Ocular side effects of antitubercular drugs - a focus on prevention, early detection and management.

Given the increasing prevalence of tuberculosis, antitubercular drugs frequently used are also associated with ocular toxicity. Ethambutol is the most commonly implicated drug. It is generally well tolerated, but known to cause optic neuritis, more specifically retro bulbar neuritis causing blurred vision, decreased visual acuity, central scotomas, and loss of red-green color vision. The exact mechanism of toxicity is not understood. Though optic neuritis due to ethmabutol is generally considered to be reversible upon prompt discontinuation of the drug, there are reports of reversible toxicity, particularly in the elderly population. Isoniazid can rarely cause retro bulbar neuritis. Dose relationship is usually not seen. Streptomycin is known to cause pseudo tumorcerebri. Thiacetazone can produce severe cutaneous reactions including Steven Johnson Syndrome affecting the skin and mucosa including conjunctiva. Educating the patients for early detection of the ocular manifestations and regular follow-ups are very essential.

Prevalence of high risk children under five--a study in rural Delhi.

678 under five children were surveyed in village Shahbad Mohammadpur, Delhi. Two weeks morbidity was also recorded. 47.9 per cent children had one or more risk factors studied. Significantly more female children (54.1 per cent) were at risk than male children (43.3 per cent). 433 risk factors were observed in 325 at risk children. Majority of them had one or two risk factors. Birth interval less than two years and malnutrition were most frequent risk factors. At risk children suffered significantly more than not at risk (21.2 per cent vs 14.4 per cent). The results confirmed the validity of the risk factors considered for the study.