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Photo Essay
February 1999

Methanol-Induced Optic Nerve Cupping

Arch Ophthalmol. 1999;117(2):286. doi:10.1001/archopht.117.2.286

WHEN first seen, a 31-year-old previously healthy man was comatose after excessive alcohol consumption. He was found to have consumed methanol and was treated for metabolic acidosis and encephalopathy. On awakening, the patient was blind. Eight months later, his visual acuity was light perception OU. Pupils measured 6 mm OU and were nonreactive to light. Intraocular pressures were 11 mm Hg and 12 mm Hg, respectively. Dilated funduscopy (Figure 1 and Figure 2) showed totally cupped optic nerves. There was no residual neuroretinal rim, and the lamina cribrosa was visible throughout the base of the optic nerves. Retinal tissue, vessels, maculae, and the peripheral fundus were otherwise normal.

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