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Ethambutol and visual assessment in England: current practice and recommendations
Sally MacVinish1, David McMaster2, Tanya Moledina1
1UK Health Security Agency, London, UK.
Eye (London, England)
|June 22, 2023
Summary
Standard tuberculosis treatment uses ethambutol, which can cause vision loss. This survey found varied eye testing practices among English TB services, highlighting the need for consistent guidelines to protect patient vision during treatment.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Ethambutol is a standard tuberculosis treatment.
- Ethambutol can cause optic neuropathy and irreversible vision loss.
- Current guidance on visual assessments during ethambutol treatment is inconsistent.
Purpose of the Study:
- To assess current practices for visual assessment in patients receiving ethambutol for TB in England.
- To identify variations in visual testing protocols.
- To inform the development of best practice recommendations.
Main Methods:
- An online survey was distributed to all TB services in England in 2018.
- The survey was developed by Public Health England.
- 66 TB professionals responded, achieving a 54% response rate.
Main Results:
- Significant variations in practice were observed across England.
- Inconsistencies included timing, frequency, and type of visual assessments.
- Differences were noted in ethambutol omission, referral processes, and management of visual changes.
Conclusions:
- There is a critical need for clear national guidelines on vision testing for patients on ethambutol.
- Current practices for visual assessment during TB treatment vary widely.
- A pragmatic, stepwise approach to visual assessment is proposed to standardize care.
