[Pepper spray injuries of the anterior segment of the eye].
BACKGROUND
A wide variety of pepper sprays is currently available and gaining increasing popularity among both professional guardians and amateurs. Adverse side effects to the anterior segment of the eye are known but underestimated.


METHODS
We present two cases with severe corneal and conjunctival damage after accidental self injury by a pepper spray (Jet Protector Guardian Angel), benzyl alcohol 90.1 %, capsaicinoids 2.6 %).


RESULTS
Despite immediate and intensive irrigation, a complete epithelial defect, extensive ischemia to the limbus and the conjunctiva and a circular conjunctival chemosis were diagnosed. After slow re-epithelialization in both cases, a neurotrophic superficial keratitis, a reduced corneal sensibility and in one case deep stromal scarring were noted.


CONCLUSIONS
Pepper spray application to the eye might result in severe and permanent damage to the corneo-conjunctival tissue which is not adequately addressed in the current literature. From the present case reports arise the discussion whether the irritative and lipophilic capsacin/benzyl alcohol mixture or the pyrotechnical additives nitrocellulose und sinoxide are responsible for the anterior segment injuries.
Kniestedt
C
C
Augenklinik Kantonspital Winterthur, Winterthur, Schweiz. Christoph@Kniestedt.ch
Fleischhauer
J
J
Stürmer
J
J
Thiel
M A
MA
D000287:Administration, Topical; D000328:Adult; D002057:Burns, Chemical / Q000175:diagnosis* / Q000473:pathology; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology; D003231:Conjunctivitis / Q000139:chemically induced* / Q000473:pathology; D003315:Cornea / Q000187:drug effects* / Q000473:pathology; D019573:Epithelium, Corneal / Q000187:drug effects / Q000473:pathology; D005126:Eye Burns / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D005392:First Aid; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000139:chemically induced / Q000473:pathology; D007634:Keratitis / Q000139:chemically induced* / Q000473:pathology; D016850:Limbus Corneae / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000633:toxicity*; D007507:Therapeutic Irrigation
D010936:Plant Extracts; C018620:oleoresins