From the Guidelines
Hydrochlorothiazide is not directly associated with causing vision issues, but it can trigger photosensitive eruptions, which may indirectly affect vision due to increased sensitivity to light. The primary concern with hydrochlorothiazide is its potential to cause photosensitivity, as noted in a study published in Nature Reviews Cardiology in 2022 1. This photosensitivity can lead to various skin reactions, including an exaggerated sunburn reaction, dermatitis, and a lichenoid eruption. While these reactions are primarily cutaneous, increased sensitivity to light could potentially affect vision comfort or lead to discomfort in bright environments. However, it's essential to note that direct vision issues, such as blurred vision or changes in color vision, are not commonly highlighted as side effects of hydrochlorothiazide in the provided evidence. If a patient experiences any vision changes while taking hydrochlorothiazide, it is crucial to contact a healthcare provider promptly to rule out any serious complications and to discuss potential adjustments to the medication regimen. The evidence from 1 suggests that patients should be advised to protect themselves from excessive sun exposure, especially during peak hours, by seeking shade, wearing protective clothing, and using broad-spectrum sunscreens with a high sun protection factor. In the context of managing hypertension and fluid retention, the benefits of hydrochlorothiazide often outweigh the risks, but monitoring for any adverse effects, including those related to vision or photosensitivity, is important for maintaining patient safety and quality of life.
From the FDA Drug Label
WARNINGS Acute Myopia and Secondary Angle-Closure Glaucoma: Hydrochlorothiazide, a sulfonamide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. Symptoms include acute onset of decreased visual acuity or ocular pain and typically occur within hours to weeks of drug initiation Untreated acute angle-closure glaucoma can lead to permanent vision loss. Special Senses: Transient blurred vision, xanthopsia.
Yes, hydrochlorothiazide can cause vision issues, including:
- Acute transient myopia
- Acute angle-closure glaucoma
- Decreased visual acuity
- Ocular pain
- Transient blurred vision
- Xanthopsia 2, 2
From the Research
Hydrochlorothiazide and Vision Issues
- Hydrochlorothiazide has been associated with various vision issues, including acute-onset bilateral myopia and ciliochoroidal effusion 3.
- A study published in the Korean journal of ophthalmology found that two middle-aged women taking hydrochlorothiazide experienced bilateral myopic shift, intraocular pressure elevation, shallowing of the anterior chambers, choroidal effusions, radiating retinal folds, and conjunctival chemosis 3.
- Another study reported a case of retinal phototoxicity induced by hydrochlorothiazide after exposure to a UV tanning device, resulting in phototoxic macular damage and significant visual acuity impairment 4.
- The patient's visual acuity improved by about 60% from baseline over a 12-month follow-up period after discontinuing hydrochlorothiazide and wearing UV filtering glasses 4.
- Hydrochlorothiazide has also been linked to chronic photosensitivity, with four patients developing debilitating photosensitivity that persisted for months to years after stopping the diuretic 5.
- Phototesting and histologic examination of skin biopsy specimens revealed decreased minimal erythemal doses and acute eczematous dermatitis in these patients 5.