Cocaine Affecting Your Eyes

Cocaine Eyes: How Is Cocaine Affecting Your Eyes?

Prolonged substance abuse is always likely to show in your facial appearance and cocaine addiction is no exception. Heavy cocaine use produces a special look, commonly known as ‘cocaine eyes’, and severe and lasting tissue damage can result – to your eyes and other parts of your body as well. Here we examine what to do about Cocaine affecting your eyes.

How Is Cocaine Used?

Cocaine is a versatile and deadly drug that is usually snorted, smoked or injected. It can also be rubbed on the gums or taken orally (although this is not common because doing so will lessen the effect). Whatever the method of ingestion, it is highly addictive, and people tend to repeat cocaine use obsessively, despite evidence of self-harm such as nosebleeds, ulcers, sore eyes and heart palpitations.

If you are concerned about cocaine use, the following test can help you identify a problem.

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What are Cocaine Eyes?

The effects of cocaine eyes can vary (and other substances can harm the eyes too). Cocaine use can constrict blood vessels, leading to diminished blood flow and reduced oxygen to the eyes. This can cause decreased vision and a temporary loss of colour perception. The drug can also cause increased sensitivity to light, a condition known as photophobia1, as well as dilated pupils.

In some cases, cocaine use can lead to corneal abrasions, a condition in which the clear outer layer of the eye becomes scratched or damaged, causing pain, redness, and light sensitivity, impairing vision and even causing blindness. Heavy substance abuse can also affect the eye muscles, causing weakness and double vision. In other cases, the eye muscles can become overactive, leading to involuntary eye movements.

Here are some common forms of damage found in people with coke addiction:

  • Ocular Bone Damage

Snorting or smoking cocaine can cause the vessels in and around the nose to shrink. This decreases blood and oxygen supply to the nose tissue and surrounding areas and it can become permanently damaged. Sometimes the bone in the sinus around the eyes can deteriorate. Sinus infections become common when the nose is damaged and can’t properly clean the air that is breathed in.

  • Nystagmus

People with nystagmus generate small eye movements that they can’t control. One or both eyes may quickly move up and down or from side to side. This often makes it harder for the person to see clearly.  Cocaine may lead a person to develop this condition because of damage to the nerve muscles or the central nervous system.

  • Retinal Vascular Occlusive Disease (ROVD) 

ROVD Happens when a blood clot blocks a vein to the eye. This can be a danger for cocaine users because the substance can cause blood clotting. When this happens, vision becomes blurred or may be lost altogether. ROVD can sometimes be permanent and successful treatment is not easy.  However, the condition can sometimes improve providing drug use stops altogether.

the optic nerve, which transmits visual information from the eyes to the brain, can become damaged if the blood supply is constricted or adulterated by cocaine abuse. This can lead to vision loss, especially in the peripheral areas of the visual field.

  • Talc Retinopathy 

The eye’s blinking reflex also becomes affected causing the cornea to become dry. This renders it vulnerable to damage and scratching from foreign particles. Snorted cocaine absorbed through the nose produces keratitis (inflation of the cornea) and adulterants to pure cocaine such as talc, sugar or flour can cause surface damage to the cornea too. This is sometimes called ‘crack cornea’.

  • Yellow Eyes

Yellowness in the eyes is often a result of jaundice because cocaine abuse can cause liver damage. Combined with broken blood vessels in the eyes, another effect of cocaine, the sclera (white of the eye) can become yellow and generally discoloured.

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Why Does Cocaine Dilate the Pupils?

Dilation of the pupils is perhaps the most commonest and most recognisable side effect of using cocaine. However, the size of the pupils can be affected by other factors besides cocaine use, such as changes in lighting, stress, and certain medical conditions, so it is important to note that dilated pupils are not definitive indicators of cocaine use.

Cocaine constricts blood vessels and stimulates the nervous system, leading to increased heart rate, body temperature, and blood pressure. This stimulates the muscles that control the size of the pupil to open wider. In addition, cocaine use encourages the body’s production of dopamine, a neurotransmitter associated with pleasure and reward. This increase in dopamine levels causes the pupils to enlarge or dilate.

What Do Cocaine Eyes Look Like?

The main indicator of heavy cocaine abuse is marked dilation of the pupils (cocaine pupils), but there are others:

  • Bloodshot eyes
  • Swollen or ‘bulging’ eyes denoting high blood pressure
  • Yellowness indicating jaundice due to drug abuse
  • Dark circles under the eyes due to anaemia or tiredness
  • Rapid eye movements and twitching
  • The tear ducts may also be producing fluid.

The combination of some or all of these indicators produces a very recognisable look, called ‘cocaine eyes’ that is often referred to in songs for example, by The Rolling Stones and Neil Young.

Cocaine Affecting Your Eyes

What Other Effects Does Cocaine Have on the Body?

Chronic cocaine abusers tend to build up a tolerance to the drug that increases the danger of serious damage to the body. There are likely to be a number of negative consequences as a result:

Damage to Nose and Mouth

The soft tissues inside the nose and mouth contain mucous membranes which dry out as a result of the construction of the blood supply that cocaine use causes. These can become so damaged or ulcerated that perforation of the septum in the nose can lead to facial disfigurement.

Damage to the Respiratory Tract

When cocaine is smoked, this can cause serious breathing problems from lack of oxygen and destruction of the blood vessels. Pneumonia, asthma, and pulmonary embolisms can result.

Cardiac Problems

Cocaine use affects the blood content as well as the blood supply itself. As a result, blood clotting becomes a risk with the possibility of heart attacks, embolisms, strokes, and deep vein thrombosis. The heart itself has to struggle with contaminated blood, high blood pressure, and damaged veins, all of which can lead to chronic hypertension, arrhythmia, and direct damage to the heart muscle itself.

Liver and Kidney Problems

The toxicity of cocaine abuse in the bloodstream puts both liver and kidneys at risk. They struggle to cope and jaundice and other diseases can result.

The Digestive Tract

Once again, the effect that cocaine abuse has on the bloodstream impacts negatively on the stomach and the whole digestive tract. The contaminated and limited blood supply can cause poor digestion, ulcers and colitis. Cocaine addiction commonly renders people thin and undernourished.

The Brain

The brain is particularly vulnerable to a blood supply that is deficient in quantity and quality. This can lead to aneurysms, strokes, seizures and cerebral vasculitis (inflammation of the vessels in the brain). Brain functions can become impaired especially concentration, cognition, impulsiveness, and decision-making. The memory too can suffer.


Chronic cocaine use can compromise the body’s immune system. Injecting cocaine can be particularly dangerous, resulting in gangrene, hepatitis, and clotting.

Central Nervous System (CNS)

The CNS is an extremely delicate structure controlling muscle activity, thinking processes, consciousness, and sensation. Introducing cocaine can have severe consequences, which include sleeping problems, paranoia, hallucinations, and a reduced sense of well-being. Cocaine affects the nervous system through the neurotransmitter dopamine – the chemical responsible for feelings of euphoria and pleasure. The distortion caused by drug abuse directly impacts normal neurotransmitter activity – basic brain functions become unpredictable, and a person’s mental health eventually suffers as well.

Other Signs of Cocaine Use

Behavioural signs of heavy cocaine use include severe mood swings, hyperactivity, paranoia, bad temper, sleeplessness, loss of appetite, and isolation. Friends and family often remark that a loved one suffering from coke addiction has become a more difficult and unpleasant person.

Treatment Options for Cocaine Addiction

Coke addiction is today one of the most common forms of substance abuse in the UK. At Castle Craig Hospital we have successfully treated thousands of people suffering from this illness. Our 12-step programme is well suited to helping and supporting people with the condition.

Alternatives to residential treatment include day care such as provided by our colleagues at Catch Recovery in London, and individual counselling which can often be accessed through local social care and addiction teams. Many people have also found lasting and happy sobriety through the support of self-help groups such as Cocaine Anonymous and  Narcotics Anonymous.

Cocaine Detox

Cocaine is a dangerous drug and detox following chronic substance abuse should always be handled carefully and under medical supervision. It can be highly dangerous to attempt detox on your own. Symptoms experienced during detox include shaking and sweating, nausea, extreme anxiety and depression, suicidal ideations, tiredness, and intense cravings. Where cocaine use has been especially heavy, withdrawal symptoms can include hallucinations and seizures.  At Castle Craig, we always ensure that detox is carefully and sensitively handled to minimise distress.

Private Residential Rehab

Entering a private rehab is always a difficult decision because apart from the likely high cost financially, there is a feeling of giving up control of your life, something that seems frightening to most people. However, if you can try to consider the situation calmly, there are some obvious benefits: you will be in a safe place where all your needs will be addressed by a focused and caring team of professionals;

You will receive positive support from an individual counsellor and a caring peer group of recovering people; You will learn about addiction and techniques for combating it. In addition, you will save money in the long run by achieving lasting sobriety because an active cocaine habit is extremely expensive, probably between £5k and £10k yearly, to which the add-on costs of legal, health, employment, and social problems should be added.

Safe Detox in Comfort

Castle Craig has a dedicated detoxification centre and 24/7 supervision by doctors and nurses to ensure the utmost patient safety.

Outpatient Rehab

If you are unable to commit to a residential course of treatment because of work or family demands, then the solution may be outpatient treatment. Although you may feel that this is less intense and leaves you vulnerable to outside pressures to relapse, there are many positive benefits: it is less costly, more flexible and often more convenient. It is also likely to be cheaper, allowing you to attend sessions over a longer period.

At the Castle Health Group, we can offer either residential treatment or daycare, (provided your location makes this possible). There is also an option for teletherapy. We recognise that everyone’s circumstances and needs are different and we will do our best to construct a recovery programme based on what is best for you.

If you are worried that you might have an addiction or are worried about someone else close to you, don’t hesitate to give us a call – we are always happy to discuss the options and help find the best solution for you.

How Can Castle Craig Help?

How Do I Pay For Rehab?

One concern we sometimes hear from people is how they will fund their rehab treatment. The cost of rehab varies depending on what kind of accommodation you choose. You can pay for treatment at Castle Craig privately, or through medical insurance, and some people receive funding through the NHS.

How Long Is the Rehab Programme?

Residential rehab treatment starts at four weeks and can go up to 12+ weeks. Research shows us that the longer you stay in rehab and are part of the residential therapy programme, the longer the likelihood of continued abstinence and stable recovery.

Who Will I Speak to When I Call?

When you call you will reach our Help Centre team who will give you all the information you need to help you decide whether to choose treatment at Castle Craig. Once you have decided that you would like to have a free screening assessment you will be put in touch with our admissions case managers who will guide you through the admissions process.

What Happens at the End of My Treatment?

Castle Craig thoroughly prepares patients before departure by creating a personalised continuing care plan which is formulated following discussions with the medical and therapeutic team. We offer an online continuing care programme which runs for 24 weeks after leaving treatment, in order to ensure a smooth transition back into your everyday life. Patients leaving treatment automatically join our alumni group where they can stay connected via our annual reunion, events, online workshops and recovery newsletters.

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