RESUMO
We report the spectrum of ocular toxicity following accidental inoculation of latex of Calotropis procera (Sodom apple) in 29 eyes between January 2003 and December 2006. All patients presented with sudden painless dimness of vision with photophobia. Twenty-five (86%) patients had initial visual acuity of less than 20/60. All eyes had conjunctival congestion and mild to severe corneal edema with Descemet's folds. Three (10%) eyes had an epithelial defect, nine (31%) had iridocyclitis, and seven (24%) had associated secondary glaucoma. After treatment with topical corticosteroids, antiglaucoma agents, cycloplegics, hypertonic saline and tears supplements, 27 (93%) eyes recovered completely within 3-14 days. After three months, 17 (74%) out of 23 eyes showed a significant low endothelial cell count compared to the normal fellow eye ( P 0.001). The latex of Calotropis procera causes significant ocular morbidity which may be preventable by simple health education. The long-term effect on corneal endothelium has to be studied further.
Assuntos
Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Calotropis/efeitos adversos , Doenças da Túnica Conjuntiva/induzido quimicamente , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/tratamento farmacológico , Edema da Córnea/induzido quimicamente , Edema da Córnea/diagnóstico , Edema da Córnea/tratamento farmacológico , Feminino , Glaucoma/induzido quimicamente , Glaucoma/diagnóstico , Glaucoma/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Iridociclite/induzido quimicamente , Iridociclite/diagnóstico , Iridociclite/tratamento farmacológico , Látex/efeitos adversos , Masculino , Pessoa de Meia-Idade , Midriáticos/uso terapêutico , Fotofobia/induzido quimicamente , Estudos Retrospectivos , Transtornos da Visão/induzido quimicamente , Acuidade VisualRESUMO
Calotropis procera produces copious amounts of latex, which has been shown to possess several pharmacological properities. Its local application produces intense inflammatory response. In the 10 cases of Calotropis procera -induced keratitis reported here, the clinical picture showed corneal edema with striate keratopathy without any evidence of intraocular inflammation. The inflammation was reversed by the local application of steroid drops.