Additionally, caffeine consumption is associated with decreased choroidal thickness at least four hours after ingestion. 15,16 In fact, more recent research lauds the potential use of caffeine to decrease ocular hypertension and attenuate neuroinflammatory responses, particularly in reducing the loss of retinal ganglion cells in ocular hypertensives. 10-16 The rise in previous studies was likely secondary to water absorption. Although previous reports indicated that coffee consumption (and by extension, caffeine) raised intraocular pressure (IOP), more recent studies could not elicit a statistically significant change. 7,8Ĭaffeine consumption increases pupil size and amplitude of accommodation and can even dampen spontaneous pupillary oscillations up to six and a half hours after ingestion. 5,6 In animal models, during prenatal development ingested caffeine caused decreased total corneal thickness it changed the thickness of each corneal layer in chicken embryos via changes in structure and the amount of collagen fibers. Excess caffeine is associated with eyelid myokymia. 3,4 It is not until an individual ingests in excess of 5g of caffeine that toxicity is observed. 3,4 Over-the-counter commercially available caffeine supplements contain between 100mg and 200mg per unit. The average cup of coffee or tea (in the United States) contains between 40mg and 150mg of caffeine. This patient displays toxic conjunctivitis secondary to methamphetamine use. This article reviews commonly used legal and illicit substances, and how each are associated with the formation, or exaggeration, of disease or damage. As primary care physicians, optometrists can play a role in recognizing damage or dysfunction to either ocular structures or the components of the visual pathway these drugs cause and counseling patients in these circumstances. 2 The cost can be devastating, but substance abuse is a modifiable lifestyle factor.

1 That same year, approximately two million Americans suffered from substance abuse disorders related to prescription opioid pain relievers, 591,000 from heroin use alone. According to the NIH, more than 33,000 Americans died from opioid overdoses in 2015 alone. It’s no secret that Americans are in the midst of a substance abuse crisis.

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