Toxic Keratouveitis Following Exposure to Plant Milk
Year: 2025
Type: article
Study design: Case Report
Abstract: A 65-year female presented with sudden painful loss of vision in the left eye over the past 2 hours, following fall of some plant milk, while gardening. Ophthalmic examination revealed visual acuity of 6/60 and intraocular pressure of 39 mmHg in the left eye. Slit-lamp examination revealed features of keratouveitis with lid edema, subconjunctival haemorrhage, central epithelial defect, mild stromal edema, diffuse medium sized fresh keratic precipitates, a fixed dilated pupil, with anterior chamber cells graded +3 and fibrin over the lens [Figure 1]. Fundus examination was unremarkable. The eye was irrigated copiously with normal saline and treated with topical antibiotic and steroid, cycloplegic, and antiglaucoma drops for 3 weeks [Figure 2].Figure 1: Image showing subconjunctival haemorrhage, corneal edema, fresh diffuse keratic precipitates, fibrin over pupil and mid dilated pupil suggestive of toxic keratouveitisFigure 2: Post treatment day 10 image showing subconjunctival haemorrhage, few Descemet folds with no keratic precipitates and pharmacologically dilated pupilThe plant was identified as Claoxylon sandwicense of the Euphorbiaceae family [Figure 3], which produces a milky latex sap containing compounds like diterpenes and phorbol esters, which can be highly irritating to the eyes.[1] Clinical course may be affected by particular species of Euphorbia, the amount of sap exposure, the time between exposure and irrigation, and host factors.[1]Figure 3: Photograph of the plant species taken by the patient as evidenceDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Authors: Shagun Korla, Gain Chand Rajput, Shreya Narang
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7107960711