Drug side-effects of the eye--a contribution to quality assurance in ophthalmology

The aim of this research is to catalogue the increasing number of side effects of medications on the eyes and, by putting this catalogue into a data bank, to make it available for use in hospitals. Here a deliberate search is made for medications, which could possibly cause certain side effects as well as a list of possible undesired side effects caused by a certain group of medications analogous to the main groups in the so-called "Rote Liste". With the use of the medical literature data bank MEDLINE (CD-ROM) and a search strategy suitable to the topic, German or English publications are included in the data bank, when dose, duration and method of application has been stated, and there had to be a definite or at least possible connection between the side effects observed and the substance causing the side effects. The relevant datas in each article, for example, details about the substance, its application, the publication reference, the individual side effects, categorized according to anatomical or functional aspects, and, if necessary, details about reversibility and therapy were registrated on the data bank. The most common side effects in systemic therapy relate to conjunctiva, cornea/sclera, retina as well as a large number of changes in vision. In external application the undesired side effects were also mainly on conjunctiva, cornea/sclera, as well as on eyelids, uvea, and changes in visual acuity. In medications taken externally ophthalmological side effects were most frequently caused by cytostatics, dermatics, corticoids and antibiotics. In the case of external application on the eye, by far the most undesired side effects were caused by glaucoma medications, followed by antibiotics, mydriatics and corticoids. In future, with the use of the data bank, it should be possible to quickly observe a relation between undesired side effects and medications which could possibly cause these side effects.