Does Lexapro Change Your Eyes? A Guide to Ocular Side Effects

October 5, 2025 •

4 min read

With over 21 million Americans prescribed Lexapro (escitalopram), many are asking: Does Lexapro change your eyes? [1.2.1] While effective for depression and anxiety, this SSRI can indeed cause several ocular side effects, from common issues like dry eye to rare emergencies.

Quick Summary

Lexapro (escitalopram) can cause changes to the eyes, including blurred vision, dry eye, and pupil dilation. A rare but serious risk is acute angle-closure glaucoma, a medical emergency requiring immediate attention.

Key Points

Common Side Effects: Lexapro can cause blurred vision, dry eyes, and pupil dilation due to its effect on serotonin receptors and the nervous system [1.2.2, 1.5.6].
Dry Eye Mechanism: It reduces tear production by suppressing the parasympathetic nervous system and can alter the composition of the tear film [1.2.1, 1.8.2].
Glaucoma Risk: A rare but serious risk is acute angle-closure glaucoma (AACG), a medical emergency caused by pupil dilation blocking fluid drainage in the eye [1.2.2, 1.3.6].
Emergency Symptoms: Seek immediate medical help for severe eye pain, sudden vision changes with headache, seeing halos around lights, or nausea while on Lexapro [1.2.2].
Management is Key: Do not stop taking Lexapro abruptly. Consult both your eye doctor and prescribing physician to manage symptoms or explore alternative medications [1.9.1, 1.9.5].
Risk Factors: Women, contact lens wearers, and those with pre-existing dry eye or anatomically narrow angles are at higher risk for ocular side effects [1.8.1, 1.2.2].
Symptom Duration: Many common side effects like blurred vision are temporary and may resolve within a few weeks as your body adjusts to the medication [1.7.1].

Understanding Lexapro and Its Mechanism

Lexapro, with the generic name escitalopram, is a widely used antidepressant belonging to the Selective Serotonin Reuptake Inhibitor (SSRI) class [1.2.5]. It works by increasing the levels of serotonin, a neurotransmitter in the brain, which helps regulate mood, anxiety, and emotion [1.8.2]. While its primary action is in the brain, serotonin receptors are found throughout the body, including in and around the eyes [1.3.4]. This systemic presence is why medications like Lexapro can lead to unintended side effects in various parts of the body, including the visual system.

Common Ocular Side Effects of Lexapro

Many users experience mild and often temporary eye-related side effects. These issues arise because SSRIs can affect the muscles that control the pupil and lens, as well as the glands responsible for tear production [1.5.6, 1.4.1].

Blurred Vision and Difficulty Focusing

One of the most frequently reported ocular side effects is blurred vision [1.2.3]. Lexapro can directly affect the ciliary muscle, which is responsible for changing the shape of the eye's lens to focus on near objects [1.2.3]. When this muscle's function is impaired, it can become difficult to read or focus on close-up tasks [1.4.5]. This side effect often subsides within a few weeks as the body adjusts to the medication [1.7.1].

Dry Eye Syndrome

Lexapro is significantly linked to dry eye symptoms, affecting up to 30% of patients in some studies [1.8.1]. This occurs through two primary mechanisms:

Reduced Tear Production: SSRIs can suppress the parasympathetic nervous system, which stimulates tear secretion from the lacrimal glands [1.2.1]. This leads to an insufficient volume of tears.
Altered Tear Composition: The medication may also change the balance of the tear film, potentially disrupting the mucin or lipid layers, leading to quicker evaporation and an unstable ocular surface [1.8.2].

Symptoms of dry eye include a gritty or burning sensation, redness, light sensitivity, and ironically, excessive watering as the eyes try to compensate for the irritation [1.2.2].

Pupil Dilation (Mydriasis)

The serotonergic effects of Lexapro can cause the pupils to dilate (mydriasis) [1.2.2, 1.5.2]. This can lead to increased sensitivity to light (photophobia) and can contribute to blurry vision [1.4.5]. For most people, this is a minor annoyance, but for individuals with specific anatomical predispositions, it can lead to a much more serious condition.

Rare but Serious Risk: Acute Angle-Closure Glaucoma

The most serious ocular risk associated with Lexapro is acute angle-closure glaucoma (AACG) [1.2.2]. This condition is a medical emergency that can lead to permanent vision loss if not treated immediately [1.3.6].

It occurs when pupil dilation causes the iris (the colored part of the eye) to bunch up and block the eye's drainage angle [1.2.2]. This blockage prevents aqueous humor fluid from draining properly, causing a rapid and painful increase in intraocular pressure (IOP) [1.2.2]. Individuals with anatomically narrow drainage angles, a condition more common in farsighted individuals and older adults, are at a higher risk [1.2.2].

Symptoms of Acute Angle-Closure Glaucoma are sudden and severe. Seek immediate medical attention if you experience:

Sudden, severe eye pain [1.2.2]
Blurred vision accompanied by a headache [1.2.2]
Seeing halos or colored rings around lights [1.2.2]
Nausea and vomiting [1.2.2]
Redness and swelling in or around the eye [1.2.4]

Comparison of Ocular Side Effects in Antidepressants

Different classes of antidepressants carry varying risks for ocular side effects. Here’s how Lexapro (an SSRI) compares to others:


Antidepressant Class	Common Examples	Common Ocular Side Effects	Risk of AACG
SSRIs	Lexapro, Prozac, Zoloft	Mild-to-moderate dry eye, blurred vision, pupil dilation [1.2.2]	Increased risk, especially in predisposed individuals [1.2.2]
SNRIs	Cymbalta, Effexor	Similar to SSRIs: dry eye, blurred vision, pupil dilation [1.2.2]	Increased risk, similar to SSRIs [1.2.2]
TCAs (Tricyclics)	Elavil, Tofranil	Moderate-to-severe dry eye, blurred vision due to strong anticholinergic effects [1.2.2, 1.4.1]	Higher risk than SSRIs [1.2.2]
MAOIs	Nardil, Parnate	Dry eye, eyelid twitching, involuntary eye movements [1.2.2]	Can precipitate AACG, especially with other anticholinergic drugs [1.6.3]

What to Do If You Experience Eye Changes

If you notice any changes in your vision or eye comfort while taking Lexapro, it is important to take action.

Do Not Stop Your Medication: Never abruptly stop taking Lexapro without consulting your prescribing doctor. Doing so can lead to withdrawal symptoms and a return of depression or anxiety [1.8.2].
Consult Your Eye Doctor: Schedule an appointment with an optometrist or ophthalmologist. Inform them about all the medications you are taking, including Lexapro [1.9.5]. They can assess your symptoms, diagnose the underlying cause (e.g., dry eye vs. a more serious issue), and recommend management strategies.
Manage Mild Symptoms: For dry eye, over-the-counter preservative-free artificial tears can provide relief [1.8.2]. Taking breaks from screens, staying hydrated, and using a humidifier can also help [1.3.4]. For light sensitivity, wearing sunglasses can be beneficial.
Communicate with Your Prescribing Doctor: Share the eye doctor's findings with the physician who prescribed your Lexapro. If side effects are severe or unmanageable, they may consider adjusting your dosage or switching to an alternative antidepressant that may have a lower risk of ocular effects [1.9.1].

Conclusion

So, does Lexapro change your eyes? Yes, it can. For many, the effects are limited to manageable issues like temporary blurred vision and dry eyes. However, the potential for serious complications like acute angle-closure glaucoma means that any new or worsening eye symptoms should be taken seriously. Proactive communication with both your eye doctor and prescribing physician is key to safely managing your mental health without compromising your vision.

For more information on the impact of antidepressants on eye health, you can visit All About Vision.

Frequently Asked Questions

Common side effects like dry eye and blurred vision are frequently reported, with some studies suggesting up to 30% of users experience dry eye symptoms [1.8.1]. Serious side effects like acute angle-closure glaucoma are rare [1.2.2].

Generally, common side effects like blurred vision and dry eye are reversible and do not cause permanent damage [1.7.1]. However, if Lexapro triggers acute angle-closure glaucoma and it is not treated immediately, it can lead to permanent vision loss [1.3.6].

Many mild side effects, such as blurred vision, often improve or resolve within a few weeks of starting the medication [1.7.1]. Dry eye symptoms may persist and require ongoing management [1.8.1].

While less common than dry eye or blurred vision, some reports have linked antidepressants to visual disturbances like eye floaters (photopsia) [1.4.5].

If your vision becomes blurry, you should consult your eye doctor to rule out serious issues and discuss management options like lubricating eye drops. Also, inform your prescribing doctor, but do not stop the medication on your own [1.9.1, 1.9.5].

Yes, Lexapro can cause pupil dilation (mydriasis), which allows more light into the eye and can result in light sensitivity, also known as photophobia [1.2.2, 1.4.5].

Getting a baseline eye exam is a good practice, especially for high-risk patients (e.g., those with a family history of glaucoma or who are farsighted). This allows your doctor to assess if you have anatomically narrow angles, which would increase your risk for acute angle-closure glaucoma [1.4.3, 1.6.3].