Bilateral Total Optic Atrophy Due to Transdermal Methanol Intoxication
A 54-year-old woman was seen for progressive vision loss for the last 2 months. Her past medical history, 2 months ago, said she had pain in her feet for which she wrapped them with methylated spirit-soaked materials for 6-7 h in order to get relief from pain. She had nausea, vomiting, and unconsciousness after 2 days and was diagnosed with methanol intoxication. On neurological examination, she was comatose with dilated pupils with an absent light reflex. The Glasgow Coma Scale score was 6. After treatment in the intensive care unit for 6 days she was discharged from the hospital with progressive vision loss.\nOn ophthalmic examination, there was no light perception and no light reflex in both eyes. According to gonioscopy, the anterior chamber was deep, no new vessels were observed in the iris or angles and all quadrants of the angle were open bilaterally. Intraocular pressure was 15 mmHg in the right eye and 16 mmHg in the left eye by Goldmann’s applanation tonometry. There was no sign of uveitis on slit-lamp examination. Nystagmus was not present on the optokinetic nystagmus test. Fundoscopy disclosed bilateral total optic atrophy []. Neurological examination was unremarkable. Computed tomography revealed symmetrical putaminal necrosis and generalized cortical atrophy []. She had no signs or symptoms of intoxication except for total bilateral optic atrophy during the 4-month follow-up period.