Ocular manifestation of polychlorinated biphenyls intoxication

One hundred thirty patients with polychlorinated biphenyl (PCB) poisoning (46 males, 84 females) were examined in the department of Ophthalmology, Veterans General Hospital, Taiwan. The main ocular manifestations were profuse discharge from the eye, swelling and pigmentation of the upper lids, abnormal pigmentation of the conjunctivae, and hypersecretion and swelling of the Meibomian glands. Eye discharge was present in 104 (80.5%) of the 130 patients; swelling of upper lids was seen in 79 (60.4%); pigmentation of conjunctivae was found in 88 (67.6%); hypersecretion and cystic swelling of the Meibomian glands was seen in 92 (70.7%); and 5 patients (3.8%) required incision and drainage because of cystic formation with secondary infection of the Meibomian glands. PCB concentration in the blood was classified into five groups: 0-15 ppb, 16-40 ppb, 41-60 ppb, and over 100 ppb by gas chromatography. Positive clinical findings increased parallel to high blood PCB concentration. In particular, heavy pigmentation of conjunctivae, abnormal cystic formation and hypersecretion of the Meibomian glands occurred markedly in those patients whose blood PCB concentration was above 41 ppb. It is concluded that the severity of ocular manifestations was closely related to high blood PCB levels. Ocular signs might help not only as a guide to early diagnosis but might also serve to indicate the degree of poisoning by PCB.