alexa The Ocular Effects of Methyl Alcohol Poisoning: Report of a Catastrophe Involving 320 Persons
Toxicology

Toxicology

Journal of Clinical Toxicology

Author(s): Curtis D Benton

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Clinical and pathologic observations on a group of 320 patients with acute methyl alcohol poisoning are reported. There were 37 deaths. Visual symptoms, occurring 18 to 48 hours after ingestion of methanol, included blurred vision, loss of central vision, and complete blindness. The pupils reacted sluggishly or not at all to light. Absence of the pupillary light reflex was a sign of poor prognosis for life or eventual restoration of visual acuity. The visible retinal changes were hypermia of the optic nervehead and superficial edema of the papilla and surrounding retina, and later a simple atrophy of the optic nerve. All patients with severe retinal edema had some degree of permanent visual loss. The earliest central field defect was usually a centrocecal scotoma. Later more complex types of visual defects appeared. Acidosis was present in every severely poisoned patient. The degree of acidosis paralleled the severity of general and ocular symptoms. Partial or complete recovery of the initially reduced visual acuity was observed in most patients. If the visual acuity did not return to normal within six days after treatment was begun, it invariably dropped again to a very low level. The final vision was 20/200 or less in both eyes of six patients and in one eye of three patients. Histologic studies on six eyes enucleated after death revealed only changes consistent with post-mortem degeneration. On the basis of results obtained in this series of cases, the most effective treatment of acute methyl alcohol poisoning consists of intensive and prolonged alkalinization.

This article was published in American Journal of Opthamology and referenced in Journal of Clinical Toxicology

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