title: Calotropis procera (ushaar) keratitis.
abstract: OBJECTIVE
  To report a case of permanent endothelial cell injury after intracorneal penetration of milky latex from Calotropis procera (ushaar).
  
  
  METHODS
  Interventional case report.
  
  
  METHODS
  A 40-year-old patient developed painless corneal edema despite minimal epithelial injury after exposure to ushaar latex.
  
  
  RESULTS
  Confocal and specular microscopy confirmed permanent endothelial cell loss with morphologic alteration after intracorneal penetration of ushaar latex. Corneal edema resolved completely after 2 weeks, although reduced endothelial cell count and abnormal morphology persisted.
  
  
  CONCLUSIONS
  Ushaar latex is capable of penetrating the corneal stroma and inducing permanent loss of endothelial cells. Corneal edema resolves if sufficient endothelial cell viability is still present after resolution of ushaar keratitis.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. meddir@awalnet.net.sa
authors.forename: Hani S
authors.initials: HS
authors.lastname: Al-Mezaine
authors.forename: Ali A
authors.initials: AA
authors.lastname: Al-Rajhi
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Assiri
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wagoner
mesh_terms: D000287:Administration, Topical; D000328:Adult; D031107:Calotropis / Q000009:adverse effects*; D002452:Cell Count; D015715:Corneal Edema / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D007840:Latex / Q000009:adverse effects*; D018613:Microscopy, Confocal; D009883:Ophthalmic Solutions; D010936:Plant Extracts / Q000009:adverse effects*
chemical_list: D005938:Glucocorticoids; D007840:Latex; D009883:Ophthalmic Solutions; D010936:Plant Extracts