Late-onset blindness

One of the most distressing effects of exposure to sulphur mustard, which appears after a considerable delay, is late onset blindness associated with keratitis of the cornea. This was reported in cases of World War I mustard exposure during the 1920s and 1930s the exact explanation for this effect seems unclear. Damage to the nerve endings of the cornea reflected in comeal anaesthesia seems to play a part. 

A (Hex A) catalyzing the biodegradation of gangliosides. Accumulation of gangliosides in lysosomes primarily affects brain neurons. In the early onset form of the disease, children become blind, deaf, and unable to swallow. Children die usually before the age of three. A late onset form ofthe disease occurs in young adults and is usually nonfatal. 

Non-insulin-dependent diabetes mellitus (NIDDM), also known as late-onset or type II diabetes, affects over 12 million Americans, only about half of whom are aware of their disease (H6). Importantly, most diabetics have the disease for 4-7 years before it is diagnosed. About 50% of men and women aged 65-74 years demonstrate glucose intolerance (i.e., increased glucose levels but below that required for a definitive diagnosis) about 20% of these have NIDDM (C3, B16). NIDDM is a major cause of cardiovascular disease, stroke, renal failure, and blindness it is also associated with accelerated aging. 

MUd cases of eye exposure usually recover in 1-2 weeks, with more severe damage taking 2-5 weeks. Temporary blindness may occur with severe comeal damage recovery takes 2-3 months. Late-onset keratitis may occur years after exposure. Permanent blindness is rare. 

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