Can Sertraline Cause Blurry Vision?
Yes, sertraline can cause blurry vision, though it is not one of the most common side effects and is generally less problematic than with older antidepressants like tricyclic antidepressants.
Common Visual Side Effects
Blurred vision is not listed among the most frequent adverse effects of sertraline, which primarily include gastrointestinal disturbances (nausea, diarrhea), headache, insomnia, somnolence, dizziness, and sexual dysfunction 1.
Sertraline is notably free of the anticholinergic effects that commonly cause blurred vision with tricyclic antidepressants, making it a safer choice in patients concerned about visual disturbances 2, 3.
Documented Visual Effects
Pupillary Changes
- Sertraline can cause mild pupillary dilation, which in susceptible individuals may lead to angle-closure glaucoma 1.
- Patients with narrow angles are at particular risk and should be examined to determine susceptibility before starting treatment 1.
Reported Visual Disturbances
- The FDA label lists "eye pain," "abnormal accommodation," and "visual field defect" as rare adverse effects occurring in post-marketing surveillance 1.
- "Abnormal accommodation" specifically can manifest as blurred vision, particularly when focusing on near objects 1.
Serious but Rare Visual Complications
- There is one case report of presumed sertraline-induced maculopathy with bilateral macular lesions that resolved after discontinuation, though visual function did not fully recover 4.
- Conjunctivitis, xerophthalmia (dry eyes), photophobia, and diplopia have been reported rarely in clinical trials 1.
Clinical Context and Comparison
- SSRIs as a class, including sertraline, are associated with mydriasis that is often transient and typically without major consequences 5.
- Compared to tricyclic antidepressants, which cause transient blurred vision in up to one-third of patients, sertraline has a significantly lower incidence of accommodation problems 5.
- The side effect profile of sertraline includes dizziness, insomnia, fatigue, somnolence, and headache when used in various clinical contexts, but blurred vision is not prominently featured 6.
Important Caveats
- If blurred vision occurs, consider angle-closure glaucoma in susceptible patients, particularly those with pre-existing narrow angles 1.
- Visual symptoms warrant ophthalmologic evaluation, especially if accompanied by eye pain, redness, or halos around lights 1.
- Patients should be counseled that while sertraline does not commonly impair vision, they should exercise caution with activities requiring visual acuity until they know how they respond to the medication 1.