Euphorbia lactea Sap Keratouveitis

Abstract

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.

Euphorbia grandicornis Sap Keratouveitis: A Case Report

“…Initial symptoms include lacrimation, pain, and photophobia with worsening symptoms and visual acuity several hours after initial sap contact, as in this case [ 3 ]. Severe keratouveitis has been associated with exposure to the sap of several Euphorbia species, including lactea , royleana , lathyris , trigona, tirucalli , peplus, cyparissias, and helioscopia but not E. grandicornis [ 2 , 3 , 4 ]. Symptoms begin immediately after contact with the sap; patients refer burning pain, photophobia and lacrimation that worsen despite treatment; central corneal epithelial defect develops 24 h later and takes several days to heal [ 3 , 4 ].…”

“…The genus Euphorbia belongs to a group of plants characterized by tall thick stems, resembling cacti, with a highly corrosive, milky sap [ 1 ]. Ocular inflammation due to Euphorbia sap is usually self-limited, though potentially blinding if left untreated [ 2 , 3 ]. Euphorbiacae keratitis is characterized by initial punctate keratopathy and progression to larger epitheliopathy, with excellent final visual outcome [ 4 ].…”

“…Euphorbiacae keratitis is characterized by initial punctate keratopathy and progression to larger epitheliopathy, with excellent final visual outcome [ 4 ]. Euphorbia sap keratouveitis has been associated with exposure to the sap of several Euphorbia species, including lactea , royleana , lathyris , trigona, tirucalli , peplus, cyparissias, and helioscopia but not Euphorbia grandicornis [ 2 , 3 , 4 ]. We present the clinical evolution of E. grandicornis (Goebel ex N.E.Br.)…”

Keratouveitis caused by Euphorbia plant sap

“…On initial examination, the corneal epithelium may be intact or with mild punctate epitheliopathy, but eventually it may show frank epithelial defect on the next day. [10] It takes around four to seven days for the epithelium to heal completely. There is stromal edema with Descemet's fold which decreases with time.…”

“…In case of suspected bacterial infection and in the presence of a hypopyon, topical corticosteroids may be started later once the epithelial defect gets healed. [10]…”