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Corneal and conjunctival toxicity from hydrogen peroxide: a patient with chronic self-induced injury
Farnaz Memarzadeh1, Neda Shamie, Ronald N Gaster
1Department of Ophthalmology, University of California, Irvine, 92697, USA.
Purpose:
To report a patient with severe corneal and conjunctival toxicity from long-term, habitual use of hydrogen peroxide as an eye wash.
Design:
Observational case report.
Intervention And Testing:
Serial examinations of the cornea, conjunctiva, and ocular adnexa were done. Penetrating keratoplasty with amniotic membrane transplantation was performed.
Main Outcome Measures:
Ocular inflammation, pain, and visual acuity outcome.
Results:
Bilateral corneal and conjunctival inflammation and scarring mimicking ocular-cicatricial pemphigoid were noted. Formation of a descemetocele after starting treatment with low-dose topical steroids required emergent penetrating keratoplasty with amniotic membrane transplantation.
Conclusions:
This is the first reported case of ocular surface toxicity in a patient after deliberate chronic use of high-dose hydrogen peroxide. It highlights the value of obtaining a thorough medical and social history and the importance of direct questioning about the use of any medications or agents on the eyes before making a diagnosis or initiating therapy.
