Bilateral blindness due to anti-tubercular treatment: A rare presentation

Abstract

Ethambutol and isoniazid (INH) are antimicrobial agents used in the treatment of tuberculosis. Optic neuropathy is a well-recognized toxic effect of 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 male diagnosed 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 resonance imaging brain complemented the confirmation of the diagnosis.