Medications are prescribed to help treat one or more conditions, but while a certain medicine may help in one area, it may be harming or worsening things in another part of your body. This includes your vision, as certain medications can raise your intraocular pressure (IOP). Learn more about what types of medications can adversely affect people with glaucoma.* 

What types of glaucoma are more affected by medications?

Certain medications may cause or worsen narrow angles, i.e. angle-closure glaucoma, the second most common type of glaucoma. This particular type of glaucoma is caused by an angle that is too narrow in the passageway where aqueous humor (AH), or eye fluid, would normally drain from. 

Included in this group is acute (or closed-angle) angle-closure glaucoma, which “begins suddenly when the normal flow of aqueous humor between the iris and lens is blocked,” according to the BrightFocus Foundation. “This condition is a medical emergency and must be treated immediately” to prevent blindness.

While angle-closure glaucoma is largely genetic, some medications have the potential to narrow the drainage angle of your eye, too.

Which medications can adversely affect or cause glaucoma?

While you may still require these medications for treatment, the following medications are known to have negative associations with narrow angles and angle-closure glaucoma:

• Anticholinergic medications are used to block the action of acetylcholine, a chemical messenger that transmits signals from one nerve cell to another cell. They may be used for short-term or long-term to treat: asthma and COPD; incontinence (overactive bladder); gastrointestinal issues; muscle spasms; depression and anxiety; allergies; and nausea.
• Ephedrine-containing drugs are typically prescribed to manage congestion that comes along from the common cold.
• Sulfonamide-containing drugs can cause an allergic reaction in some individuals where angle-closure glaucoma can develop. 
• Oral steroids are used to reduce inflammation but can raise eye pressure in angle-closure glaucoma patients. 
• While it is a very rare occurrence, antihistamine medications (used to treat common allergy-related symptoms) can cause an acute (short-term) glaucoma attack. 

If you’re unsure if any of your medications fall into these categories, most pharmacies will allow you to speak with a pharmacist about your medication regimen. A pharmacist can tell you what possible symptoms and adverse reactions can be caused by the medications you’re taking, especially concerning any pre-existing conditions. 

What can increase your risk of medication-induced angle-closure glaucoma?

Certain factors that may increase the odds include:

• Advanced age
• Female sex
• Hyperopia (farsightedness)
• Asian ethnicity
• Positive family history of angle-closure glaucoma
• Known pre-existing narrow angles

What medications can cause adverse reactions with open-angle glaucoma?

Since open-angle glaucoma (OAG) is the most common type of glaucoma, accounting for 70-90% of all cases, you may also be wondering if any medications can negatively impact OAG. At present, only one type of medication is known to potentially cause adverse reactions: oral steroids. 

Oral steroids can increase eye pressure in some, but not all, open-angle glaucoma patients. They can be prescribed for either short-term or long-term use and are used to treat:

• Autoimmune diseases
• Anti-inflammatory bowel diseases
• Joint and muscle diseases
• Allergies and asthma 

While an oral steroid may not increase your eye pressure, it is important to discuss it with your doctor, especially if you are planning to undergo glaucoma surgery. Your ophthalmologist (eye surgeon) may want to monitor you more closely while you are on the steroid treatment. 

Additional information about medications with potential adverse effects related to glaucoma can be found on the Glaucoma Research Foundation and American Academy of Ophthalmology  (AAO) websites.

*Ou, Y. (2019, May 6). Medications that May Adversely Affect Glaucoma. BrightFocus Foundation. https://www.brightfocus.org/glaucoma/article/medications-may-adversely-affect-glaucoma

Any sources from outside of Prevent Blindness do not imply an endorsement from Prevent Blindness. The contents of the material used are the responsibility of the authoring organization, Responsum Health.