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

Abstract

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.