Journal of the Chinese Medical Association
Volume 69, Issue 12 , Pages 589-590, December 2006

Methylphenidate (Ritalin)-associated Cataract and Glaucoma

  • Chao-Kung Lu

      Affiliations

    • Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Tung-Mei Kuang

      Affiliations

    • Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Joe Ching-Kuang Chou

      Affiliations

    • Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Joe Ching-Kuang Chou, Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 24 October 2005; accepted 31 October 2006.

Article Outline

Methylphenidate hydrochloride (Ritalin) is the drug of choice for attention deficit hyperactivity disorder (ADHD). However, an association of Ritalin with glaucoma has been reported. We report a case of Ritalin-associated cataract and glaucoma. A 10-year-old boy was diagnosed with ADHD and had received methylphenidate hydrochloride, 60 mg/day for 2 years. He presented with blurred vision. Best-corrected visual acuity was 6/60 in both eyes. Ocular examinations revealed intraocular pressure (IOP) of 30 mmHg under medication, dense posterior subcapsular opacity of lens, pale disc with advanced cupping, and marked constriction of visual field. Despite maximal anti-glaucomatous medication, IOP still could not be controlled. The patient then received combined cataract and glaucoma surgery. Visual acuity improved and IOP was within normal limits in both eyes postoperatively. Large dose of methylphenidate may cause cataract and glaucoma. The mechanism remains unclear. Doctors should be aware of the possible ocular side effects of methylphenidate.

Key Words:  cataract , glaucoma , methylphenidate , Ritalin

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References 

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PII: S1726-4901(09)70335-1

doi:10.1016/S1726-4901(09)70335-1

Journal of the Chinese Medical Association
Volume 69, Issue 12 , Pages 589-590, December 2006

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