[A case of optic atrophy of a lead worker (author's transl)]

We found bilateral optic atrophy and visual field defects (paracentral scotoma and blind spot enlargement) in a worker who had been engaged in lead refining work in a lead refinery factory for 30 years. The worker is a 53-year-old Japanese male with no specific family and past histories. He complained of headache and vertigo after getting up in the morning for the past several years. He had several examinations in departments of psychiatry, otorhinopharyngolaryngology, neurosurgery and ophthalmology. Abnormal findings were not obtained by neurological examinations, electroencephalography, CT scanning for the head, Doppler test for jugular, vertebral and ophthalmic arteries, and equilibrium function (nystagmus) tests, except for labyrinthine deafness. Though the environmental conditions in this factory had been much improved recently, considerable high concentrations of lead were found till around 1965. Considering the results of hematological examinations for the past 30 years, it is clear that he had been affected by lead. We suspect that the causative relationship exists between lead exposure and optic atrophy and visual field defects.