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August 28, 1981

Retinal Detachment and Vitreous Hemorrhage due to Talc Emboli

Author Affiliations

From the Jules Stein Eye Institute, Department of Ophthalmology, UCLA School of Medicine, and the Ophthalmology Section, Wadsworth Veterans Administration Medical Center, Los Angeles.

JAMA. 1981;246(9):980-981. doi:10.1001/jama.1981.03320090042027

INTRAOCULAR talc particles have been described after intravenous (IV) injection of dissolved methylphenidate hydrochloride tablets.1,2 Presumably the talc, which is used as a filler in the methylphenidate tablet, is captured in the retinal capillaries, usually in the macular region. Although mild reductions in visual acuity after a talc injection have been reported,3 in most cases visual acuity has been normal.

We report a case of bilateral severe visual loss secondary to talc emboli.

Report of a Case  A 42-year-old black man was seen in December 1979 complaining of decreased vision. A "curtain" had descended into his visual field five days previously, but the patient could not tell if it was noted while using the right or left eye.The patient had been a heroin addict from 1968 to 1976. He then changed to IV injections of dissolved methylphenidate tablets, injecting from two to six tablets a day. He