Visual manifestations of neurologic decompression sickness

Although visual changes are considered a common finding in Type II altitude-related decompression sickness (DCS), the specific symptoms have not been described. To better understand the visual symptomatology of neurologic DCS, 38 cases of neurologic DCS that identified visual changes (on file at the Davis Hyperbaric Medicine Laboratory, Brooks AFB, TX) were reviewed. Information obtained from each record included date of treatment, patient age and sex, exposure environment, maximum altitude, onset time of symptoms, clinical manifestations, treatment table type and results of therapy. Most cases (87%) resulted from altitude chamber exposure. Visual changes were reported as the initial symptom in 24% of cases, with blurred vision the most common manifestation. Hyperbaric oxygen treatment produced completely successful results in 97% of the cases. A better understanding of visual changes that occur in neurologic DCS will, we hope, lead to early diagnosis and treatment, reducing the potential for severe secondary effects and residual deficits.