At the American Academy of Ophthalmology 2026 meeting in New Orleans, Alison Dzwonczyk Early, MD, and Joan Wilson, BS, COMT, LSBB, lead technician/facilitator, both of Signature Cataract and Laser Consultants in Cincinnati, Ohio, explained why systemic medications matter in treating ophthalmology patients in both clinic and surgical settings, and why it is crucial for ophthalmic technicians to understand these medications.

“Technicians and staff have a very important role in 'teeing up' patients to be ready for the physician,” said Dr. Early. “Part of this process is patient intake, medical history, and medication review. Having basic recognition of certain classes of medications that have an impact on ocular health, surgical risk, and potential pathology helps the surgeon understand the broader context of the patient's visit. For example, if a patient presents with central serous chorioretinopathy, a technician might understand that steroid or testosterone medications are a likely culprit and will be sure to inquire with the patient as part of their workup.” 

Systemic Medications With Potential Ocular Side Effects

Dr. Early discussed 3 commonly used systemic medications technicians should be familiar with:

1. Hydroxychloroquine: “This medication can cause dose-dependent and duration-dependent retinal toxicity, particularly parafoveal photoreceptor/retinal pigment epithelium damage, so technicians should recognize the importance of appropriate retinal screening,” Dr. Early explained.

2. Tamsulosin: “This medication is associated with intraoperative floppy iris syndrome during cataract surgery even after discontinuation of the medication, so identifying current or prior use preoperatively is important for preop consults," Dr. Early said.

3. Amiodarone: “This medication commonly causes corneal verticillata (vortex keratopathy) and can rarely be associated with optic neuropathy, making medication history relevant when these findings are present,” noted Dr. Early.

From a trainer and technician perspective, Wilson said that shealways trains techs to be “deTECHtives” in all workups. “Learning medications and the ocular side effects takes studying. The medication list can give you clues about why a patient may have a particular ocular finding—and sometimes the technician is the first person to notice a change,” she explained. “As a trainer, I would teach this as 'Medication → Ocular effect → What the tech should notice.' I specifically train technicians to recognize these as red flags: for example, sudden vision loss, sudden pain, new onset relative afferent pupillary defect, new disc edema.”

Wilson added that thebiggest opportunity for technicians is asking the patient if they have had any medication changes since the last visit, then going through the list with the patient—not just saying okay, and continuing with the exam. “A great technician teaching point is that medications are not just something administrative we have to do; it's part of the ocular history. This should be part of all technician onboarding.”

Linking Systemic Conditions to Medications

Dr. Early noted that ophthalmic technicians should recognize common systemic medications and understand the medical conditions for which they are typically prescribed. “Connecting a medication list with a patient’s medical history can reveal important diagnoses, clarify ocular findings, and identify potential medication-related risks or side effects,” she said. “It can also uncover incomplete or inaccurate histories. For example, a patient taking metformin or semaglutide may have diabetes even if they did not report it on their intake form. Developing this clinical awareness helps technicians collect a more complete history and alert the physician to information that may affect evaluation, treatment, or surgery.”

Wilson added that this is an important step in moving technicians from “data collectors” to clinical team members who recognize meaningful patterns. “The goal isn't for technicians to diagnose—it is for them to understand why a medication is being taken, what systemic condition it represents, and what ocular implications may follow,” she said. “Connecting medications actually tells us a story, and we should be connecting the dots. Encourage critical thinking when it comes to systemic medications.”

Wilson said that technicians should be asking the following questions:

1. Why is the patient taking this medication?

2. How long has the patient been taking this medication?

3. Can this systemic disease affect the eyes?

4. Does any of this information change what testing I should acquire before rooming the patient?

“When technicians can identify if the patient needs additional testing, it takes less interruption for the patient’s time with the doctor,” Wilson explained. “The patient doesn't have to be moved again and again. Technicians should be clinically engaged and have excellent critical thinking skills. I teach boundaries! Techs should recognize and communicate to the doctor, not diagnose a patient.”

For commonly prescribed systemic medications, Wilson said technicians should

1. Understand the medication's indication,

2. Identify relevant systemic conditions,

3. Recognize important ocular adverse effects,

4. Obtain appropriate history,

5. Perform relevant testing within their scope, and

6. Communicate significant findings to the physician.

“That creates a much higher-level technician who isn't simply asking ‘What medications are you taking?’ They're asking: ‘What does this medication tell me about my patient—and does it matter for their eyes today?’” OM