Clinico-biochemical correlation of ocular manifestations and visual prognosis in victims of hooch tragedy

Abstract

Background: Hooch tragedies are very common in India, especially in the low socioeconomic group resulting in varying mortality and morbidity. Various biochemical changes occur following methanol poisoning. An attempt is made to follow up such patients to correlate these biochemical changes and clinical presentations to the final visual outcome. Aim: To study the visual problems in the victims of acute methanol poisoning and its correlation with biochemical changes. We also studied the visual prognosis and sequel of acute methanol poisoning in correlation with the initial presentation, biochemical changes and treatment modalities. Study Design: Observational study. Materials and Methods: Twenty-nine patients attended in ophthalmology casualty of a tertiary center with history of blurring of vision after consuming illicit liquor were included in the study. Four patients presented with no perception of light, 15 patients were having poor vision (<6/18). On follow up, the two patients remained with no perception of light. Even though four patients showed initial improvement, they later deteriorated. Patients who permanently lost vision were having severe metabolic acidosis at presentation. Statistical Analysis: Was done by chi square test using SPSS 16 version software for studying the significance. Results and Conclusion: Acute methanol poisoning can badly affect the visual functions. Blood pH and serum bicarbonate level has got direct correlation with visual deficit. The presence of metabolic acidosis, if not corrected early will result in permanent visual impairment. Early intervention with hemodialysis and systemic steroids can improve the visual outcome.

Keywords

• Blood pH
• methanol
• metabolic acidosis
• optic neuropathy