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Acute Myopia Induced by Sulfanilamide
NOTES, CASES, INSTRUMENTS ACUTE MYOPIA INDUCED BY SULFANILAMIDE REPORT OF A CASE BERNARD B. FRIEDMAN,
M.D.
Corpus Christi, Texas One of the most important studies in relation to a drug that has been newly adopted for the treatment of disease is its toxicology. Most of this can be devel oped experimentally by animal study be fore its release for human use. However, one phase of such work cannot be so solved, and that is its effect on vision due to its subjective nature. Several toxic effects of sulfanilamide have been reported in the literature, among them acute myopia induced by its ingestion. Due to the wide application of this drug and its ever-expanding field of therapy, it is felt that any toxic condition that may result from its use should be brought to the attention of all who pre scribe it. Report of a case. T. H., a white male, aged 29 years, caught cold July 11, 1940. On the following day his physician or dered sulfanilamide. He took no medica tion other than the prescribed 150 grains in the following 20 hours. He came to me on July 15, 1940, with the complaint that his distance vision was considerably blurred. He feared he was going blind. His past history revealed no similar experience at any time. His general con dition had always been good, and he was not in the habit of taking any medication whatsoever. Examination revealed the following positive findings: The vision for distance
93S
was: R.E. 20/80; L.E. 20/100. The near vision was normal. The pupils were slightly larger than normal but reacted promptly to light and accommodation. The fields and tension were within normal limits. There were no evidences of patho logical change. Refraction showed that vision in the R.E. with - 1 . 5 0 D. sph. =C= +.75 D. cyl. ax. 80° was 20/20; in the L.E. with - 1 . 7 5 D. sph. O +.75 D. cyl. ax. 90° was 20/20. Homatropine was then in stilled and retinoscopy showed the refrac tion to be approximately the same as given. This eliminated the possibility of a case of spasm of the accommodation. Two days later on July 17, 1940, when no more sulfanilamide had been taken, the vision was 20/20 in each eye without cor rection and the acceptance was in the R.E. +.50 D. cyl. ax. 90° = 20/20; in the L.E. +.25 D. sph. =C= +.50 D. cyl. ax. 90° = 20/20. He stated that his vision had returned to normal as well as he was able to appreciate it. He was last examined on November 7, 1940, when no changes were found from the previous examination. Whether or not a change similar to that which takes place in a case of diabetes resulting in an acute temporary myopia took place here, is a matter of conjecture. Conclusion. Acute myopia is another of the possible toxic manifestations of the ingestion of a most useful drug, sulfa nilamide. The use of medication with less toxic reactions than sulfanilamide may be suggested in the treatment of diseases when sulfanilamide is not specifically indicated. 916 Jones Building.
M.D.
Corpus Christi, Texas One of the most important studies in relation to a drug that has been newly adopted for the treatment of disease is its toxicology. Most of this can be devel oped experimentally by animal study be fore its release for human use. However, one phase of such work cannot be so solved, and that is its effect on vision due to its subjective nature. Several toxic effects of sulfanilamide have been reported in the literature, among them acute myopia induced by its ingestion. Due to the wide application of this drug and its ever-expanding field of therapy, it is felt that any toxic condition that may result from its use should be brought to the attention of all who pre scribe it. Report of a case. T. H., a white male, aged 29 years, caught cold July 11, 1940. On the following day his physician or dered sulfanilamide. He took no medica tion other than the prescribed 150 grains in the following 20 hours. He came to me on July 15, 1940, with the complaint that his distance vision was considerably blurred. He feared he was going blind. His past history revealed no similar experience at any time. His general con dition had always been good, and he was not in the habit of taking any medication whatsoever. Examination revealed the following positive findings: The vision for distance
93S
was: R.E. 20/80; L.E. 20/100. The near vision was normal. The pupils were slightly larger than normal but reacted promptly to light and accommodation. The fields and tension were within normal limits. There were no evidences of patho logical change. Refraction showed that vision in the R.E. with - 1 . 5 0 D. sph. =C= +.75 D. cyl. ax. 80° was 20/20; in the L.E. with - 1 . 7 5 D. sph. O +.75 D. cyl. ax. 90° was 20/20. Homatropine was then in stilled and retinoscopy showed the refrac tion to be approximately the same as given. This eliminated the possibility of a case of spasm of the accommodation. Two days later on July 17, 1940, when no more sulfanilamide had been taken, the vision was 20/20 in each eye without cor rection and the acceptance was in the R.E. +.50 D. cyl. ax. 90° = 20/20; in the L.E. +.25 D. sph. =C= +.50 D. cyl. ax. 90° = 20/20. He stated that his vision had returned to normal as well as he was able to appreciate it. He was last examined on November 7, 1940, when no changes were found from the previous examination. Whether or not a change similar to that which takes place in a case of diabetes resulting in an acute temporary myopia took place here, is a matter of conjecture. Conclusion. Acute myopia is another of the possible toxic manifestations of the ingestion of a most useful drug, sulfa nilamide. The use of medication with less toxic reactions than sulfanilamide may be suggested in the treatment of diseases when sulfanilamide is not specifically indicated. 916 Jones Building.