Visual changes have been reported with the use of these drugs. Blue vision has been demonstrated and this is a reversible side effect. However there have been rare reports of NAION (non-arteritic ischemic optic neuropathy, which is best understood as stroke of the optic nerve) in patients who have been using these agents. This entity is the most common optic nerve disease in patients over 50. Common risk factors for NAION and erectile dysfunction exist including hypercholesterolemia, hypertension, and diabetes; however there is no evidence that shows that NAION has occurred more frequently in men taking these agents and men of similar age and health who did not use these substances. It is wise for patients who have multiple risk factors for NAION, to seek consultation with their ophthalmologist prior to using these agents.
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