Corneal and conjunctival toxicity from hydrogen peroxide: a patient with chronic self-induced injury.
OBJECTIVE
To report a patient with severe corneal and conjunctival toxicity from long-term, habitual use of hydrogen peroxide as an eye wash.


METHODS
Observational case report.


METHODS
Serial examinations of the cornea, conjunctiva, and ocular adnexa were done. Penetrating keratoplasty with amniotic membrane transplantation was performed.


METHODS
Ocular inflammation, pain, and visual acuity outcome.


RESULTS
Bilateral corneal and conjunctival inflammation and scarring mimicking ocular-cicatricial pemphigoid were noted. Formation of a descemetocele after starting treatment with low-dose topical steroids required emergent penetrating keratoplasty with amniotic membrane transplantation.


CONCLUSIONS
This is the first reported case of ocular surface toxicity in a patient after deliberate chronic use of high-dose hydrogen peroxide. It highlights the value of obtaining a thorough medical and social history and the importance of direct questioning about the use of any medications or agents on the eyes before making a diagnosis or initiating therapy.
Department of Ophthalmology, University of California, Irvine, 92697, USA.
Farnaz
F
Memarzadeh
Neda
N
Shamie
Ronald N
RN
Gaster
Roy S
RS
Chuck
D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D002908:Chronic Disease; D003229:Conjunctival Diseases / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D003316:Corneal Diseases / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D004483:Ectropion / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000009:adverse effects*; D015948:Keratoplasty, Penetrating; D009883:Ophthalmic Solutions / Q000009:adverse effects; D010390:Pemphigoid, Benign Mucous Membrane / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D012651:Self Medication / Q000009:adverse effects*; D007507:Therapeutic Irrigation
D000891:Anti-Infective Agents, Local; D009883:Ophthalmic Solutions; D006861:Hydrogen Peroxide