As per a 2009 review by the American Academy of Ophthalmology (Academy) in relation to safety and efficacy of a widely-used corneal transplant procedure and an unusual but severe reaction to systemic fluoroquinolones, antibiotics meant for treating bacterial infections may lead to double vision.

The 2009 review by the cornea panel of the Academy’s Ophthalmic Technology Assessment Committee, led by W. Barry Lee, M.D., suggested that Descemet’s Stripping Endothelial Keratoplasty (DSEK) corneal transplant procedure is a safe and effective treatment option for corneal endothelial disease.

From News-Medical.Net:

The researchers, led by Frederick W. Fraunfelder, M.D., found 171 cases between 1986 and 2009 of fluoroquinolone use associated with double vision through a review of reports from the Food and Drug Administration, World Health Organization, and the National Registry of Drug-Induced Ocular Side Effects. The median patient age was 51.6 years, medication doses were within recommended levels, and the interval from starting medication to onset of double vision was 9.6 days on average. Medication was discontinued in 53 patients, and diplopia resolved in all cases.

“Doctors need to be aware of this potential reaction when prescribing these antibiotics and consider stopping therapy if diplopia occurs,” Dr. Fraunfelder said. He also said that special care should be taken with patients who are older than 60, have had renal failure, or are taking steroids, and that thorough ophthalmic and neurological exams should be done to rule out other causes of double vision.

It was remarked by Dr. Lee that there is a need for improving DSEK and related procedures in addition to providing the best patient care and this can be done by prospective clinical studies to set expectations for long-term endothelial cell survival and ascertainment of acceptable complication rates.