Ocular toxicity of sulfur mustard

This chapter describes the consequences of sulfur mustard (SM) exposure to the eyes and their treatments. Corneal SM exposure causes injuries that range from mild conjunctivitis to advanced corneal disease. As a warfare agent, SM is extremely effective because even mild ocular exposure causes some visual incapacitation and a panic and fear of blindness whose psychological impact cannot be underestimated. As for clinical symptoms, extensive military data have documented that the effects of SM vary widely according to the exposure time and concentration of the vesicant, as well as individual susceptibility. Most descriptions of the degree of ocular injury in humans characterize the phenotypes into three classes, each being a variant of mild, moderate, or severe. One of the worst consequences of SM exposure is corneal perforation. This effect can occur many weeks after exposure, and animal data are beginning to suggest that treatments for SM injury may, in themselves, contribute to toxicity. There is much research being done to identify countermeasures against mustards. There are many other promising therapies for mustard exposure but still in experimental phase.