The Critical Role of Medication Reviews in Ophthalmic Care

Clinical Report: The Critical Role of Medication Reviews in Ophthalmic Care

Overview

At the 2026 American Academy of Ophthalmology meeting, Alison Dzwonczyk Early, MD, and Joan Wilson, BS, COMT, LSBB, described medication review as part of ophthalmic history-taking and preparation for clinical evaluation and surgery. They highlighted medication-related ocular risks, the value of checking for medication changes, and the technician’s role in recognizing relevant patterns and alerting the physician without diagnosing.

Background

Systemic medications can be associated with ocular findings and may affect screening or surgical planning. The source identifies hydroxychloroquine-related retinal toxicity, tamsulosin-associated intraoperative floppy iris syndrome, and amiodarone-associated corneal verticillata as examples relevant to ophthalmic care. Medication lists may also provide clues to underlying conditions not reported on intake forms, such as diabetes in patients taking metformin or semaglutide. The article frames medication review as a clinical component of technician intake and onboarding, rather than solely an administrative task.

Data Highlights

The source article reports no numerical study results. It describes three medication–ocular effect associations: hydroxychloroquine with dose- and duration-dependent retinal toxicity; tamsulosin with intraoperative floppy iris syndrome, including after discontinuation; and amiodarone with commonly occurring corneal verticillata and rare optic neuropathy.

Key Findings

Early said hydroxychloroquine can cause dose- and duration-dependent retinal toxicity, particularly parafoveal photoreceptor and retinal pigment epithelium damage, and emphasized appropriate retinal screening.
Tamsulosin use is associated with intraoperative floppy iris syndrome during cataract surgery; the article states that identifying current or prior use is important even if the medication has been discontinued.
Amiodarone commonly causes corneal verticillata (vortex keratopathy) and can rarely be associated with optic neuropathy.
Wilson advised technicians to ask about medication changes since the previous visit and review the medication list with the patient, connecting each medication with its indication and possible ocular effects.
The article identifies sudden vision loss, sudden pain, a new relative afferent pupillary defect, and new disc edema as red flags for technicians to recognize and bring to the physician’s attention.
Early noted that medication history can reveal potentially unreported systemic diagnoses; metformin or semaglutide use may indicate diabetes, and Wilson emphasized that technicians should recognize patterns without diagnosing.

Clinical Implications

The speakers describe medication reconciliation, including current and prior use and changes since the last visit, as relevant to ocular history, evaluation, and surgical preparation. Technicians are encouraged to recognize medication-related clues and red flags, consider whether additional testing is needed before rooming, and alert the physician rather than make diagnoses.

Conclusion

The article presents medication review as a practical part of ophthalmic intake that can help clinicians interpret ocular findings and identify potential risks. Its central emphasis is on training technicians to connect medication history with relevant systemic and ocular context while keeping diagnostic decisions with the physician.