A Case of Clozapine-induced Corneal and Lenticular Pigmentation

Ji Seon An; Young Mi Lee; Joo Young Kwag; Joo Hyun; Jin Seok Choi; Kyu Hong Pak; Sung Kun Chung

doi:10.3341/jkos.2019.60.3.276

Journal List > J Korean Ophthalmol Soc > v.60(3) > 1117654

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An, Lee, Kwag, Hyun, Choi, Pak, and Chung: A Case of Clozapine-induced Corneal and Lenticular Pigmentation

Case Report

J Korean Ophthalmol Soc 2019;60(3):276-279.

Published online: 25 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.3.276

A Case of Clozapine-induced Corneal and Lenticular Pigmentation

Ji Seon An, MD¹, Young Mi Lee², Joo Young Kwag, MD¹, Joo Hyun, MD¹, Jin Seok Choi, MD, PhD¹, Kyu Hong Pak, MD, Sung Kun Chung, MD, PhD

¹Saevit Eye Hospital, Goyang, Korea

²Department of Pharmacy, Saevit Eye Hospital, Goyang, Korea

Address reprint requests to Sung Kun Chung, MD, PhD Saevit Eye Hospital, #1065 Jungang-ro, Ilsandong-gu, Goyang 10447, Korea Tel: 82-31-900-7700, Fax: 82-31-900-7777 E-mail: eyekun@gmail.com

Received 30 August 2018 Revised 7 November 2018 Accepted 19 February 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of corneal and lenticular pigmentation after prolonged clozapine therapy.

Case summary

A 56-year-old male visited our hospital with a progressive decline in vision that affected both eyes. He had a history of schizophrenia. He was being treated with 200 mg clozapine and 1 mg lorazepam daily, and had been treated with clozapine for 5 years. At the first visit, his best-corrected-visual acuity was 20/32 in both eyes. Slit lamp examination of the corneas showed bright, fine, grayish-brown deposits on the endothelium, and on dilation, bilateral central stellate opacity of the anterior portion of the lens capsule was revealed.

Conclusions

Clozapine may induce corneal and lenticular pigmentation and thus may lead to a decline in vision. Patients on long-term clozapine therapy should be considered for regular ophthalmic review.

Keywords: Clozapine, Corneal pigmentation, Lenticular pigmentation

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Figure 1.

Anterior segment photographs showed pigmented deposits on the corneal endothelium. (A) Right eye. (B) Left eye.

Figure 2.

Anterior segment photographs showed pigmented deposits on the lens. (A) Right eye. (B) Left eye.

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