COVID casualty: Bilateral blindness due to ingestion of spurious sanitizer

Abstract

Intentional ingestion of alcohol-based handrub (ABHR) or sanitizer solution is uncommon. The coronavirus disease-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to lockdowns being put in place in many countries across the globe and resulted in a surge in ABHR usage to maintain hand hygiene. In this communication, we report the case of a 56-year-old male, a chronic alcoholic who presented during the lockdown period, with acute bilateral loss of vision following ingestion of ABHR. The handrub was found to be a nonstandardized sanitizer with no labels mentioning its constituents. Typically, the ingestion of ABHR solutions results in isopropanol or ethanol poisoning, both of which have low toxicity. Based on the clinical history and findings in our patient, a diagnosis of optic neuropathy due to accidental ingestion of sanitizer containing methyl alcohol as an unlisted ingredient was made. Our report underscores the need for strict guidelines, toxicovigilance, and surveillance systems to be in place to prevent such adulterated ABHRs from being commercially available.

COVID-19: Update on Its Ocular Involvements, and Complications From Its Treatments and Vaccinations

“…A patient developed bilateral complete vision loss within 24 hours following intentional ingestion of alcohol-based sanitizer solution. 96 Alcohol-based sanitizers usually contain ethanol, isopropyl alcohol, n-propyl alcohol, or their combinations as the major component. These agents had not been previously reported to result in vision loss.…”

“…At the beginning of the rapidly evolving pandemic, public fear and confusion regarding appropriate public health measures and behaviors to eliminate COVID-19 transmission have fuelled the dissemination of erroneous information and false beliefs. A patient developed bilateral complete vision loss within 24 hours following intentional ingestion of alcohol-based sanitizer solution 96 . Alcohol-based sanitizers usually contain ethanol, isopropyl alcohol, n-propyl alcohol, or their combinations as the major component.…”

Unravelling the Enigma of Hand Sanitizer In COVID-19 – A Bibliometric Analysis of Related Publications Over the Year

“…Methanol in formulations when inhaled or even exposed to human skin gets into the blood through dermal absorption if used very frequently (Mojica et al 2020). Ingestion or transdermal absorption of ABHRs with undisclosed methanol content has been reported to cause acute bilateral loss of vision (Kochgaway et al 2020) or even death (Overbeek et al 2021;Yip et al 2020). CDC released an advisory on a speci c methanol-based hand sanitizer manufactured in Mexico, due to the potential presence of methanol (CDC 2020).…”

Did people really drink bleach to prevent COVID-19? A guide for protecting survey data against problematic respondents

“…Such practices are commonly observed among vulnerable populations like low socioeconomic groups, teenagers, and prison inmates. There have been several documented cases of blindness and death from drinking hand sanitizer since the start of the COVID-19 pandemic [ 54 , 55 ], but in virtually all cases, people ingest and inhale sanitizer for its alcohol content and psychotropic effects [ 56 ]. It is possible that the use of sanitizer for its psychotropic effects increased at the start of COVID-19 due to the psychological toll of the pandemic, particularly on vulnerable groups.…”