucoma (AACG), a condition that can rapidly cause permanent vision loss if not treated immediately. The findings highlight the importance of recognizing warning signs early rather than avoiding these medications altogether.
Researchers warn that several commonly prescribed medicines can rarely trigger sudden angle-closure glaucoma, making early symptom recognition essential to prevent permanent blindness
A Rare but Serious Threat to Vision
Acute angle-closure glaucoma occurs when fluid inside the eye suddenly cannot drain properly, causing a rapid rise in pressure. This pressure can damage the optic nerve within hours if left untreated. Symptoms often include severe eye pain, blurred vision, halos around lights, headache, nausea, and vomiting.
Although the condition is uncommon, the review emphasizes that it is a genuine medical emergency. Women, older adults, people with naturally narrow drainage angles inside the eye, and many Asian populations are considered to have a higher risk, although some medication-related cases can also occur in people with previously normal eyes.
Which Medications Carry the Greatest Risk?
The review found that a relatively small number of medication groups account for most reported drug-induced cases.
Among the most important are topiramate and other sulfonamide-derived drugs, commonly prescribed for epilepsy, migraine prevention, and weight management. Unlike many other medicines, topiramate can trigger swelling behind the eye that pushes the lens and iris forward, closing the drainage angle in both eyes. This reaction usually develops within days or up to two weeks after starting treatment or increasing the dose.
Other medications linked to acute angle closure include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, migraine medications known as triptans, anticholinergic drugs used for bladder disorders and Parkinson's disease, adrenergic decongestants found in many cold remedies, and certain alpha-blockers prescribed for enlarged prostate. Most cases appear shortly after treatment begins or after dosage increases.
Different Medicines Trigger Different Mechanisms
One of the review's most important findings is that not every medication causes glaucoma in the same way.
Many antidepressants, anticholinergic medicines, and decongestants enlarge the pupil, blocking normal fluid drainage in people whose eye anatomy is already narrow.
Topiramate and related drugs work differently. Instead of blocking the pupil, they cause swelling inside the eye that shifts internal structures forward. This distinction is critical becau
se treatments that help one form of glaucoma may actually worsen the other. This
Medical News report highlights why doctors must quickly identify the underlying cause before deciding on treatment.
Early Recognition Can Prevent Blindness
The researchers stress that routine eye screening before prescribing these medications is not practical and would not identify every patient at risk. Instead, the most effective preventive strategy is educating patients about symptoms that require urgent medical attention.
Anyone developing sudden blurred vision, halos around lights, severe eye pain, headache, nausea, vomiting, or a sudden increase in short-sightedness soon after starting one of these medications should seek immediate ophthalmic evaluation. Rapid discontinuation of the triggering medication together with prompt treatment to lower eye pressure can often prevent permanent vision damage.
Researchers Call for Better Awareness
The authors also point out that many healthcare professionals outside ophthalmology prescribe these medications daily. Better education for physicians, pharmacists, and patients could significantly improve recognition of early warning signs. They also recommend future studies to better measure the true risk associated with individual drugs and to develop practical patient education tools that can be used during routine medical consultations.
Conclusion
The review makes it clear that medication-induced acute angle-closure glaucoma remains rare, but its consequences can be devastating when symptoms are ignored. The greatest protection is not avoiding useful medications, but ensuring patients and healthcare providers recognize the warning signs quickly so treatment can begin before irreversible optic nerve damage and permanent vision loss occur.
The study findings were published in the peer reviewed: Journal of Clinical Medicine.
https://www.mdpi.com/2077-0383/15/15/5834
For the latest on Glaucoma and other eye conditions or diseases, keep on logging to Thailand
Medical News.
Read Also:
https://www.thailandmedical.news/articles/glaucoma-news
https://www.thailandmedical.news/articles/ophthalmology-(eye-diseases)
https://www.thailandmedical.news/articles/med-news
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