Side Effects of Cocaine Abuse and the Eyes

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Last Updated - 03/31/2022

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Updated 03/31/2022

Cocaine use can dilate the pupils, damage multiple parts of the eye and result in long-term vision problems. Learn more about how cocaine use affects the eyes.

Cocaine is an illegal stimulant drug that affects each person a little differently. Most people feel a euphoric high and have higher amounts of energy. This increased energy may make some people feel more mentally alert and focused, allowing them to be more productive than normal. However, others may feel more aggressive or irritable. Other possible effects include being more social, feeling less hungry, not sleeping and having hallucinations.

When people use cocaine, they often have negative health effects. Many people have heart issues, such as an increased heart rate, raised blood pressure and heart attacks. Cocaine also affects a person’s mental health, often leading to depression, anxiety, and altered sleep patterns. People who snort cocaine will often have nose damage, and people who inject the drug tend to have track marks and damage to veins near injection sites. Additionally, when the effects of cocaine start to wear off, people tend to crash. They will typically feel exhausted, depressed, irritated and paranoid.

In addition to these effects, cocaine use can also damage the eyes. Cocaine’s effects on the eyes range from simple things that affect the appearance of the eye, such as dilated pupils, to more serious eye conditions that affect vision. People who believe that cocaine is affecting their eyes should see an eye doctor to check for and treat damage.

Cocaine Effects on Appearance

People who use cocaine may have eye symptoms that include:

Bloodshot Eyes

Red or bloodshot eyes from cocaine use is common because the substance affects a person’s blood vessels.

Eye Muscle Twitching

Cocaine can damage muscles and nerves. In some cases, this may lead to eye tremors or muscle twitches around the eye and eyelid.

Dilated Pupils

common effect of cocaine is eye dilation or enlarged pupils. When people have dilated eyes, the black part of their eyes looks very large and the colored iris looks smaller. Some people call this effect “cocaine eyes” or “cocaine pupils.”

Yellow Eyes

Cocaine is processed by the liver. If someone takes a high dose of cocaine or uses cocaine that has been cut with harmful substances, the liver may not be able to process the substances quickly enough. Jaundice, or yellow skin and eyes, happens when the liver is damaged or can’t keep up. Someone may also have jaundice if they get an infection from contaminated needles.

Cocaine-Related Eye Conditions

The changing appearance of the eye can be a sign that there are underlying issues. People who use cocaine can have eye damage that is sometimes serious and permanent. Types of eye damage resulting from cocaine use include:

Crack Cornea

The cornea is the clear layer in the front part of the eye that sits over the iris and pupil. “Crack cornea” is a condition where the cornea is damaged. Small groups of cells in the cornea may die in some cases, and other cases may involve ulcers on the surface of the eye. When someone smokes cocaine, the cocaine in the vapor numbs the eye and makes a person blink less often. Other substances that the cocaine is cut with may then get in the eye and damage the surface. Additionally, snorting can cause crack cornea, although doctors don’t know exactly how. This condition can cause permanent damage and scarring to the eye, especially if someone has ulcers that get infected.

Light Sensitivity

People who use cocaine are often more sensitive to light because their pupils are dilated. Enlarged pupils let in more light, so any lights in a person’s environment may seem extra bright. Some people who are using cocaine may wear sunglasses indoors or at night because of this effect.


People with nystagmus have small eye movements that they can’t control. One or both of a person’s eyes may quickly move up and down or from side to side. This often makes it harder for the person to see clearly. Cocaine and other illicit drugs may lead a person to develop this condition because of damage to nerves, muscles or the brain.

Ocular Bone Damage

When someone snorts cocaine, the blood vessels in and around the nose shrink. This causes decreased blood supply to tissues in the nose and surrounding areas. When tissues don’t get enough blood, they don’t get enough oxygen, and they can become damaged or even die. Sometimes, the bones in the sinuses around the eyes can deteriorate. People who snort cocaine also get frequent sinus infections because the nose is damaged and can’t properly clean the air that is breathed in. In addition, people who share needles while injecting are more at risk of getting infections. Infections can damage sinus tissues.

Open-Angle Glaucoma

Glaucoma is an eye disease that is one of the leading types of blindness in America. People with glaucoma begin losing their side vision, and then the rest of their vision will slowly disappear. People who use cocaine are more likely to get this disorder, and glaucoma patients with a history of cocaine use tend to be 18 years younger than patients without a history of substance misuse.

Blurred Vision

Many of the above conditions are ways that cocaine causes blurred vision. Damage to the surrounding eye muscles or bone and damage to the surface of the eye or retina can make it harder for a person to see. Additionally, nerves that help the eye function can be wounded by cocaine. A nerve may be compressed because of tissue inflammation, or it may die from a lack of oxygen caused by shrunken blood vessels. Eye infections or eye disease may also be the cause of blurred vision.

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Although cocaine can directly damage the eye, eye problems will usually get worse the longer or more frequently someone uses cocaine. This means that if someone stops using cocaine and talks to an eye doctor, they can prevent further eye damage. Many people who use cocaine have a substance use disorder, making it hard to control when or how often they use cocaine. Unfortunately, only 19% of people who struggle with cocaine misuse end up getting treatment. People who seek professional help have much higher chances of successfully recovering from cocaine addiction.

If you are worried about the negative side effects of cocaine use and are ready to overcome your addiction, The Recovery Village Palm Beach at Baptist Health is here to help. Contact us today to learn about treatment options that can work well for your situation.

View Sources

French, Dustin D.; Margo, Curtis E.; Harman, Lynn E. “Substance Use Disorder and the Risk of Open-angle Glaucoma.” Journal of Glaucoma, September 2011. Accessed October 6, 2019.

Karbach, Nicholas; et al. “How Drug Abuse Affects the Eye.” Review of Optometry, September 15, 2018. Accessed October 6, 2019.

National Eye Institute. “Glaucoma.” July 2019. Accessed October 6, 2019.

Peragallo, Jason; Biousse, Valerie; Newman, Nancy. “Ocular manifestations of drug and alcohol abuse.” Current Opinion in Ophthalmology, November 2013. Accessed October 6, 2019.

Substance Abuse and Mental Health Services Administration. “Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.” August 2019. Accessed October 6, 2019.