CO Intoxication with Cortical Blindness

  • An-Guor Wang


A 27-year-old female presented after losing consciousness in the bathroom due to CO intoxication 2 years ago. She was sent to the emergency room of another hospital. According to her family, she woke up a few days later and experienced visual disturbances in both eyes. She came to our clinic for an ophthalmic consultation. Normal visual acuity of 6/6 was found in both eyes. Anterior segments were normal with prompt light reflexes noted in both pupils. Fundoscopic examination revealed normal eye ground (Fig. 22.1). GDx examination showed normal nerve fiber layer thickness in both eyes (Fig. 22.2). A visual field test demonstrated a specific homonymous pattern of constricted bilateral fields with vertical steps (Fig. 22.3). MRI showed multiple lesions in bilateral parieto-occipital regions with low signal on T1-weighted images and high signal on T2-weighted images, compatible with encephalomalacia (Fig. 22.4).


  1. 1.
    Prockop LD, Chichkova RI. Carbon monoxide intoxication: an updated review. J Neurol Sci. 2007;262(1–2):122–30.CrossRefPubMedGoogle Scholar
  2. 2.
    Rodkey F, O’Neal J, Collison H. Relative affinity of hemoglobin S and hemoglobin A for carbon monoxide and oxygen. Clin Chem. 1974;20:83–4.PubMedGoogle Scholar
  3. 3.
    Varon J, Marik PE, Fromm RE Jr, Gueler A. Carbon monoxide poisoning: a review for clinicians. J Emerg Med. 1999;17(1):87–93.CrossRefPubMedGoogle Scholar
  4. 4.
    Kara H, Bayir A, Ak A, Degirmenci S. Cerebrovascular ischaemia after carbon monoxide intoxication. Singap Med J. 2015;56(3):179.CrossRefGoogle Scholar
  5. 5.
    Meredith T, Vale A. Carbon monoxide poisoning. Br Med J. 1988;296:77–8.CrossRefGoogle Scholar
  6. 6.
    Ferrier D, Wallace CJ, Fletcher WA, Fong TC. Magnetic resonance features in carbon monoxide poisoning. Can Assoc Radiol J. 1994;45(6):466–8.PubMedGoogle Scholar
  7. 7.
    Sener RN. Acute carbon monoxide poisoning: diffusion MR imaging findings. AJNR Am J Neuroradiol. 2003;24(7):1475–7.PubMedGoogle Scholar
  8. 8.
    Olson KR, Seger D. Hyperbaric oxygen for carbon monoxide poisoning: does it really work? Ann Emerg Med. 1995;25:535–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Thom S, Keim L. Carbon monoxide poisoning: a review. Epidemiology, pathophysiology, clinical findings, and treatment options including hyperbaric therapy. Clin Toxicol. 1989;27:141–56.Google Scholar
  10. 10.
    Piantadosi C. The role of hyperbaric oxygen in carbon monoxide, cyanide and sulfide intoxications. Prob Resp Care. 1991;4:215–31.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • An-Guor Wang
    • 1
  1. 1.Department of OphthalmologyTaipei Veterans General Hospital, National Yang-Ming University School of Medicine, Yun-San Ophthalmology Education Research FoundationTaipeiTaiwan

Personalised recommendations