Doug has been complaining about problems with his vision over the past 7-10 days. Dr Cohen, recommended he see an opthalmologist as long term use of high dose prednisone can cause glaucoma or cataracts. Today he had an appointment with the opthalmologist. The eye doctor states Doug does not have cataracts or glaucoma. He feels one of the new medications (probably the Zoloft) is affecting his near vision. Reading glasses over his contacts may help or he could add bifocals to his current prescription.
Zoloft is an SSRI and it is known to cause mydriasis. Mydriasis is an excessive dilation of the pupil due to disease, trauma, or the use of drugs. Normally, the pupil dilates in the dark and constricts in the light to improve vividity at night and to protect the retina from sunlight damage during the day. A mydriatic pupil will remain excessively large even in a bright environment.
Doug has started feeling less anxious and has decreased his Zoloft from 50mg to 25 mg. I am sure once he is off this medication, his vision problems will go away. He also has been on prednisone at 15mg per day. He will continue this for a few days and then decrease to 10mg until he sees his rheumatologist on March 18th.
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