Cocaine snorting may induce ocular surface damage through corneal sensitivity impairment.

Area of Science:

• Ophthalmology
• Toxicology
• Neuroscience

Background:

• Cocaine abuse is linked to tissue damage, but its effect on the avascular cornea is unclear.
• Corneal health depends on nerve trophic support, making it vulnerable to cocaine-induced damage.
• The pathogenesis of cocaine-related corneal lesions requires further investigation.

Purpose of the Study:

• To investigate the impact of habitual cocaine snorting on corneal sensitivity.
• To assess ocular surface health and tear function in cocaine users.
• To determine if cocaine abuse damages corneal nerves and affects tear production.

Main Methods:

• Ocular examinations, corneal sensitivity tests, and tear function tests were performed on 48 cocaine addicts.
• Controls included 22 heroin addicts and 30 drug-free individuals.
• Corneal confocal microscopy, conjunctival cytology, and tear analysis were utilized.

Main Results:

• Reduced corneal sensitivity was observed in 26 cocaine addicts.
• Six cocaine users developed neurotrophic keratitis, characterized by corneal damage, reduced tearing, and prolonged interblink time.
• No significant ocular changes were noted in heroin addicts; duration and frequency of cocaine use were key risk factors.

Conclusions:

• Ophthalmic evaluation, including corneal sensitivity testing, is essential for managing cocaine addicts to prevent vision impairment.
• Early detection of corneal damage is vital, even in the absence of symptoms.
• Sensory nerve damage should be considered in cocaine-induced lesions affecting other organs.