Evaluation of Visual Disturbance in Infertile Patients on Clomiphene Citrate Therapy

1. Dr. Pikee Saxena¹
2. Vimla Menon²
3 Rohit Saxena²
4. Hemlata¹

¹Department of Obstetrics and Gynecology, Lady Hardinge Medical College and SSKH, New Delhi, India.
²Squint and Neuro-Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Purpose: To evaluate the incidence and severity of visual disturbance in infertile patients undergoing treatment with clomiphene citrate (CC).

Methods: This was a prospective observational study of 100 cases of infertility undergoing treatment with clomiphene citrate. All cases enrolled into the study underwent a baseline ophthalmic examination with visual acuity testing. Any case with history of visual problems other than refractive error or vision <6/9 was excluded from the study. All cases were directly asked to report any visual complaints during or after the treatment of clomiphene citrate. All cases reporting the same underwent a detailed ophthalmic examination with visual acuity testing, fundus examination, colour vision, contrast sensitivity, visual fields and visual evoked potentials (VEP).

Results: One patient on 150 mg and 3 on 100mg of clomiphene therapy reported visual symptoms during treatment. Most common reported symptoms were photophobia followed by shimmering and flashes. Although blurred vision was reported in 2 cases, all patients had normal visual acuity, fundus, colour vision, visual fields and contrast sensitivity. The VEP showed mild increase in the latency in 3 cases.

Conclusion: Women with characteristic visual symptom should be specifically enquired about treatment with CC. These patients need close follow up and change in treatment may be considered in consultation with the treating gynecologist.