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We presented a case of sudden and painless vision impairment connected with the recreational usage of cocaine. According to many authors illicit use of cocaine has been associated with the most common adverse effect among all psychoactive drugs. In the last years there were a few articles about vision problems after the usage of cocaine. In most cases the main mechanism was central retinal artery occlusion (CRAO). The vision impairment developed from 3 to 10 hrs after the cocaine use and the outcome, despite the intensive treatment, was usually poor. All doctors should keep in mind the possibility of cocaine usage, in young and healthy people, who developed a sudden and painless vision loss.

The aim of this study was the assessment of disorders after chronic intake of psychoactive drugs, like marijuana, amphetamine, ecstasy, cocaine and opiates. In 2002 in the Department of Clinical Toxicology detoxification unit were treated 117 chronic drug abusers. The 76 of them use the opiates predominantly, the next 41 persons (35 men, 6 women), were heavy abusers of psychostimulant drugs. In opiate abusers typical withdrawal signs and symptoms were observed. In the group of psychostimulants users, the mean time of marijuana use was 6 years, amphetamine--5 years. The cocaine was used rarely. Among 25 persons (61%) from these group the withdrawal syndrome were established. The excitation of neurovegetative system, depression, or psychomotor effects were observed. We concluded the necessity of estimation of neurobiological changes after using of psychostimulants and that more controlled research might uncover a clinically diagnosable withdrawal syndrome in human psychostimulants users.