Revista Mexicana de Oftalmología

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VOLUME 97 , ISSUE 2E ( March-April, 2023 ) > List of Articles

Case Study

Irreversible and Bilateral Optic Nerve Neuropathy Induced by Oral Ingestion of an Industrial Solvent

Celia Ruiz-Arranz, José Alberto Reche-Sainz, Sara Estefanía Hernández-Almeida, Cristina Calleja-García, Manuel Ferro-Osuna

Keywords : Acute poisoning, Hypokalemia, Metabolic acidosis, Methanol, Optic neuropathy, Toluene

Citation Information : Ruiz-Arranz C, Reche-Sainz JA, Hernández-Almeida SE, Calleja-García C, Ferro-Osuna M. Irreversible and Bilateral Optic Nerve Neuropathy Induced by Oral Ingestion of an Industrial Solvent. 2023; 97 (2E):61-65.

DOI: 10.5005/rmo-11013-0016

License: CC BY-NC-ND 4.0

Published Online: 13-07-2023

Copyright Statement:  Copyright © 2023; Sociedad Mexicana de Oftalmología.


Objective: To describe the clinical manifestations and evolution of a patient with an acute intoxication due to the ingestion of paint thinner. Observations: A 35-year-old man was assisted for a picture of agitation and disorientation. He had consumed a mixture of alcohol, diazepam, and marijuana for fun, and had drunk an indeterminate amount of paint thinner containing methanol and toluene. A very severe metabolic acidosis with an increased anion gap and hypokalemia was observed, which required corrective measures of the electrolyte balance. Visual acuity was greatly decreased bilaterally to light perception, and he had mild optic disc edema that evolved to total optic atrophy, without visual improvement. Conclusions and importance of the case: In acute intoxications by methanol and toluene, both may produce severe psychoactive symptoms and metabolic acidosis. Hypokalemia with muscle weakness is characteristic of toluene, while methanol produces severe and progressive bilateral acute optic neuropathies.

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