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Suggest Treatment For Retrobulbar Neuritis
Question:
I am speaking about my mother who is aged 54 years. Last XXXXXXX 2014 she was diagnosed with Extra-pulmonary TB due to enlargement of Left armpit lymphnodes. Her fever started from 12th May 2014. She was diagnosed on 23/6/2014. She was also complaining about severe headache. Tests were carried out and TB Meningitis was proved. She started with the first line of drugs consisting of
Isoniazid-300mg
Rifampicin-450mg
Pyrazinamide
Ethambuto-1000mg
She continued Ethambutol till November 2014 when suddenly she complained of blurriness and also Green Colour blindness(to slight extent) and was diagnosed Retrobulbar Neuritis. Ethambutol was discontinued at once followed by Isoniazid within one week. MRI was carried out which confirmed the same but of very low intensity.
Right now the colour issue has disappeared but still she is suffering from blurry vision. Her eye is perfect and fundus of eye is perfect as confirmed by two ophthalmologists.
Is there any chance she can get her clear vision back? She is suffering from diabetes mellitus but it almost remains close to the normal level. Right now she is only having rifamcin and ofloxacin. All other medicines are stopped.
I am speaking about my mother who is aged 54 years. Last XXXXXXX 2014 she was diagnosed with Extra-pulmonary TB due to enlargement of Left armpit lymphnodes. Her fever started from 12th May 2014. She was diagnosed on 23/6/2014. She was also complaining about severe headache. Tests were carried out and TB Meningitis was proved. She started with the first line of drugs consisting of
Isoniazid-300mg
Rifampicin-450mg
Pyrazinamide
Ethambuto-1000mg
She continued Ethambutol till November 2014 when suddenly she complained of blurriness and also Green Colour blindness(to slight extent) and was diagnosed Retrobulbar Neuritis. Ethambutol was discontinued at once followed by Isoniazid within one week. MRI was carried out which confirmed the same but of very low intensity.
Right now the colour issue has disappeared but still she is suffering from blurry vision. Her eye is perfect and fundus of eye is perfect as confirmed by two ophthalmologists.
Is there any chance she can get her clear vision back? She is suffering from diabetes mellitus but it almost remains close to the normal level. Right now she is only having rifamcin and ofloxacin. All other medicines are stopped.
Brief Answer:
Her vision will improve.
Detailed Answer:
Welcome to Health care Magic.
I am Dr. DADAPEER K, an Ophthalmologist and I will be answering your question.
I reviewed your history. It seems from the history that your mother had retrobulbar neuritis following treatment with Ethambutol for tuberculosis.
Ethambutol is known to cause retrobulbar neuritis. Hence frequent eye examination is advised while on treatment with this drug.
Isoniazid is also known to cause this problem less commonly than Ethambutol.
The treatment is mainly by stopping these drugs and use of B complex vitamins.
The vision lost due to retrobulbar neuritis will improve slowly and this recovery period is about 6 months.
Since color vision has improved and fundus examination is normal as told by your ophthalmologists, the blurred vision will resolve slowly.
Hope this is helpful to you.
Do write back to me for further questions.
Thank you
Her vision will improve.
Detailed Answer:
Welcome to Health care Magic.
I am Dr. DADAPEER K, an Ophthalmologist and I will be answering your question.
I reviewed your history. It seems from the history that your mother had retrobulbar neuritis following treatment with Ethambutol for tuberculosis.
Ethambutol is known to cause retrobulbar neuritis. Hence frequent eye examination is advised while on treatment with this drug.
Isoniazid is also known to cause this problem less commonly than Ethambutol.
The treatment is mainly by stopping these drugs and use of B complex vitamins.
The vision lost due to retrobulbar neuritis will improve slowly and this recovery period is about 6 months.
Since color vision has improved and fundus examination is normal as told by your ophthalmologists, the blurred vision will resolve slowly.
Hope this is helpful to you.
Do write back to me for further questions.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Is there any chance of permanent damage after she has stopped ethambutol almost 2.5 months back? Also she has diabetes but it remains almost normal.
Thanks and Regards,
XXXXXX XXXXXXX
Is there any chance of permanent damage after she has stopped ethambutol almost 2.5 months back? Also she has diabetes but it remains almost normal.
Thanks and Regards,
XXXXXX XXXXXXX
Brief Answer:
Permanent damage is unlikely.
Detailed Answer:
Hello
Thank you for the follow up question.
Ethambutol induced retrobulbar neuritis will cause some amount of permanent damage if the diagnosis is delayed.
In your mothers case since fundus examination is normal, permanent damage is unlikely.
Hope this is helpful to you.
Do write back to me for further questions.
Thank you
Permanent damage is unlikely.
Detailed Answer:
Hello
Thank you for the follow up question.
Ethambutol induced retrobulbar neuritis will cause some amount of permanent damage if the diagnosis is delayed.
In your mothers case since fundus examination is normal, permanent damage is unlikely.
Hope this is helpful to you.
Do write back to me for further questions.
Thank you
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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