Visual Disturbance Secondary to Clomiphene Citrate

Objective: To identify a distinctive constellation of persistent visual abnormalities secondary to treatment with clomiphene citrate. Design: Description of the clinical findings in three patients with visual disturbance secondary to clomiphene treatment. Setting: A neuro-ophthalmology referral center. Patients: Three women aged 32 to 36 years treated for infertility with clomiphene for 4 to 15 months. Results: All three patients experienced prolonged afterimages (palinopsia), shimmering of the peripheral field, and photophobia while undergoing treatment with clomiphene. The results of the neuro-ophthalmologic examination and electrophysiologic studies were normal in all three patients. Unlike previously reported cases, visual symptoms did not resolve on cessation of treatment. Patients remain symptomatic from 2 to 7 years after discontinuing treatment with the medication. Conclusions: Treatment with clomiphene can cause prolonged visual disturbance. Patients who develop such symptoms should be advised that continued administration may cause irreversible changes. Women with characteristic visual symptoms should be questioned about past use of clomiphene.