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Brad Schuster
Brad Schuster, Board Certified Opthamologist
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Experience:  Glaucoma Specialist
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Which of the following medications cause possible eye

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Which of the following   medications cause possible eye problems: celebrex, methotrexate,lyrica, natrilix, amloc, (for blood pressure)   and lexamil ,        .I have intraocular implants in both eyes and had a tear in the retina in one eye some years back. Also have an allergy of the eyes for which I use Efemoline and Refresh drops(both don't seem to help anymore). Since my rheumatologist put me onto the first-mentioned lot of medication for osteo and rheumatoid arthritis, my eyesight has worsened considerably. Have recently been examined by my opthalmologist who seemed to think I was making a fuss about nothing. Have mentioned to the rheumatologist that I am worried about my failing sight and he too seemed to think I was making a fuss. I am 76 years old and very worried as my eyesight is all to me. If I cut back on the medication for rheumatology then I can't handle the pain and am immobile. What can I do?


I am sorry to hear of your problems. Celebrex, methotrexate and lyrica can all cause conjunctivitis and dry eyes. None of these are very notorious in causing vision problems per se (unlike Plaquenil). However, dry eyes can really affect your vision as well. If drops don't do the job, there are other things like plugs, Restasis, and serum drops that can be tried.

Keep in mind that "vision" as we check it (reading chart) is only a small part of your overall vision. There is contrast, color, glare, and peripheral vision that we don't routinely check. So, even if your Snellen acuity (reading chart) is good, your overall vision may be decreased. We know that decreased contrast sensitivity is part of aging. That's why some people come into the office and read 20/20 but yet say that they have problem seeing.

Dr. Chan, Ophthalmologist
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The answer from dr Chan is right on. In addition, you are using a steroid drop mixed with a vasoconstrictor (Efemoline). While this may be effective in the short term for allergy, it has some risk of creating redness when you don't use it, and it can accelerate cataract development and possibly raise the eye pressure. I would not recommend using this for more than a week or two.

The other drugs you mentioned will be reviewed below:

Natrilix: a thiazide diuretic which can lead to dryer eyes

Amloc: (amlodipine) a calcium channel blocker: safe for the eyes

Lexamil: a seretonin reuptake inhibitor used for depression or anxiety conditions: can slightly dilate the pupil and give blurring.

In general, you have many drugs going that may or may not be helping your situation with the fibromyalgia. It looks like you are suffering from polypharmacy in addition to your medical conditions of osteo and rheumatoid arthritis. There is no really good treatment for fibromyalgia. To add this level of chemical mix that you are possibly taking may be making things worse. I think your doctors are trying to help you but consider fibromyalgia to be a form of depression or anxiety which it may be. This can lead to a somewhat dismissive stance with you because they know you will have a million complaints that will not respond well to anything in the pharmaceutical arsenal. It takes more time to go through all of the symptoms than other diseases. You may be best served with fibromyalgia help groups rather than drugs.

Your rheumatoid arthritis meds are celebrex and methotrexate: these should not be stopped unless your rheumatologist says it is safe.

Brad Schuster, Board Certified Opthamologist
Category: Eye
Satisfied Customers: 4
Experience: Glaucoma Specialist
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