Sparfloxacin-associated corneal epithelial toxicity

Sparfloxacin is a broad-spectrum fluoroquinolone antibiotic commonly used for various bacterial corneal infections. Topical use of fluoroquinolones is considered to be safe leading to their widespread use. Common indications include blepharitis, conjunctivitis and corneal ulcers. However, unsupervised prolonged use is associated with deposition of crystalline material in the epithelial and anterior stromal layers of the cornea. These may be associated with significant visual symptoms including diminution of vision and glare/photophobia. We present a case of a 40-year-old man who was treated with topical 0.3% sparfloxacin unsupervised for a long time. The patient developed significant visual impairment due to diffuse epitheliopathy. Cessation of the drug was slowly followed by reversal of manifestations and normalisation of corneal morphology.