Bilateral Optic Disc Edema in a Patient with Lead Poisoning.

Kaveh Abri Aghdam,Amin Zand,Mostafa Soltan Sanjari

doi:10.18502/jovr.v14i4.5465

Kaveh Abri Aghdam, Amin Zand + Show 1 more

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https://doi.org/10.18502/jovr.v14i4.5465

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Abstract

PurposeHeavy metals, such as lead can cause optic neuropathy. Optic disc neuropathy due to lead intoxication has previously been reported. We report a rare case of lead toxicity-induced optic neuropathy presenting with bilateral hemorrhagic optic disc swelling.Case ReportThe patient was a 42-year-old man with a history of chronic oral opium use, who had a gradually progressing blurred vision in both eyes over 40 days, with ataxia, paresthesia, and a toxic level of serum lead. He had been treated with lead chelators for lead poisoning. His color vision was impaired in both eyes. Humphrey's visual field test revealed double arcuate scotoma with enlargement of the blind spot. Funduscopy revealed bilateral optic disc swelling, which was confirmed on optical coherence tomography and fluorescein angiography.Conclusion In cases of optic disc edema, a comprehensive history should be taken to detect the cause. Further, in cases of chronic oral opium use, lead toxicity should be considered.

Highlights

Optic disc swelling or edema can be unilateral or bilateral
Bilateral disc edema can occur due to increased intracranial pressure (ICP), inflammatory processes, toxic agents, nutritional deficit or hypertensive emergencies.[1]
Our patient was not exposed to any of these sources or risks. He was a chronic oral opium user, and recently, the opium used by him contained lead as a chemical impurity

Summary

Introduction

Optic disc swelling or edema can be unilateral or bilateral. Bilateral disc edema can occur due to increased intracranial pressure (ICP), inflammatory processes, toxic agents, nutritional deficit or hypertensive emergencies.[1]. How to cite this article: Abri Aghdam K, Zand A, Sanjari MS.

Objectives

Conclusion