Abstract :
Background: Corneal edema following contact with plant extracts occur not only with horticultural
workers but also with amateur gardeners. The condition causes reasonable visual debility but is reversible
and self limiting. Till date, no established therapeutic protocol exists for management of this particular
condition.
Objectives: To re-examine the etiological factors behind this condition and to develop a definitive
therapeutic prescript for this problem.
Materials and Methods: Forty six patients suffering from this condition were randomly divided into two
equal groups. Group A was treated with topical steroids (commercially available moxifloxacin 0.5% w/v
dexamethasone sodium phosphate 0.1% w/v), whereas Group B was treated with a placebo (carboxy
methylcellulose 0.5% w/v). All patients were monitored on alternate days in terms of BCVA, non contact
tonometry and slit lamp examination. Pachymetry was done on arrival and after complete resolution of
corneal edema.
Results: In both the groups, corneal edema resolved in all eyes by the fifth day without any residual clinical
deficit. The mean pachymetry value on presentation in Group A was 626 microns and in Group B was 628
microns, and returned to 550 microns or below by day five in all patients. Visual acuity was restored to 6/9
or better in all patients of Group B and 96% (n= 22) patients in Group A, but this deficiency was not related
to the disease process in question.
Conclusion: Botanical toxin induced corneal edema was self limiting and resolved in a time bound pattern
without any sequel. Topical steroids neither seemed to hasten the resolution of corneal edema nor affected
the final outcome of this clinical condition in any way.
Keyword :
Calptropis gigantea, Na K pump, Corneal edema, Topical steroids, Cardiac glycosides.