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Corneal toxicity of propamidine

K J Johns1, W S Head, D M O'Day

  • 1Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, TN 37232.

Insights

Prolonged use of propamidine isethionate for Acanthamoeba keratitis can cause corneal abnormalities. Stopping the drug led to recovery, suggesting these changes mimic active infection.

Area of Science:

  • Ophthalmology
  • Microbiology
  • Pharmacology

Background:

  • Acanthamoeba keratitis is a serious eye infection.
  • Propamidine isethionate is a topical treatment used for this condition.

Observation:

  • Two patients receiving prolonged 0.1% propamidine isethionate treatment developed corneal abnormalities.
  • These changes were not associated with active Acanthamoeba infection.

Findings:

  • Corneal abnormalities resolved gradually after discontinuing propamidine isethionate.
  • No permanent damage was observed in the patients' corneas.

Implications:

  • The observed corneal changes can be mistaken for active Acanthamoeba keratitis.
  • Clinicians should consider drug-induced keratopathy when evaluating patients on prolonged propamidine isethionate therapy.

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