Acute loss of vision-an uncommon presentation of decompression sickness (DCS). A case report and review of literature
Nasser B. Al Sharari*, Imran Sadiq, Yousef Al Oufi, Omar Khan
Journal Title:Basic Research Journal of Medicine and Clinical Science
Decompression Sickness (DCS) results from gas bubble formation in the tissues of individuals who undergo a reduction in ambient pressure without adequate time to eliminate excess inert gas from body. These gas bubbles cause vascular/cellular insufficiency which is responsible for all types of clinical manifestations. DCS occurs in divers and also in those who work in compressed- air as in caissons and tunnels. It can also result from a reduction of normal barometric pressure, such as breathing in an unpressurized aircraft at high altitude. DCS has been classified as Type I , Type II and Type III named as Arterial Gas Embolism( AGE) ; In Type I, Limb and joints pain is present; while in Type II, systemic symptoms or signs, caused by the involvement of the CNS or Cardiopulmonary systems are dominant. Divers usually present with Type I DCS which can be easily recognized because of the symptom of joints pain while the neurological symptoms of Type II DCS mostly are not recognized early, while in case AGE patient have almost similar symptoms as in Type II DCS but these symptoms are more severe and rapid in onset. Neurological manifestations of DCS comprise symptoms from Cerebral hemisphere, the spinal cord, vestibular, retinal/optic nerve involvement. Retinal or optic nerve involvement results in monocular loss of vision, homonymous hemianopia, nystagmus, papilledema and rarely loss of vision. But fortunately with Hyperbaric oxygen therapy (HBOT) the recovery is rapid and complete.
Keywords: Acute vision loss, Hyperbaric Oxygen Therapy (HBOT), Decompression Sickness (DCS), Central Retinal Artery Occlusion.