Can isotretinoin affect your eyes? Dryness, contact lenses and night vision
Yes. Isotretinoin can cause dry, irritated eyes and make contact lenses uncomfortable. Less commonly, it can affect vision in dim light. Most symptoms improve after treatment, but persistent dry eye and night-vision problems have occasionally been reported. Tell your clinical team promptly, and do not drive at night if your vision is affected. [1–4]
Why can isotretinoin make the eyes dry?
Isotretinoin reduces oil production to treat severe acne. It can also affect the oily layer of the tear film that helps stop tears evaporating. The result may be burning, grittiness, watering, redness or tired-feeling eyes. Inflammation around the eyelids (blepharitis) or conjunctivitis can also occur. [3,4]
Symptoms that interfere with reading, screen work, contact-lens wear or driving deserve review. Eye pain, marked redness, light sensitivity or a vision change needs more urgent assessment.
What can help with dry eyes?
The British Association of Dermatologists advises lubricating eye drops when needed. UK product information also mentions tear replacements or lubricating eye ointment. A pharmacist or optometrist can help you choose a suitable product, particularly if you need drops frequently or use contact lenses. [2–4]
Helpful measures include:
taking breaks during screen work;
avoiding smoke or airflow directly towards the eyes;
wearing sunglasses outdoors if bright light feels uncomfortable; and
cleaning make-up away gently without rubbing sore eyelids.
Do not use somebody else’s prescription eye drops. Products intended only to reduce redness may not treat the cause, while a painful red eye or new light sensitivity needs assessment rather than repeated self-treatment.
Can I continue wearing contact lenses?
Some people continue wearing lenses comfortably, but isotretinoin can cause contact-lens intolerance. If lenses sting, feel dry or cause persistent redness, remove them and use glasses. Do not sleep in lenses or keep wearing them through discomfort. [2–4]
Ask an optometrist or your clinical team if symptoms continue. Seek prompt assessment for significant pain, light sensitivity, reduced vision or a very red eye.
Can isotretinoin reduce night vision?
Reduced night vision is uncommon but important. The change can begin suddenly, and rare cases have persisted after treatment. You may first notice difficulty adapting when moving from a bright place into darkness, problems seeing road markings or hazards at night, or greater discomfort from glare. [2–4]
If this happens:
Do not drive, cycle on the road at night or operate machinery when you cannot see safely.
Contact your isotretinoin prescriber promptly.
Arrange an eye assessment if advised, and avoid risky activities until your vision is adequate.
BAD advises people whose work depends on night vision—such as professional drivers, pilots, military personnel or heavy-machinery operators—to discuss the issue with their employer before starting treatment. [2]
Which eye or vision symptoms need urgent help?
Stop taking isotretinoin and seek urgent medical advice if you develop a severe or persistent headache with nausea, vomiting, blurred vision or another visual change. This combination can be a sign of raised pressure around the brain (benign intracranial hypertension). It is rare, but the risk is one reason isotretinoin must not be combined with tetracycline antibiotics such as doxycycline or lymecycline. [3,4]
Also seek prompt medical or eye-care assessment for:
sudden blurred, distorted or reduced vision;
new double vision or a noticeable colour-vision change;
eye pain, marked redness or strong light sensitivity;
a sudden deterioration in night vision; or
contact-lens symptoms that do not settle after removing the lenses.
The patient leaflet advises stopping isotretinoin and contacting a doctor straight away for blurred vision. Other visual changes should be reported as soon as possible. [4]
Should I have an eye test before treatment?
Routine specialist eye tests are not required for every patient. Tell the acne clinician before starting if you have dry-eye disease, wear contact lenses, have a condition affecting vision, use prescription eye treatment or depend on night vision for work. A baseline assessment may be useful when there is a pre-existing concern.
Record when symptoms started, whether one or both eyes are affected, contact-lens use and any effect on driving or work.
Will changing the isotretinoin dose help?
Some side effects are dose-related, but do not reduce the dose, skip capsules or stop treatment solely on internet advice. Your prescriber may recommend eye care, specialist review, dose adjustment, a temporary pause or stopping after assessing the symptom and treatment benefit. [3]
Most dry-eye and visual effects resolve after isotretinoin is stopped, although improvement may not be immediate and persistent symptoms have been reported. Follow up any continuing problem rather than assuming it will settle.
Eye symptoms are part of the wider safety review
In the UK, isotretinoin is reserved for severe acne, or acne at risk of permanent scarring, when appropriate standard treatments have not worked. Current MHRA measures require a lead prescriber with expertise in systemic retinoids, an Acknowledgement of Risk form, pregnancy-prevention measures where relevant, and assessment and monitoring of mental health, sexual function and other adverse effects. [5,6]
Discuss eye symptoms at follow-up appointments. Isotretinoin is not suitable for everyone, and an acne assessment does not guarantee a prescription.
Frequently asked questions
Are preservative-free eye drops better?
They may be preferable when drops are needed frequently, but the best choice depends on your eyes and contact-lens use. Ask a pharmacist or optometrist.
Can I drive during isotretinoin treatment?
Usually, provided your vision is normal and you have no dizziness or other symptom that makes driving unsafe. Do not drive at night if night vision has deteriorated, and do not drive at all if blurred vision or another significant visual problem affects safety. [3]
Do dry eyes mean I must stop isotretinoin?
Not necessarily. Mild dryness can often be managed, but persistent, painful or vision-affecting symptoms require clinical review. Do not make the treatment decision alone.
Can symptoms continue after the last capsule?
Most settle, but persistent dry eye and night-vision problems have rarely been reported. Arrange review if symptoms continue after treatment. [2–4]
Taking the next step
If acne is painful, scarring, persistent or affecting your wellbeing, a structured assessment can review treatments already tried and identify appropriate next options. mySkinDoc offers a remote skin consultation for suitable concerns. If isotretinoin may be relevant, further assessment and current UK safeguards are required. An assessment does not promise a particular medicine. You can also read our guides to skin care during isotretinoin and medicines and supplements that need review.
References
NHS. Isotretinoin: a medicine for severe acne. Accessed 28 October 2026.
British Association of Dermatologists. Isotretinoin patient information leaflet. Accessed 28 October 2026.
electronic Medicines Compendium. Isotretinoin 20 mg soft capsules: Summary of Product Characteristics. Updated April 2026; accessed 28 October 2026.
electronic Medicines Compendium. Isotretinoin 20 mg soft capsules: Patient Information Leaflet. Updated September 2026; accessed 28 October 2026.
MHRA. Isotretinoin: changes to prescribing guidance and additional risk-minimisation measures. Published 22 January 2026; accessed 28 October 2026.
NICE. Acne vulgaris: management (NG198). Accessed 28 October 2026.
This article provides general information and does not replace individual medical or eye-care advice.
