Custard apple seed induced keratitis: a harmful traditional practice in South India

Custard apple seeds have been used as a traditional remedy for scalp infestation of lice and dandruff since many years in our part of the world. Not many people, doctors even, are aware about the ill effects of this practice. Surprisingly, there are very few reports on poisoning due to these seeds and the management is not very well streamlined. Rohit Shetty et al. highlighted the ill effects of the seeds and the need to avoid steroids in these cases as they worsen the clinical scenario. We present 2 patients who developed keratoconjunctivitis due to ocular exposure with custard apple seeds. However, we managed our cases slightly differently. We scraped off the loose epithelium and patched the eye for a day or two with topical antibiotics and lubricants. The patients responded very well. We highlight our series to describe an alternate way of treatment for cases with custard apple seed injury.