Ethambutol (EMB, Myambutol) is regarded as one of the best tolerated tuberculostatics. Concerning to the side effects of EMB, the ocular disturbances are the only severe complication. Recently, the author have a chance to evaluate ocular toxicity of the EMB. A total of 40 patients being treated with EMB, received a complete ophthalmic examination including visual acuity, visual field, ophthalmoscopy and color vision test (by means of the Ishihara pseudo-isochromatic plate, Farnsworth-Munsell 100 hue test). Ocular toxicity occurred in four cases: 1. One was 18 yrs. old girl, two was fifth decade men and the other was 70 yrs. old man. 2. One case was bilateral renal tuberculosis and other cases were pulmonary tuberculosis. 3. Such patients received EMB daily in a single dose of 16~24mg/kg for a period of 4~17 months. 4. The ocular toxicity was manifested as follows: 1) loss of central vision in all cases. 2) associated with a central scotoma in 3 cases and normal field in 1 case. 3) marked decrease in color discrimination in all cases. 4) fundus was normal in all cases. 5. By the F-M test, EMB-induced acquired dyschromatopsia was detected, which was presented both graphically and numerically. 6. The F-M test permits early detection of the changes developing in the optic nerve and enables one to evaluate the dynamics of the toxic precess. In patients treated with EMB, ophthalmic examination should be done prior to and in the course of therapy. Owing to its sensitivity, the F-M test is of great value in the ophthalmic control examinations and early diagnosis can shorten the duration of complications involving the optic nerve.
Color Vision ; Diagnosis* ; Discrimination (Psychology) ; Early Diagnosis ; Ethambutol* ; Female ; Humans ; Male ; Ophthalmoscopy ; Optic Nerve ; Scotoma ; Tuberculosis, Pulmonary ; Tuberculosis, Renal ; Visual Acuity ; Visual Fields

PURPOSE: Bell's phenomenon (BP), which may disturb screening examinations for retinopathy of prematurity (ROP), is known to present infrequently in premature babies. Stress associated with the examinations can influence expression of BP. The authors of the present study evaluated BP during examinations for ROP. METHODS: The present study included 102 eyes of 51 premature babies. Expression of BP was assessed at 3 steps of the examination in the following order: after insertion of a speculum, after illumination of an indirect ophthalmoscope and after scleral depression. The relationship between the expression of BP and the gestational age at the examination was analyzed in each step of the examination. RESULTS: The frequency of BP after the speculum insertion and the illumination was 77% to 92% in infants 32 weeks of age or younger, and decreased significantly to 16% to 57% in infants 42 weeks of age or older (p < 0.005). BP after the scleral depression had no significant association with the gestational age. Frequency of BP increased significantly as the steps of the examination proceeded (p < 0.01). CONCLUSIONS: BP was frequent in premature infants during ROP examination in spite of neurological immaturity. The examiner should take BP into consideration, which frequently occurs in younger infants.
Gestational Age ; Humans ; Incidence ; Infant, Newborn ; *Infant, Premature ; Korea/epidemiology ; Mass Screening/adverse effects/*methods/psychology ; Ophthalmoscopy/*psychology ; Retinopathy of Prematurity/*diagnosis/epidemiology ; Retrospective Studies ; Risk Factors ; Stress, Psychological/*epidemiology/etiology ; Vision Screening/adverse effects/*psychology

PURPOSE: The purpose of this study was to understand the situation of diabetes patients receiving examinations for diabetes complications and to explore the factors influencing their intention to receive examinations for diabetes complications. METHODS: A cross-sectional study was performed that included 251 diabetes patients who visited outpatient clinics in Southern Taiwan. A survey using a self-administered questionnaire was conducted from October 2015 to January 2016. The questionnaire included items on demographic characteristics, perceived susceptibility to diabetes complications, perceived seriousness of diabetes complications, perceived benefits of taking action to receive diabetes complication examinations, perceived barriers to taking action to receive diabetes complication examinations, and the intention to receive diabetes complication examinations. The data were analyzed using regression analysis. RESULTS: The percentage of participants who received fundus, foot, and kidney examinations was 67.7%, 61.4%, and 73.3%, respectively. Every point increase on the perceived barriers to taking action to receive diabetes complication examinations scale increased the intention to receive a foot examination in the following year by 0.91 times (p = .002), and every point increase on the perceived susceptibility to diabetes complications scale increased the intention to receive a kidney examination in the following year by 1.19 times (p = .045). CONCLUSIONS: Nurses should shoulder the responsibility to increase patients' intention to receive examination of diabetes complications. The results of this study can be used to promote nurses' care efficacy in preventing diabetes complications. They can also provide medical institutions with information to establish prevention and control policies for diabetes complications.
Ambulatory Care/utilization ; Cross-Sectional Studies ; Diabetic Angiopathies/nursing/*prevention & control/psychology ; Diabetic Nephropathies/nursing/*prevention & control/psychology ; Disease Susceptibility/psychology ; Early Diagnosis ; Female ; Humans ; Intention ; Kidney Function Tests ; Male ; Middle Aged ; Nurse-Patient Relations ; Ophthalmoscopy ; Patient Acceptance of Health Care/*psychology ; Perception ; Physical Examination/nursing/*psychology/utilization ; Taiwan