Can Using Too Much Aspirin Hurt Your Eyes?

Weighing benefits against age-related macular degeneration risk

Can Using Too Much Aspirin Hurt Your Eyes?

If you take aspirin regularly to reduce the risk of heart attack or stroke or to control pain, you may wonder about reports in recent years linking aspirin use and eye disease, such as age-related macular degeneration (AMD).

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Could your aspirin use be putting your sight at risk?

“It is a good question, but at this point there doesn’t appear to be a major link,” says eye surgeon Rishi Singh, MD. “It is a concern, but it’s not large enough to stop what you are doing.”

Dr. Singh says many of his patients ask if they are harming their eyes when they take aspirin for other health benefits. And he understands why — some researchers see a link between regular aspirin use and AMD.

Although researchers’ definition of “regular use” varies, people in the studies generally are in this category if they use aspirin once or more a week for more than a month.

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Older patients and aspirin use

This issue principally affects older patients. AMD is a leading cause of blindness in people over the age of 65, many of whom take aspirin to relive arthritis pain or reduce the risk of heart attack and stroke.

Wet (neovascular) AMD is responsible for most dramatic vision loss in patients. It is less prevalent, and only seen in about 10 percent of people with AMD. With this condition, vessels leak blood into the retina, causing damage and distorted vision. Eventually, if scar tissue forms, it can permanently block the central vision.

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Dry AMD is much more common, but progresses slowly and doesn’t cause sudden vision loss.

It occurs when yellow deposits form on the middle of the retina, or what is referred to as the macula. If enough of these deposits form, you begin to notice poorer vision, especially when you read. If the condition continues to advance, it, too, can lead to central vision loss.

An important point about studies on aspirin use is that people who regularly use aspirin are typically older and more likely to have cardiovascular disease, diabetes and hypertension. All of these conditions also increase the risk of getting AMD.

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What do the studies say?

To date, research on the topic has mixed results. Some studies suggest a possible worsening of AMD while there are a few that actually suggest a possible benefit for AMD.

For example, a study conducted in 2013 found that regular users of aspirin were twice as likely to have wet AMD over the long-term than those not taking it regularly. But the differences were reduced when factoring in patients who had not had cardiovascular disease.

On the other hand, a large-scale study conducted in 2001 found that low-dose aspirin use may actually slightly reduce the chances of getting AMD. (Researchers stopped the trial early, however, because of aspirin’s marked beneficial effects on heart attack risk.)

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But when researchers take everything into account, including risks for AMD and benefits of reducing risk for cardiovascular events, aspirin is clearly beneficial.

It may increase the risk of AMD slightly, but it can dramatically reduce the risk of life-threatening conditions.

In fact, regular users of aspirin had a 32 percent lower rate of strokes and were 15 percent less likely to have a heart attack than people who didn’t use aspirin regularly, according to a report presented at the 2015 annual meeting of the American Society of Retina Specialists.

“It could be that aspirin does affect AMD, but the small potential doesn’t trump the effect on the heart,” Dr. Singh says.

If you do take aspirin frequently for its other health benefits, it’s a good idea to have your vision checked regularly, he says.

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