title: Corneal injury by anti-misting agent in swim goggles: a case report.
abstract: OBJECTIVE
  To report a case of corneal injury by swim goggle anti-misting agent.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 47-year-old man presented with ocular injury caused by swim goggle anti-misting agent. Two weeks previously, the patient felt sudden ocular pain and grit after pool water flooded his goggles while swimming. Before the patient's swim, a copious amount of anti-misting agent was sprayed inside his goggles. On examination, severe corneal epithelial defect and stroma edema of the right eye were noted. Best-corrected visual acuity (BCVA) was 20/40. Right eye corneal thickness was 625 microm. Topical corticosteroids, antibiotic eye drops, and oral tetracycline were started. After 1 week of treatment, the epithelial defect of his right cornea improved slightly. Stromal edema decreased mildly. Epithelial defect persisted at 1 month follow-up. Right eye BCVA remained 20/40. Three months after treatment, the right eye epithelial defect healed completely. Mild diffuse superficial stromal opacity was noted. BCVA improved to 20/20. At 1-year follow-up, right eye corneal thickness was 547 microm, which was thinner than the left eye. Right eye corneal endothelial cell density measured approximately 1500 cells/mm2, which was less than the left eye at 2300 cells/mm2. The faint, diffuse stromal opacity disappeared; however, white subepithelial plaques were noted in the cornea centers. After 1 month of treatment with topical corticosteroids, the plaques subsided completely. The corneas remained clear at 2-year follow-up.
  
  
  CONCLUSIONS
  Anti-misting agent can cause severe corneal injuries, including persistent epithelial defects, stromal edema and opacity, endothelial cell loss, and subepithelial plaque.
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital 201, Taipei, Taiwan.
authors.forename: Kai-Ling
authors.initials: KL
authors.lastname: Peng
authors.forename: Ko-Hua
authors.initials: KH
authors.lastname: Chen
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hsu
authors.forename: Hei-Chung
authors.initials: HC
authors.lastname: Ho
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Chiang
authors.forename: Yen-Cheng
authors.initials: YC
authors.lastname: Lee
authors.forename: Jui-Yang
authors.initials: JY
authors.lastname: Lai
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002057:Burns, Chemical / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003315:Cornea / Q000473:pathology; D065306:Corneal Injuries; D004338:Drug Combinations; D000431:Ethanol / Q000009:adverse effects; D005126:Eye Burns / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D005135:Eye Protective Devices; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D000432:Methanol / Q000009:adverse effects; D008875:Middle Aged; D009883:Ophthalmic Solutions; D013501:Surface-Active Agents / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D013501:Surface-Active Agents; D000431:Ethanol; D000432:Methanol