The ocular complications of mustard gas poisoning and their association with the respiratory system involvement: an experience in 112 Iranian veterans.

OBJECTIVE

To investigate ocular complications and their association with respiratory involvement in 112 patients with first exposure of mustard gas for at least 19 years ago.

DESIGN

Cross-sectional study.

PARTICIPANTS

One hundred and twelve veterans (224 eyes) with documented exposure to sulphur mustard (SM) for the first time.

METHODS

All participants were interviewed and clinically examined by an ophthalmologist and a specialist in respiratory disease. Data filed from the exposure time and regular follow-ups thereafter were reviewed. The patients were categorized in three subgroups according to the severity of respiratory system involvement as determined by spirometry (normal, mild, and moderate-severe).

RESULTS

Subjective and objective ocular problems were documented in 83.9 and 70.6% of victims, respectively. Normal, mild, and moderate-severe respiratory system problems were present in 37.5, 22.3 and 40.2% of cases, respectively. Abnormal ocular findings were severe conjunctival vascular tortuosity (65.2%, mean: 13.71 years after exposure), corneal neovascularization (19.6%, mean: 16.54 years after exposure), conjunctival/limbal vessels with ampulliform dilatation (17.9%, mean: 9.33 years after exposure), and delayed keratitis (9.8%, mean: 19.54 years after exposure). The ocular abnormal findings were significantly more frequent in victims with moderate-severe respiratory system involvement.

CONCLUSION

Structural ocular abnormalities are frequently found in patients with long-term history of mustard gas intoxication. These abnormalities are more common in severe respiratory system involvement.