National Academy of Sciences | 150 Year Anniversary

Questions? Call 800-624-6242

| Items in cart [0]

The National Academies Press

PAPERBACK
price:$111.75
add to cart

Rights & Permissions

topleft topright

Veterans at Risk: The Health Effects of Mustard Gas and Lewisite (1993)
Institute of Medicine (IOM)

Citation Manager

. "8 Ocular Effects of Mustard Agents and Lewisite." Veterans at Risk: The Health Effects of Mustard Gas and Lewisite. Washington, DC: The National Academies Press, 1993.

Please select a format:

BibTeX EndNote RefMan


Page
138
bottomleft bottomright

The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy.


Veterans at Risk: The Health Effects of Mustard Gas and Lewisite

TABLE  8-3 Characteristics of Sulfur Mustard and Lewisite Ocular  Lesions

Types

Sulfur Mustard

Lewisite

Onset of ocular action

No initial reaction; symptoms do not appear for some hours.

Immediate and painful reaction.

Pupillary reaction

Not affected.

Immediate strong miotic action.

Vascularization

Never occurs unless limbus is damaged.

Independent of the site of the primary lesion; occurs when a sufficient dose reaches the cornea or limbus.

Vascular lesions

Do not all perforate; tend to be chronic, to relapse, and to show intracorneal hemorrhages from newly formed vessels; vessels have peculiar and characteristic form.

Not all vascular lesions perforate; there are no relapses and no recurrent hemorrhages.

Cholesterin and other lipoid scars

Follow some vascular lesions, and subsequently these tend to break down (delayed mustard gas keratitis).

Do not occur, and there is no late breakdown due to them.

Perforation and loss of an eye

Caused by relatively large doses (0.005 cc), and even then are long delayed. Perforation never occurs as a primary lesion before the stage of vascularization.

Caused by relatively small doses (0.001 cc); perforation may occur within a few days without vascularization, or later after the entry of blood vessels.

Edema

Edema of the conjunctiva and cornea is present, but not excessive.

Edema of the lids and conjunctiva is immediate and severe. Edema of the cornea is extreme in all but the smallest doses.

Iris and ciliary body

Relatively little involvement. No late effect on pigment.

Early and severe involvement, followed by gradual depigmentation and shrinkage of the iris stroma.

Vessel formation

Characteristic vessels form in cornea and conjunctiva.

Corneal vessels do not show the characteristic varicosities of mustard vessels.

 

SOURCE: Adapted from Mann et al., 1946.

by loss of the conjunctival and corneal epithelial cells. Edema of the stroma developed as a consequence of endothelial cell damage and loss. From 12 to 24 hours after exposure, the conjunctiva was edematous, the endothelium of the blood vessels was lost, and an infiltrate accumulated, composed primarily of neutrophils.

The conjunctival epithelium began to regenerate two days after injury. If the corneal and limbal epithelium had been lost, conjunctival epithelium was observed to cross the limbus to resurface the cornea.

Page
138
Front Matter (R1-R20)
Executive Summary (1-8)
1 Introduction (9-13)
2 Methods of Literature Collection and Survey (14-20)
3 History and Analysis of Mustard Agent and Lewisite Research Programs in the United States (21-60)
4 Findings from the Public Hearing Process (61-70)
5 Chemistry of Sulfur Mustard and Lewisite (71-80)
6 Relationship of Mustard Agent and Lewisite Exposure to Carcinogenesis (81-111)
7 Nonmalignant Respiratory Effects of Mustard Agents and Lewisite (112-130)
8 Ocular Effects of Mustard Agents and Lewisite (131-147)
9 Dermatological Effects of Mustard Agents and Lewisite (148-178)
10 Other Physiological Effects of Mustard Agents and Lewisite (179-198)
11 Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction (199-213)
12 Summary of Findings and Recommendations (214-226)
Bibliography (227-330)
A. Scientific and Background Presentations Made to the Committee (331-334)
B. Excerpt from The Residual Effects of Warfare Gases (335-337)
C. Involvement of the National Academy of Sciences Complex in World War II Research Programs: A Summary (338-339)
D. Excerpts from Chamber Tests with Human Subjects I, II, and IX. Naval Research Laboratory Reports Nos. P-2208 and P-2579 (340-369)
E. Interim Report and Addendum: Feasibility of Developing a Cohort of Veterans Exposed to Mustard Gas During WWII Testing Programs (370-377)
F. Summary of the Department of the Army Report: Use of Volunteers in Chemical Agent Research (378-381)
G. Public Hearing Announcement (382-385)
H. Letter from Dr. Jay Katz to Dr. David P. Rall (386-389)
I. Risk Assessment Considerations for Sulfur Mustard (390-398)
J. Examination of the Effects of Certain Acute Environmental Exposures on Future Respiratory Health Consequences (399-416)
List of Acronyms and Abbreviations (417-420)
Index (421-428)