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Acute, persistent quinine-induced blindness. A case report.

P Rheeder1, W L Sieling

  • 1Department of Medicine, 1 Military Hospital, Voortrekkerhoogt, Tvl.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|May 4, 1991
PubMed
Summary
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Quinine, an essential malaria treatment, can cause total and permanent blindness, a rare and severe side effect. Physicians must be aware of this risk, even though visual deficits usually resolve quickly.

Area of Science:

  • Ophthalmology
  • Pharmacology
  • Infectious Diseases

Background:

  • Quinine is a critical medication for malaria treatment.
  • Adverse effects of quinine can occur, including visual disturbances.
  • Previous reports suggest quinine-induced visual deficits are typically transient and mild.

Observation:

  • A case of a young man treated empirically for malaria is presented.
  • The patient developed total and permanent blindness following quinine administration.
  • This outcome is unusual compared to previously documented cases.

Findings:

  • The reported case demonstrates a rare, severe manifestation of quinine toxicity.
  • Permanent vision loss is a significant deviation from the usual prognosis of quinine-induced visual impairment.

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  • The patient's blindness did not resolve over time.
  • Implications:

    • Clinicians must maintain a high index of suspicion for severe quinine toxicity.
    • Awareness of potential permanent visual deficits is crucial for patient counseling and monitoring.
    • This case highlights the importance of risk-benefit assessment in empirical malaria treatment.