Keratoconjunctivitis Resulting From the Sap of Candelebra Cactus and the Pencil Tree

Keratouveitis caused by Euphorbia plant sap

“…tirucalli. [ 451112] Only one case of ocular toxicity with E. trigona was reported earlier by Scott et al [5] and they reported only corneal epithelial defect without edema and anterior chamber reaction. But in our Case 1, there was gross corneal edema with moderate anterior uveitis and secondary elevated IOP.…”

A Case of Acute Keratoconjunctivitis from Exposure to Latex of Euphorbia Tirucalli (Pencil Cactus)

“…Research has revealed variable differences in the toxicities associated with different Euphorbia species. Because only two other case reports have specifically identified ocular exposure to Euphorbia tirucalli, it is difficult to assess the relative toxicity of this plant's latex (3,4). The active ingredient in Euphorbia's latex has been identified as a diterpene ester, which acts as a tumor-promoting factor-a property that has been implicated in the keratoconjunctivitis seen in exposures (14).…”

“…In modern biomedical literature, reports of ocular toxicity have been reported in the German literature since 1940 but were first reported in English journals in 1964 (3,4,15). Since then, scattered case reports have appeared in the ophthalmology literature, with the largest being a clinical case series of seven patients (1).…”

“…Widely distributed in all major continents, some of these plant species are commonly found as garden weeds and decorative house plants (1,2). Cases of ocular toxicity from direct eye contact with the latex have been reported in the ophthalmology literature since 1940, ranging from keratoconjunctivitis to blindness (1,(3)(4)(5)(6)(7)(8)(9)(10). Despite the common nature of this plant species and known toxicity of its latex within ophthalmology, this problem is not well known in Emergency Medicine.…”

Euphorbia lactea Sap Keratouveitis

“…Epiphora, lid swelling, photophobia, chemosis, and anterior-chamber inflammation were also common. [2][3][4][5][6][7][8][9][10][11] Symptoms generally worsened several hours to days after exposure. Final visual acuity was 6/6 in many cases.…”