Neuro-ophthalmological Sequelae of Carbon Monoxide Poisoning: A Brief Case Series

Carbon-monoxide (CO) exposure causes brain damage by hypoxia resulting from binding to hemoglobin to form carboxy-hemoglobin reducing oxygen delivering capacity of blood, increasing free radical formation and cardiovascular compromise related hypotension (1). Neuro-imaging has identified basal ganglia, cortical and deep white matter injury with the latter being attributed to chronic symptoms more than the gray matter injury (2). While varying neuro-psychiatric (impaired cognitive ability, memory loss, mood disorder, personality change) and movement disorders (Parkinsonism, tremors, dystonia) have been reported, descriptions of ocular manifestations of CO poisoning are rare in our literature (3, 4). We report three patients who presented with delayed neurological sequelae (DNS) 2.5 years after accidental carbon monoxide poisoning with emphasis on their neuro ophthalmological findings.