Corneal Toxicity due to Datura Inoxia

Abstract

PurposeTo report corneal toxicity following intentional inoculation of the juice of crushed leaves of datura (Datura Inoxia).Case ReportA 70-year-old male presented with diminished vision, redness, watering, and photophobia in his right eye one day before his presentation. The patient had instilled the juice of datura leaves in his right eye to treat his ocular problems. Slit lamp examination revealed mild conjunctival and circumcorneal congestion, corneal edema, and folds in Descemet's membrane. The left eye was pseudophakic with an otherwise unremarkable examination. The patient was treated with dexamethasone, cycloplegics, and lubricants. The cornea did not sufficiently recover after one month of treatment leaving him with permanent corneal decompensation that required a referral for keratoplasty. The patient was followed up for six months. We hypothesize damage to the corneal endothelial Na+/K+-ATPase pump by tropane alkaloids as a cause for corneal decompensation.ConclusionAwareness about toxicity of this commonly grown plant in the tropics and subtropics is essential in order to avoid blindness due to accidental or deliberate use.

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“…In one case, after self-instillation of plant sap for self-therapy due to ocular problems, the tropane alkaloids caused decreased vision, redness, lacrimation, photophobia and in the course conjunctival and circumcorneal congestion, corneal oedema, and folds in Descement's membrane. With insufficient conservative therapy, keratoplasty was eventually required [16]. In addition, as described in the case of Kim et al, the flowers of the plant are used for decoration and as an ingredient in cooking.…”