Walsh & Hoyt: Tropical Optic Neuropathy

There are optic neuropathies endemic to tropical regions for which a nutritional etiology has been invoked. An early report by Strachan from Jamaica appeared in 1897. The clinical features of his patients resemble in some ways those of the epidemic cases described above. There was numbness and cramps in the hands and feet. The visual loss was bilateral and was sometimes accompanied by hearing loss. However, other features were unusual. Muscle wasting often developed. The pain was so severe that patients were kept awake. A dermatopathy was a constant finding. In any case, Strachan made no claim for a nutritional etiology. When the disorder was subsequently reevaluated by others, they concluded that this was not a nutritional disease. Despite that, some authors use Strachans syndrome to designate nutritional optic neuropathy. The eponym is inappropriate.