From the Guidelines
Sertraline can occasionally affect the eyes, causing side effects such as blurred vision, dry eyes, or increased pupil size, which typically occur in about 4-7% of users and are usually mild and temporary. When considering the effect of Sertraline on the eye, it is essential to weigh the potential benefits against the risks, prioritizing morbidity, mortality, and quality of life as the outcome. According to the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1, SSRIs, including sertraline, can have various side effects, but the guideline does not specifically mention the frequency or severity of eye-related side effects.
Potential Eye-Related Side Effects
- Blurred vision
- Dry eyes
- Increased pupil size (mydriasis) These side effects are thought to occur because serotonin receptors are present in ocular tissues, and sertraline's alteration of serotonin levels can affect tear production and pupillary response 1.
Management of Eye-Related Side Effects
If patients experience persistent or severe eye symptoms while taking sertraline, they should contact their healthcare provider promptly, but not stop taking the medication abruptly. For mild dry eye symptoms, over-the-counter artificial tears can provide relief. In rare cases, sertraline may increase intraocular pressure, so patients with glaucoma should be monitored more closely 1.
Monitoring and Follow-Up
Most eye-related side effects resolve within a few weeks as the body adjusts to the medication, but patients should always report persistent visual changes to their doctor. Regular follow-up with a healthcare provider is crucial to monitor the effectiveness of the medication and manage any potential side effects, including those related to the eyes 1.
From the FDA Drug Label
Patients should be advised that taking sertraline can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle glaucoma is not a risk factor for angle closure glaucoma Patients may wish to be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure (e.g., iridectomy), if they are susceptible. 9 Visual problems eye pain changes in vision swelling or redness in or around the eye
The effect of Sertraline on the eye includes:
- Mild pupillary dilation which can lead to an episode of angle closure glaucoma in susceptible individuals
- Visual problems
- Eye pain
- Changes in vision
- Swelling or redness in or around the eye 2 2
From the Research
Effect of Sertraline on the Eye
- There is limited direct evidence on the effect of Sertraline on the eye, but some studies suggest that it may be associated with certain eye-related conditions 3, 4.
- A study on the use of Sertraline in depressed patients found that it may induce or exacerbate rapid eye movement sleep without atonia (RSWA), which is a condition characterized by the presence of muscle activity during REM sleep 3.
- Another study reviewed the relationship between depression and dry eye disease (DED), and found that the treatment of depression with selective serotonin reuptake inhibitors (SSRIs) like Sertraline may cause inflammatory cytokine secretion, leading to inflammation and apoptosis of cells on the ocular surface 4.
- However, other studies on the use of Sertraline in anxiety disorders and depression do not mention any specific effects on the eye 5, 6, 7.
Possible Mechanisms
- The exact mechanism by which Sertraline may affect the eye is not fully understood, but it is thought to be related to its effects on serotonin levels and inflammation in the body 3, 4.
- Further research is needed to fully understand the potential effects of Sertraline on the eye and to determine the best course of treatment for patients with eye-related conditions who are taking this medication.