BACKGROUND Recent reports have established that eye changes occur in patients treated with vigabatrin.

AIM To identify the eye changes associated with vigabatrin, based on a prospective study of children treated for seizures.

RESULTS Twenty one children fulfilled the inclusion criteria. Most had epileptic syndromes with infantile spasms—namely West syndrome, Lennox–Gastaut syndrome, and partial seizures. Vigabatrin dose was 25–114 mg/kg/day (mean 55.8); duration of therapy was 6–85 months (mean 35.7). Four children (19%) developed eye changes (retinal pigmentation, hypopigmented retinal spots, vascular sheathing, and optic atrophy). Visual evoked potentials were abnormal in 16 children. Electroretinography and electro-oculography, which could have picked up eye changes in early stages, were not performed, as this facility was not available.

CONCLUSIONS Vigabatrin causes eye damage. Most children with epileptic syndromes on vigabatrin cannot complain of their eye problems, hence 3–6 monthly ophthalmic follow up is strongly advised, along with regular electroretinography, electro-oculography, and visual evoked potentials if possible.