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Medical Forum / General / Vision / January 2006

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Lasik & Seizures

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mimiwilson13 - 26 Jan 2006 03:03 GMT
Does anyone know of any concerns/risks with having Lasik eye surgery
performed while being treated for seizures? They expect I will be on the
medication for seizure control for two years tops so if there are any issues
I would rather wait to have the surgery performed until I am off of the
medication. Thanks!
Glenn - USAEyes.org - 26 Jan 2006 04:10 GMT
Much (VERY much) depends upon the meds, their side effects, and their
half-life. I recommend you discuss this with both the physician
prescribing the seizure medication and any potential refractive
surgeon.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.
ycdbsoya - 27 Jan 2006 18:42 GMT
Many drugs used for the control of epilepsy - such as Depakote,
Gabapentine and Phenobarbital - cause changes in your vision and ocular
prescription. These include blurred vision, binocular diplopia, dry
eyes, enlarged or constricted pupils, etc. These changes vary from
person to person.

The likelyhood of obtaining an incorrect ocular presciption is
therefore much higher, which could seriously and adversely affect your
outcome. There may also be some biological changes caused by these
drugs which affect your immune and healing responses,again making the
outcome more uncertain.

In short, wait until you are medication free and have a stable ocular
scrip.
Neil Brooks - 27 Jan 2006 20:26 GMT
>Many drugs used for the control of epilepsy - such as Depakote,
>Gabapentine and Phenobarbital - cause changes in your vision and ocular
>prescription. These include blurred vision, binocular diplopia, dry
>eyes, enlarged or constricted pupils, etc. These changes vary from
>person to person.

Interesting.  

I was treated with Gabapentin (Neurontin) for my eye pain and had a
horrible set of side effects back in May that aren't totally gone
today.  

Do you happen to have any citations that discuss the ocular effects of
these anti-convulsants?

TIA,

Neil
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Live simply so that others may simply live

ycdbsoya - 27 Jan 2006 22:06 GMT
> Interesting.
>
[quoted text clipped - 9 lines]
> Neil
> --
Neil:

Gabapentin is famous for side effects. It is effective in the control
of neuropathic pain, specifically successful in treating trigeminal
neuralgia, shingles and herpatic syndromes

When you look in PDR and other such rescources, it is difficult to find
cites about specific visual abnormailities. Most commonly they will
list it under "Special Senses" and/or "Other" and call it "Abnormal
Vision" or "Vision Changes" with percentages of frequency of
occurrence.

There are numerous off-label uses, and this IMO is dangerous. One side
effect is suicidal ideations which tend to persist post administration.
There was a big settlement earlier. May I ask what your side effects
were?

The best thing to do is a focused search on the drugs, say using
"Gabapentin side effects" or the like. Digging down, you'll find
academic and/or medical monographs which detail these adverse effects,
but they are not expressed in lay terms.
Neil Brooks - 28 Jan 2006 01:42 GMT
>Gabapentin is famous for side effects. It is effective in the control
>of neuropathic pain, specifically successful in treating trigeminal
[quoted text clipped - 10 lines]
>There was a big settlement earlier. May I ask what your side effects
>were?

Sure.  Numerous.  Here's the synopsis (clipped right from a report to
the doc):

INCREDIBLY DRY HANDS
ACNE
EXACERBATION OF FOOT FUNGUS, ADDITION OF ?NECROSIS?
INCOORDINATION
SHAKINESS
COLD EXTREMITIES
DANDRUFF
SEVERE THIRST
SWOLLEN GLANDS
BLURRED VISION
DRIER EYES, WITH EXACERBATION OF PAIN
FREQUENT URINATION
NIGHT SWEATS
COUGH
SINUSITIS, NASAL CONGESTION W/BROWN DISCHARGE
SLURRED SPEECH
RECURRENT LOW-GRADE (99.2 - 100.5F) FEVER, >= DAILY
EXHAUSTION
DEPRESSION       

...it was ugly.  Most of it has gone away (8 months later), but not
the fevers or the fatigue....

>The best thing to do is a focused search on the drugs, say using
>"Gabapentin side effects" or the like. Digging down, you'll find
>academic and/or medical monographs which detail these adverse effects,
>but they are not expressed in lay terms.

Agreed.  The primary source for me was Pfizer's own Prescribing
Information insert (27 pages?):

http://www.pfizer.com/pfizer/download/uspi_neurontin.pdf

It seemed to validate everything I was experiencing, but led to no
course of treatment to un-ring the bell.

If only they'd caught it when I was younger -- say, at the threshold.
Maybe then, I could have treated it with plus lenses ;-)

Best,
Neil
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Live simply so that others may simply live

 
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