Drug-Induced Myopia: Pathogenesis, Diagnosis, and Treatment

Myopia is one of the leading causes of visual impairment. Systemic agents cause myopia by three main mechanisms. It is an increase in the refractive power of the lens with ciliary muscle spasm, an increase in the refractive power of the lens with water retention, and finally the anterior displacement of the lens with swelling of the ciliary processes. Idiosyncratic reaction in uveal tissue is dose-independent and is the main pathology. In general, as a result of ciliochoroidal effusion, the ciliary body-lens-iris block is displaced anteriorly, and myopia occurs with the relaxation of the zonular fibers. Many drugs have been reported to cause this condition, and mostly sulfa derivatives cause myopia. Acetazolamide, topiramate, indapamide, sulfasalazine, methazolamide, co-trimaxazole, ethoxolamide, hydrochlorothiazide, chlorthalidone, psychotropic agents are in this group. In this review, the drugs that cause myopia and their pathological mechanisms and treatments will be explained.