A Case of Toxic Optic Neuropathy

Abstract

A 28-year-old male arrived in our Ophthalmology Out patient department (OPD) with a chief complaint of bilateral sudden loss of vision in both his eyes of three days’ duration and a history of consumption of 90 mL of alcohol five days prior to the onset of symptoms. An ophthalmic examination revealed no perception of light in both eyes. Both pupils were dilated and sluggishly reacting to light. His fundus examination showed bilateral, hyperemic, and edematous discs. The veins around the disc were mildly dilated and tortuous. Magnetic resonance imaging (MRI) brain showed symmetrical hyperintensities and hemorrhages in bilateral gangliocapsular regions and signal abnormalities areas in bilateral cerebellar hemispheres, posterior part of cerebellar vermis, bilateral cingulate gyrus showing diffusion restriction which was suggestive of toxic encephalopathy and toxic neuropathy. Fundus fluorescein angiography was also done for the patient, which showed optic disc staining in the late phase suggestive of optic neuropathy. His vision improved to 20/200 in both eyes with treatment after two months.

Keywords

• alcohol intake
• bilateral loss of vision
• disc edema
• toxic neuropathy