Euphorbia lactea sap keratouveitis: case report and review of the literature.
OBJECTIVE
To describe a case of Euphorbia lactea sap keratouveitis and to review all reported cases of ocular toxicity caused by Euphorbia species.


METHODS
Case report and review of literature.


RESULTS
A 79-year-old woman presented 34 hours after she felt some sap of an E. lactea plant spray into her right eye. Visual acuity was counting fingers at 1 m. Examination revealed ciliary injection, 90% corneal epithelial defect, marked stromal edema with Descemet folds, and anterior-chamber flare with a 1-mm hypopyon. There was no vitreitis, and funduscopy was unremarkable. No foreign body was seen on B scan ultrasound or computed tomography scan of the orbits. Corneal scraping excluded bacterial and herpetic keratitis. Intensive topical antibiotic therapy was started with cephalothin 5% and gentamicin 0.9%, and the pupil was dilated with atropine. Topical steroids were started once the epithelial defect had healed. Examination 11 weeks after the injury revealed minimal subepithelial corneal haze and marked improvement in visual acuity.


CONCLUSIONS
To the best of our knowledge, this is only the third reported case of E. lactea sap keratouveitis. The clinical course of E. lactea sap keratouveitis is compared with that reported for other Euphorbia species.
Merani
Rohan
R
Sydney Eye Hospital, Sydney, New South Wales, Australia. rmerani@med.usyd.edu.au
Sa-Ngiampornpanit
Tarinee
T
Kerdraon
Yves
Y
Billson
Frank
F
McClellan
Kathy A
KA
D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage; D003315:Cornea / Q000187:drug effects*; D015715:Corneal Edema / Q000139:chemically induced / Q000188:drug therapy; D004359:Drug Therapy, Combination; D028481:Euphorbia / Q000737:chemistry*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000139:chemically induced* / Q000188:drug therapy; D010936:Plant Extracts / Q000009:adverse effects*; D014606:Uveitis, Anterior / Q000139:chemically induced* / Q000188:drug therapy; D014792:Visual Acuity / Q000187:drug effects
D000890:Anti-Infective Agents; D010936:Plant Extracts