BILATERAL BLINDNESS DUE TO ANTI-TUBERCULAR TREATMENT: A RARE PRESENTATION

ABSTRACTEthambutol and isoniazid (INH) are antimicrobial agents used in the treatment of tuberculosis. Optic neuropathy is a well-recognized toxic effectof these drugs, usually manifesting as a decrease in visual acuity and deficits in color vision. This study presents the case of a 75-year-old malediagnosed of spinal tuberculosis, who developed irreversible bilateral optic neuropathy causing complete blindness induced by ethambutol and INH.Ophthalmologic examination revealed sluggish pupillary reactions and optic disc pallor in both eyes. Visual evoked potential and magnetic resonanceimaging brain complemented the confirmation of the diagnosis.Keywords: Ethambutol, Isoniazid, Optic neuritis, Tuberculosis

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

We report two male children with persistent allergic eye disease (AED) and keratoconus (KC). Both presented with symptoms of vernal keratoconjunctivitis and decreased vision. In view of unrelenting AED, serum immunoglobulin E (IgE) quantification and identification of specific allergens were advised. Increased serum IgE levels were observed in both cases. Sunflower and sheep wool were identified as specific allergens for the first and second patient respectively by skin patch test. There was complete resolution of symptoms of AED in both patients following avoidance of causative allergens. However, the progression of KC in both eyes of the first patient and one eye of the second patient was observed. They were advised collagen cross-linking. Elevated serum IgE indicates the presence of systemic allergy. Avoiding implicated allergens help alleviate ocular symptoms. Using serum IgE and identifying specific allergen can guide in the treatment of AED and thus prevent progressive KC due to eye rubbing and resulting inflammation