|Year : 1969 | Volume
| Issue : 3 | Page : 121-122
Unusual findings in methyl alcohol poisoning
Chingleput Medical College, Chingleput, India
|Date of Web Publication||10-Jan-2008|
Chingleput Medical College, Chingleput
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sathiavakesan S. Unusual findings in methyl alcohol poisoning. Indian J Ophthalmol 1969;17:121-2
During the period 10-8-67 to 26-8-67 Chingleput medical college had the unique opportunity of admitting and treating 168 cases of varnish (methyl alcohol) poisoning being admitted from the neighbouring areas which I had the priviledge of following as superintendent in charge Chingleput medical college hospital. I have been fortunate to find some unusual findings not so far reported which I thought will be useful for the profession and also for the purpose of sharing the experience of my collegues.
Out of the 168 cases 14 died. 59 cases were complaining of defective vision after consumption of varnish. Out of these 29 cases had normal vision at the time of examination and their loss of vision was obviously transient whereas in 30 cases defective vision was present. The usual findings were toxic optic neuritis (retrobulbar), in some cases extending downwards upto the disc, and some cases of retinitis. The unusual findings observed by me were various types of hemorrhages in the fundus, which were found in three out of 59 cases complaining of defective vision.
The first case was Elumalai. His right eye was normal. The left eye had 6/12 vision, the fundus showing an extensive subhyaloid hemorrhage in the lower inner quadrant with subhyaloid hemorrhage over the macula, along with soft white exudate. Follow up was not possible due to premature discharge at request.
The second case Rajagopal had flame-shaped hemorrhage near the disc along the lower nasal vessel in the left eye. This case also was discharged soon and could not be followed.
The third case was Kuppan. He had blurring of disc margin, dilated pupil with sluggish reaction. Vision in both eyes was hand-movements. The right eye had a flame shaped hemorrhage near the disc along the superior temporal vessel and a subhyaloid type of hemorrhage near the upper pole of the disc, in between the nasal and temporal vessels. The case was followed till 21-8-67. The vision improved to 6/24 in the right eye and 1/60 in the left eye. Residual loss of vision was due to immature cataract.
| Comments|| |
- Three of 59 cases who complained of defective vision had the unusual fundus findings of various types of hemorrhages.
- Routine examination of all cases might have revealed more cases with blood in the fundus, which was not possible due to the emergency with increased work load.
- Pathologically, hemorrhages of various types are reported during post mortem, in the brain in some of the cases in our series. I presume that Retina also being neural tissue suffers from the same pathology as brain and I had the fortune of seeing some of them ante mortem.
- These findings require further confirmation before authentically accepting as occurring in methyl alcohol poisoning.
- Other cases with the classical accepted finding of retrobulbar neuritis were treated with intra-muscula injections of a corticosteroid (Decardron) and of vitamin Bi and B,2 in the usual doses and retro-bulbar injections of Decardron every day. All cases regained normal vision except one which had 3!60 after one month of follow up, and the fundus showed suns of optic atrophy.
The toxic agent in varnish has been identified as methyl alcohol by chemical examination of urine and blood in some of the serious cases.
My thanks are due to the professor of forensic medicine who did the post mortem and his oral discussion regarding the findings in the brain.