Digoxin visual toxicity with therapeutic blood levels of digoxin

Am J Ophthalmol. 1998 Mar;125(3):406-7. doi: 10.1016/s0002-9394(99)80161-5.


Purpose: To report two cases of digoxin-related visual disturbances associated with therapeutic blood levels of digoxin.

Methods: Case reports. One patient reported shimmering lights in the field of vision of both eyes; the second patient had a corrected visual acuity of BE, 20/40 and generalized visual field depression in both eyes. Both patients experienced these symptoms while receiving digoxin.

Results: Both patients had digoxin blood levels in the therapeutic range (1.7 and 1.0 ng/ml, respectively). Therapeutic levels are 0.5 to 2.0 ng/ml. After discontinuing digoxin, the first patient noted that the shimmering light symptoms resolved, and the second patient had improved visual acuity and visual fields.

Conclusions: Digoxin-related visual toxicity may be associated with therapeutic blood levels of digoxin. Recognition of this entity may avoid unnecessary testing and frustration.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Arrhythmia Agents / adverse effects*
  • Anti-Arrhythmia Agents / blood*
  • Digoxin / adverse effects*
  • Digoxin / blood*
  • Female
  • Humans
  • Middle Aged
  • Vision Disorders / blood
  • Vision Disorders / chemically induced*
  • Vision Disorders / physiopathology
  • Visual Acuity / drug effects*
  • Visual Acuity / physiology
  • Visual Fields / drug effects
  • Visual Fields / physiology


  • Anti-Arrhythmia Agents
  • Digoxin