Drug‐induced bilateral transient myopia with the sulphonamide sulphasalazine

Abstract

Whereas there are numerous reported ocular side effects from systemic sulpha medication, most are rare and reversible, with myopia being the most common reaction observed. A case report is presented of sudden bilateral onset of -1.0 DS of myopia (from -3.0 to -4.0 DS) in a young adult female following the addition of a sulphonamide (sulphasalazine) to oral non-steroidal anti-inflammatory treatment (meloxicam) for rheumatoid arthritis. The myopia regressed to -3.50 DS after 2 weeks when all medication was withdrawn and stabilised at this level when subsequent treatment was resumed after 8 weeks with the non-steroidal anti-inflammatory drug celecoxib. The case indicates that account needs to be taken of the possibility that relatively modest myopic shifts encountered in young adult contact lens wearers may be associated with concomitant systemic medication.

Ocular Complications of Drugs Used in Rheumatic Disease

“…Sulfasalazine is regarded as a relatively safe drug, but, as a sulphur-containing compound, can induce Stevens-Johnson syndrome [39]. A case of reversible myopia has been reported [40], and SSZ has also been reported to cause yellow discolouration and staining of soft contact lenses [41].…”

Review: Ocular side effects of anti-rheumatic medications: what a rheumatologist should know

“…There has been a report of peripheral facial nerve palsy and blurred near vision in association with sulphasalazine treatment 48. Santodomingo et al 49. presented a sudden bilateral onset of −1.0 diopters sphere (DS) of myopia in a young adult female following the addition of a sulphonamide (sulphasalazine) to oral non-steroidal anti-inflammatory treatment (meloxicam) for rheumatoid arthritis.…”

Drug‐induced ocular side‐effects with isotretinoin

“…Although some countries have voluntary post‐marketing surveillance systems, they can suffer from under‐reporting, incomplete case report information and lack of case follow‐up. Thus, the practicing eye care professional plays an important role in identifying and reporting the potential ocular side‐effects induced by commercially available medicines (Santodomingo‐Rubido et al. , 2003; Cox and Gilmartin, 2006; Gilmartin, 2008).…”