Bilateral Optic Neuropathy Secondary to Fragrance Ingestion

Abstract

1.1 Methanol ingestion by accident or in suicide attempts could produce life threatening conditions, but in survivors the more frequent is optic atrophy, a condition with poor results after correct treatment. 1.2 Case: A 46 years-old male come to emergency room secondary to decrease on visual acuity in right eye. He refers that 20 days ago underwent surgery for hip prosthesis fitting without complications and 48 hours after he presented the referred symptoms. He referred to be alcoholic for the past 18 years, with ingestion of fragrances the last 20 days. At physical exam visual acuity was light perception without color discrimination in right eye, and 20/800 in left eye. Intraocular pressure in both eyes were normal. Ocular movements were abnormal, without fixation and XT 30o. Anterior segment present a pupillary defect bilaterally, with mydriasis in right pupil, no reactive to light. In left eye moderate mydriasis and reactivity. Posterior pole of right eye presented an optic disc temporal pallor and optic disc periphery pallor in left eye. Visual fields show a paracentral scotoma in right eye, right superior temporal cuadrantanopsia, left eye with paracentral temporal scotoma (60o). After management with metilprednisolone for eight months’ visual acuity in right eye was finger count at 5 cm, left eye 20/400.