Visual disturbance secondary to clomiphene citrate
V. A. Purvin
Midwest Eye Institute, Methodist Hospital of Indiana, Indianapolis, USA.
OBJECTIVE: To identify a distinctive constellation of persistent visual
abnormalities secondary to treatment with clomiphene citrate. DESIGN:
Description of the clinical findings in three patients with visual
disturbance secondary to clomiphene treatment. SETTING: A
neuro-ophthalmology referral center. PATIENTS: Three women aged 32 to 36
years treated for infertility with clomiphene for 4 to 15 months. RESULTS:
All three patients experienced prolonged afterimages (palinopsia),
shimmering of the peripheral field, and photophobia while undergoing
treatment with clomiphene. The results of the neuro-ophthalmologic
examination and electrophysiologic studies were normal in all three
patients. Unlike previously reported cases, visual symptoms did not resolve
on cessation of treatment. Patients remain symptomatic from 2 to 7 years
after discontinuing treatment with the medication. CONCLUSIONS: Treatment
with clomiphene can cause prolonged visual disturbance. Patients who
develop such symptoms should be advised that continued administration may
cause irreversible changes. Women with characteristic visual symptoms
should be questioned about past use of clomiphene.
