Year : 1970 | Volume
: 18 | Issue : 3 | Page : 125--127
Eye changes in methyl alcohol poisoning
JK Patel, SK Narang
Department of Ophthalmology, S. S. G. Hospital & Medical College, Baroda, India
J K Patel
Department of Ophthalmology, S. S. G. Hospital & Medical College, Baroda
|How to cite this article:|
Patel J K, Narang S K. Eye changes in methyl alcohol poisoning.Indian J Ophthalmol 1970;18:125-127
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Patel J K, Narang S K. Eye changes in methyl alcohol poisoning. Indian J Ophthalmol [serial online] 1970 [cited 2020 Oct 28 ];18:125-127
Available from: https://www.ijo.in/text.asp?1970/18/3/125/35076
Methyl alcohol, also known as wood alcohol is known to produce. acute poisoning and rapid .loss of vision in some individuals. - I n the United States many cases of poisoning from this alcohol were seen during the prohibition era when this or denatured alcohol were consumed knowingly or accidently. In India also due to poverty and prohibition this alcohol is taken on certain occasions by ignorant villagers.
Individuals vary in their susceptibility to wood alcohol and sonic degenerates consume large quantities without particularly harmful effects. On the other hand Ziegler  , reported permanent total blindness as the result of consumption of a teaspoonful of it.
Different observers have reported different fundus changes in these cases. From Roe's  observation, it would seen that optic fundi usually are normal with occasional blurring of the disc margins and tortuosity of the vessels. Pallor of the disc and narrowing of the blood vessels start within 6-12 weeks and the pallor precedes the narrowing of the vessels. Morrison  described a case in which there was pronounced cupping and increased intraocular tension. The tension was relieved by trephining operation but the cupping continued to increase until it measured 4 Diopters and the patient became blind.
Grouening  and Shannon  described cavernous optic atrophy in these cases. According to Walsh  . Secondary optic atrophy with blurring of disc and extreme narrowing of vessels are the commonest findings and rarely cavernous type of optic atrophy. During the early stages there may be retinal haemorrhages.
About visual fields Jacobson, Russet et. al.  studied eighteen cases of acute methyl alcohol poisoning and found loss of central fields bilaterally in all the cases in which field recording was possible. Peripheral fields remain normal till late. Initially fields for green are lost.
Material and Methods
These six patients were admitted to the Medical unit of S. S. G. Hospital, Baroda. They had consumed country liquor (Known as Latha) containing methyl alcohol 48 hours prior to the admission. They were referred to us for ophthalmological check up. After recording their visual acuity; perimetery and central fields were recorded wherever possible, for different coloured objects. External examination was made especially for the pupillary reactions. Pupils were dilated with 10% phenylepherine and fundus-copy was done. Progress of these cases was recorded for two weeks.
Out of six cases who had taken methylalcohol, two (case no 2 and 6) showed typical neuroretinitis. The characteristic feature in these cases was retinal oedema which was quite marked. It was peripapillary extending up to the macula. The vision in these cases was finger counting from a distance of 3-5 metres. One of these two cases (case no 2), on further examination on 7th day showed secondary optic atrophy both eyes with no perception of light. The other case (case no 6) improved gradually and vision became 6/36 both eyes on 10th day and fields recovered, slightly. This suggests an unpredictable course that these cases may take. Case no 4 started as Retrobulbarneuritis but on further examination it showed typical picture of neuroretinitis with marked retinal oedema. Ultimately it developed secondary optic atrophy with complete loss of vision in both eyes. Rest of the three cases (cases no 1, 3 and 5) showed no abnormality except case no 1 which had central scotoma for green. It disappeared on the 10th day. There was no diminution of vision in these cases. It suggests that eye changes if they are to take place usually start within 48 hours of taking alcohol. No case had cavernous type of atrophy, retinal haemorrhages or raised intraocular tension as reported in literature.
No relationship has been noticed between the amount of liquor consumed and the eye involvement.
Six cases of methyl alcohol poisoning have been reported.Eye changes if they had to take place started within 48 hours of taking alcohol.Neuroretinitis with marked retinal oedema was seen in two cases. In one case it developed optic atrophy by 7th day whereas in the other case oedema lessened and vision improved by 10th day.Central scotoma for green was noted in a case with no other changes in the eyes. It was transitory and disappeared on the 10th day.One case had retrobulbar neuritis which later developed into neuroretinitis and ultimately into secondary optic atrophy.
|1||Gruening, E.: Methyl alcohol Amblyopia clinical records and Historical study. Arch. Ophth. (Chicago) 1910, 39, 333-336.|
|2||Jacobson. B. M.: Russel. H. K. et. al. Acute. Methyl alcohol poisoning. U.S. Nav. M. Bull. 1945, 44. 1099-1106.|
|3||Morrison: Cited by Walsh, F. B.|
|4||Roe, O.: Clinical Investigations of Methyl alcohol poisoning. Acta med. Scandinav. 1943, 113: 558-608.|
|5||Shannon, C. E. G.: A case of bilateral optic atrophy due to methyl alcohol poisoning Arch. Ophth. (Chicago) 1932, 7: 813-815|
|6||Walsh. F. B.: Clinical Neuro ophthalmology Second Edition 1957.|
|7||Ziegler, S. L.: Ocular menace of wood alcohol Brit. J. Ophth. 1921, 5: 355-373. 411-417.|