Toxic Amblyopia

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With the increased use of chemotherapy, it may be well to call attention to the symptom known to the eye physician as toxic amblyopia. Characterized by the patient as a veil, mist, fog, or haziness of the vision, further questioning reveals that this is in the direct vision and occurs most frequently in the morning. However, it is not uncommon for the cloudiness to increase during the day, usually affecting one eye, then the other, greatly alarming the patient as a rule. These cases comprise the acute group and if the condition is not recognized and appropriate measures instituted, a chronic amblyopia results. Patients in the latter group could be characterized as being apathetic—perhaps the visual fog includes the cerebrum.

References in the literature on this subject began in the middle of the eighteenth century. In 1751 an article by Boerhaave, as cited by deSchweinitz1 appeared. In 1813 it was noted that drinkers of bitter beer had difficulty with their sight. For almost two centuries alcohol has been a primary factor in the production of toxic amblyopia.

deSchweinitz1 in an excellent monograph published in 1896, lists some seventy-five drugs that have been known to produce this condition. The agent responsible for the amblyopia is usually designated in its name, such as alcohol amblyopia, tobacco amblyopia, etc.

Casey Wood2 classified the drugs into two classes:

  1. Poisons affecting the optic nerve

    1. Chronic retrobulbar neuritis.

    2. Poisoning producing other forms of optic nerve disease.

  2. Poisons which cause symptoms. . .



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