Ocular side effects associated with bisphosphonates

Bisphosphonates are used to inhibit bone resorption in postmenopausal women and in the management of hypercalcemia of malignancy. Recently, some drugs within this class of medicines have been proven to cause scleritis. Prior to this, bisphosphonates had been reported to cause a variety of ocular side effects, most of which are inflammatory. This review discusses the many different medicines called bisphosphonates and highlights the ocular side effect profile of each. In cases where information on dechallenge is provided, all the ocular side effects resolved after discontinuation of the medication. Recognition of adverse ocular events in association with bisphosphonate therapy should alert clinicians to the need for ophthalmic evaluation and the consideration of discontinuation of therapy in all cases of scleritis.