Toxic Optic Neuropathy Due to Mercury in Skin Lightening Products

ABSTRACT

Mercury has been described as been in daily household items such as soaps, skin-lightening creams (SLC), and topical disinfectants. Mercury exposure can reportedly cause damage to the optic nerve and retina. A 30-year-old Somali woman presented with decreased vision and was found to have bilateral optic atrophy. Neuroimaging and laboratory work-up for nutritional deficiencies, heavy metals, and syphilis were performed. Evaluation revealed normal neuroimaging and laboratory work-up except for elevated serum and urine mercury levels. Mercury levels at the initial blood test was 11.1 ug/L (normal limits < 10.0 ug/L) and was 15.7 ug/L on repeat testing. A 24-h urine test showed elevated mercury at 16 ug/24 h (normal limits < 2 ug/24 h). Evaluation of an unlabelled SLC that she was using showed the presence of mercury. It is worth testing for heavy metals in the work-up of bilateral optic atrophy. Clinicians should consider cosmetic products as a potential source of mercury exposure and recommend discontinuation if mercury is present.

KEYWORDS:

• Toxic optic neuropathy
• mercury toxicity
• optical coherence tomography
• retinal nerve fibre layer
• cosmetic products

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/01658107.2023.2251580.

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.