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What Causes Blurred Vision Inspite Of Being On Treatment For TB?
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.
Her eyesight has improved only 25% maybe after 4 months. Is it normal?
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.
Her eyesight has improved only 25% maybe after 4 months. Is it normal?
Brief Answer:
TBM
Detailed Answer:
My dear,
Thanks for sending your query to us.
There are two ways in which such situations effect the vision.One is Toxicity of anti tubercular drugs and two is effects of tubercular infection like menengitis and optic neuritis.The way to manage this is to contole tubercular infection and also to continue with supportive treatment like B complex vitamins.Oral steroids which are mainstay of treatment to prevent fibrosis can not be given in adequate doses due to diabetese mallitus.
It is good that the disease has been diagnosed in early stage and she is being managed well.
At the moment she has to continue with ATT and multivitamines.
Do get back to in case of any further query in this regard.
TBM
Detailed Answer:
My dear,
Thanks for sending your query to us.
There are two ways in which such situations effect the vision.One is Toxicity of anti tubercular drugs and two is effects of tubercular infection like menengitis and optic neuritis.The way to manage this is to contole tubercular infection and also to continue with supportive treatment like B complex vitamins.Oral steroids which are mainstay of treatment to prevent fibrosis can not be given in adequate doses due to diabetese mallitus.
It is good that the disease has been diagnosed in early stage and she is being managed well.
At the moment she has to continue with ATT and multivitamines.
Do get back to in case of any further query in this regard.
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Doctor,
Thanks for the reply. Is there chance of full recovery. Right now she is continuing with Rifamcin and Levofloxacin-750mg. Its almost four months she has stopped taking Ethambutol and Isoniazid. Also MRI showed optic neuritis of low intensity.
Thanks and Regards,
XXXXX XXXXXXX
Thanks for the reply. Is there chance of full recovery. Right now she is continuing with Rifamcin and Levofloxacin-750mg. Its almost four months she has stopped taking Ethambutol and Isoniazid. Also MRI showed optic neuritis of low intensity.
Thanks and Regards,
XXXXX XXXXXXX
Brief Answer:
TBM
Detailed Answer:
My Dear,
thanks for getting back to us.
Recovery takes time.How much is the recovery depends upon many factors including age,immunity of patient and virulence of organism.Levofloxicin is to be continued for a short period of time.Continue with the tt and we should have a good recovery.
Do get back to me in case of any further query in this regard.
TBM
Detailed Answer:
My Dear,
thanks for getting back to us.
Recovery takes time.How much is the recovery depends upon many factors including age,immunity of patient and virulence of organism.Levofloxicin is to be continued for a short period of time.Continue with the tt and we should have a good recovery.
Do get back to me in case of any further query in this regard.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor,
Thanks for your reply.
She is having rifamcin-450 mg and levofloxacin -750 mg. She is having too much gut pain maybe due to levofloxacin. How long she needs to continue that drug? She is having levofloxacin for last three weeks. She had ofloxacin for 4 months and moxifloxacin failed due to her optic neuritis.
Thanks and Regards,
XXXXX XXXXXXX
Thanks for your reply.
She is having rifamcin-450 mg and levofloxacin -750 mg. She is having too much gut pain maybe due to levofloxacin. How long she needs to continue that drug? She is having levofloxacin for last three weeks. She had ofloxacin for 4 months and moxifloxacin failed due to her optic neuritis.
Thanks and Regards,
XXXXX XXXXXXX
Brief Answer:
TBM
Detailed Answer:
My Dear,
Thanks for getting back to us.
Levofloxcin and norfloxcin are not anti tubercular drugs and they are antibiotics which are to be given for other bacterial infections.These are specific drugs which are to be given for infections which are sensitive to these drugs for a specific period of time and do not see any reason for rhem to be continued.
Please check it again from the physician who is treating you and do get back to me in case of any further query in this regard.
TBM
Detailed Answer:
My Dear,
Thanks for getting back to us.
Levofloxcin and norfloxcin are not anti tubercular drugs and they are antibiotics which are to be given for other bacterial infections.These are specific drugs which are to be given for infections which are sensitive to these drugs for a specific period of time and do not see any reason for rhem to be continued.
Please check it again from the physician who is treating you and do get back to me in case of any further query in this regard.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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