Poppers (alkyl nitrites) is a legal, recreational drug, known to provide users with a brief “head rush” and increased sexual arousal. But the drug appears to be linked to light sensitivity and vision loss in at least several healthy individuals, a new French review of cases reveals. Poppers can reportedly compromise the normal working of the photoreceptor cells found in the eye’s retina.

"We believe that in fact this complication is quite common," said Dr Michel Paques of the Quinze-Vingts National Hospital in Paris. However, early data suggests that "only a minority of consumers will show up to the ophthalmologist," he added. That is because popper-related retinal damage may not noticeably affect vision in some cases and may therefore go undiagnosed, he added.

Popular for decades particularly among the gay community, poppers are perceived by many as being relatively safe. They are typically sold over the counter in small bottles. But nitric oxide is known to affect the metabolism of photoreceptors, the authors note. It can also alter the operation of a key enzyme involved in photoreceptor function. The author’s report on four recent cases, which took place within a three-month period. In one instance, a woman in her 20’s experienced eye problems the day after she took the poppers drug, and drank some alcohol at a party. She saw a “central bright dot” in both her eyes, and after 11 days she sought medical attention. Upon an examination doctors found no history of eye problems, but her eyesight was less than ideal, and she had a yellow dot on the foveal portion of her eyes, and damage to the outer photoreceptor on both eyes. The fovea facilitates the sharp central vision needed for reading, driving, and watching movies.

One month later, her visual symptoms and physical damage remained unchanged, the research team noted. Over the following three months, three more patients sought care for similar visual symptoms arising after popper use. Although symptoms did not appear to worsen over time, the researchers noted that just two of the four patients have fully recovered. Meanwhile, the exact underlying mechanics of the apparent poppers-vision risk connection remains unclear. “Those who did stop taking poppers showed progressive recovery over several months,” Paques said.

“Since our initial (report) we actively searched for new cases and were surprised to find many of them, sometimes not diagnosed by previous ophthalmologists because the retinal abnormalities are in a small - yet very important - area of the retina,” he said. Based on their findings, Paques and colleagues advise eye doctors and potential users of poppers to be aware of the potential risk for popper-related retinal toxicity. “Even a single dose of poppers may affect the retina,” he cautioned. Patients should visit an eye doctor “if there are any symptoms such as bright light in the centre of the visual field, or if there is persistent visual loss, for instance, difficulty in reading small letters”.

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