Corneal Toxicity Secondary to Latex From Asclepias curassavica in a Pediatric Patient

Abstract

To report a case of corneal milkweed toxicity on the corneal endothelium with epithelial damage in a pediatric patient. Methods:We report a case of a 13-year-old boy who presented to the emergency department with complaints of left eye pain and photophobia after direct corneal exposure to milkweed latex. He was found to have a large corneal epithelial defect and diffuse stromal edema suspected to be secondary to the cardiac glycosides present in the milkweed plant. Clinical examination and course are reported. Results:The patient was seen in the outpatient clinic on multiple visits. His epithelial defect had resolved within 3 days, and all corneal damage had healed within 18 days from injury. He was treated with antibiotic and steroid eye drops. Conclusions:Corneal exposure to cardiac glycosides from milkweed plants is known to damage the endothelial sodium-potassium pumps and to cause corneal edema and decreased visual acuity. All previously documented case reports of corneal milkweed toxicity are secondary to indirect exposure to the plant's latex. Here, we report the first case of corneal endothelial toxicity because of direct latex inoculation from an Asclepias plant and the first such toxicity reported in a pediatric patient.