The onset of symptoms may be delayed if the methanol was coingested with ethanol.
Clinical findings:
(1) nausea and vomiting (from mucosal irritation)
(2) abdominal pain
(3) pancreatitis
(4) visual symptoms and/or decreased vision, including blindness (from formic acid)
(5) anorexia
(6) headache
(7) tachypnea (with secondary respiratory alkalosis) in response to the metabolic acidosis
(8) chest pain
(9) dilation of the pupils which may or may not react to light
(10) hyperemia of the optic disc with blurred margins on fundoscopy (pseudopapullitis)
Changes in severe intoxications:
(1) cardiopulmonary failure
(2) coma
Laboratory findings:
(1) metabolic acidosis
(2) increased osmolal gap (> 25 mOsm per kg water)
(3) increased anion gap (> 20 mmol/L)
(4) elevated serum amylase
(5) elevated plasma methanol level
(6) elevated serum formic acid
