Toxic Optic Neuropathy Due to Mercury in Skin Lightening Products

ABSTRACTMercury has been described as been in daily household items such as soaps, skin-lightening creams (SLC), and topical disinfectants. Mercury exposure can reportedly cause damage to the optic nerve and retina. A 30-year-old Somali woman presented with decreased vision and was found to have bilateral optic atrophy. Neuroimaging and laboratory work-up for nutritional deficiencies, heavy metals, and syphilis were performed. Evaluation revealed normal neuroimaging and laboratory work-up except for elevated serum and urine mercury levels. Mercury levels at the initial blood test was 11.1 ug/L (normal limits < 10.0 ug/L) and was 15.7 ug/L on repeat testing. A 24-h urine test showed elevated mercury at 16 ug/24 h (normal limits < 2 ug/24 h). Evaluation of an unlabelled SLC that she was using showed the presence of mercury. It is worth testing for heavy metals in the work-up of bilateral optic atrophy. Clinicians should consider cosmetic products as a potential source of mercury exposure and recommend discontinuation if mercury is present.KEYWORDS: Toxic optic neuropathymercury toxicityoptical coherence tomographyretinal nerve fibre layercosmetic products Disclosure statementNo potential conflict of interest was reported by the authors.Supplementary materialSupplemental data for this article can be accessed online at https://doi.org/10.1080/01658107.2023.2251580.Additional informationFundingThe authors reported there is no funding associated with the work featured in this article.