Ocular surface and respiratory tract damages from occupational, sub-chronic exposure to fluorspar: case report and other considerations

  • Pietro Emanuele Napoli
  • Matteo Nioi
  • Claudio Iovino
  • Raffaele Sanna
  • Ernesto d’Aloja
  • Maurizio Fossarello
Case Report



To report the ocular surface and respiratory tract damages due to a sub-chronic (3 months), occupational exposure to fluorspar dust in case of inconsistent use of personal protective equipment.


A 50-year-old man was referred to our clinic with bilateral conjunctival injection, ocular foreign body sensation and symptoms of ocular discomfort. He reported having 3 days before an urgent hospital admission for dyspnoea with odynophagia, hyposmia, nausea, vomiting, headache and asthenia. Otorhinolaryngological examination revealed a severe hypertrophic rhinopharyngitis and a significant decrease in overall sensitivity to olfactory stimuli. General anamnesis was negative for previous diseases or medication use.


Ocular examination revealed a diffuse injection of the ocular surface with some areas of conjunctival and limbal ischaemia, a best-corrected visual acuity of 20/25 in both eyes, an intraocular pressure of 23 and 21 mmHg, respectively, in the right and in the left eyes, and a normal fundus oculi. Assessment of the tear film and ocular surface showed the presence of dry eye disease. Based on medical history and clinical tests, initial diagnostic hypothesis was ocular surface burn due to chemical exposure, i.e. to fluorspar. Therefore, anterior segment fluorescein angiography was performed to confirm the extension of conjunctival and limbal ischaemia. Thus, ocular ischaemia was detected in approximately 10 clock hours of limbus and in 50% of conjunctiva.


The present work remarks the importance of using protective equipment for preventing ocular and respiratory tract damages in workers occupationally exposed to the ‘acid-grade fluorite’.


Ocular surface ischaemia Respiratory tract damage Fluorspar Occupational exposure 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Data availability

The authors confirm that all data underlying the findings are fully available without restriction. Authors confirm that all data underlying the findings in the present study are freely available in the manuscript. No additional data available.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

The patient involved in this case report gave written informed consent to publish the present paper.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Pietro Emanuele Napoli
    • 1
  • Matteo Nioi
    • 2
  • Claudio Iovino
    • 1
  • Raffaele Sanna
    • 1
  • Ernesto d’Aloja
    • 2
  • Maurizio Fossarello
    • 1
  1. 1.Department of Surgical Sciences, Eye ClinicUniversity of CagliariCagliariItaly
  2. 2.Department of Public Health, Clinical and Molecular Medicine, Forensic Science UnitUniversity of CagliariCagliariItaly

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