Optic neuritis induced by occupational exposure to solvents – a case report

Introduction
Optic neuritis is manifested by loss of visual acuity and cecocentral scotoma, with variable prognosis, where even partial recovery can be observed. In workers exposed to neurotoxic chemicals, optic neuritis, exluding other non-occupational causes, should be considered a work-related disease.

Methods
Case report of an patient attended at the Specialized Outpatient Service of Occupational Medicine from ISCMSP

Results
42-year-old male, assistant in a domestic auto body shop since January 2009, presented sudden loss of visual acuity, bilateral. He Has reported no comorbidities or drug addiction, and the examination showed mydriatic pupils, fixed with reduction of photomotor response and bilateral papilledema. Forward to the laboratory exams, the main causes were excluded and the possibility of occupational cause was suggested. The team of Occupational Medicine visited the workplace and found that it has an area of 20 m², with no exhaust system, no ventilation and no windows. He worked the night before clinical onset with the door closed. He used about 6 cans of paint, and for each can of paint, used about 225 ml of paint thinner.

Discussion
Having the main causes of optic neuritis excluded and by the history of exposure to solvents on a high concentration and in a closed environment, the clinical condition may be related to the work. There are case reports in the literature like this, where the paint thinner was contaminated with methanol or methyl acetate, agents that cause optic neuritis. An analysis of sample of paint thinner that patient used was done, but those substances were not found. However, the hypothesis of occupational association is not discarded, since the absence in the country of mandatory registration of formulation of products such as glues,paint thinners and varnish can cause the composition varies even though the same brand or origin, but from different lots.