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42. Egan R, Pomeranz H "Sildenafil (Viagra) associated anterior ischemic optic neuropathy." Arch Ophthalmol 118 (2000): 291-2

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The following groups of patients with cardiovascular disease were not included in clinical safety and efficacy trials for Cialis, and therefore until further information is available, Cialis is not recommended for the following groups of patients: Severe (Child Pugh Class C): The use of Cialis is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)].Cialis Side Effects