Uveitis-like syndrome and iris transillumination after the use of oral moxifloxacin

Objective To report a newly recognized adverse effect of oral moxifloxacin. Design Observational case reports. Participants Five patients who used oral moxifloxacin therapy. Main outcome measures In five patients, a uveitis-like episode followed oral moxifloxacin therapy, afterwards they experienced photophobia. At slitlamp investigation, the patients showed almost complete iris transillumination, not restricted to one sector, and persistent mydriasis of the pupil, with no reaction to light and no near reflex. Follow-up of 3 years in one of the patients showed no change of symptoms. Only in one patient, with a history of anterior uveitis, an anterior chamber tap was positive for herpes simplex genome. Only after the use of moxifloxacin did she experience continuous photophobia. Conclusions Iris transillumination and sphincter paralysis is a newly recognized adverse effect of oral moxifloxacin therapy. Eye (2009) 23, 2260-2262; doi:10.1038/eye.2009.234; published online 23 October 2009