Ethambutol ocular toxicity in a patient with pulmonary tuberculosis – a case report
Purpose. To highlight the importance of using the Farnsworth Panel D-15 Hue test in colour vision testing in patients on ethambutoltreatment.
Case Report. A 70 year-old lady received ethambutol as part of her anti-tuberculous regime. She developed blue-yellow colour defectdetectable with the Farnsworth Panel D-15 Hue test, but not with the Isihara Pseudoisochromatic Plates. Ethambutol was immediatelydiscontinued from her anti-tuberculous regime. Two months later, her colour vision returned to normal.
Conclusion. This case report illustrates the importance of regular monitoring of patients receiving ethambutol for blue-yellow colour defectusing the Farnsworth Panel D-15 Hue Test.
Petri WA, Chapter 48: Antimicrobial Agents. In: Hardman JG,
Limbrid LE, Gillman AG. Goodman and Gillman’s The Pharmacological Basis of Therapeutics, 10th edition, New York,
McGraw-Hill, 2001, pg 1280.
Kumar A, Sandramouli S, Verma L, et al. Ocular ethambutol toxicity: is it reversible? J Clin Neuro-ophthalmol. 1993;13(1):15-17.
Vander JF, Gault JA. Ophthalmology Secrets, 2nd edition. Pennsylvania: Mosby Elsevier, 2002, pg 1.
American Academy of Ophthalmology. Basic Science and Clinical Course. Section 12: Retina and Vitreous. San Francisco: American Academy of Ophthalmology, 2005, pg 44.
Schneck ME, Hargerstrom-Portney G. Color vision defect type and spatial vision in the optic neuritis treatment trial. Invest Ophthalmol Vis Sci. 1997;38(11):2278-89.
Polak BC, Leys M, van Lith GH. Blue-yellow colour vision changes as early symptoms of ethambutol oculotoxicity. Ophthalmologica 1985;191(4):223-6.
Good GW, Schepler A, Nichols JL. The reliability of the Lanthony Desaturated D-15 test. Optom Vis Sci 2005;82(12):1054-9.
Chan RYC, Kwok AKH. Ocular toxicity of ethambutol. Hong Kong Med J. 2006;12(1):56-60.
Lakowski R. Age and color vision. Adv Sci 1958;15:231-6.
Melamud A, Kosmorsky G, Lee MS. Ocular ethambutol toxicity. Mayo Clin Proc. 2003;78(11):1409-11.