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Manchineel keratoconjunctivitis
J F Pitts1, N H Barker, D C Gibbons
1Tennent Institute of Ophthalmology, Glasgow, Scotland.
The British Journal of Ophthalmology
|May 1, 1993
Summary
Manchineel tree sap causes severe eye inflammation, including corneal damage. However, most patients achieve excellent long-term vision with prompt treatment for this toxic plant exposure.
Area of Science:
- Ophthalmology
- Toxicology
- Dermatology
Background:
- The Manchineel tree (Hippomane mancinella) is a toxic plant found in tropical regions.
- Its milky sap (latex) is known to cause severe skin and eye irritation since the 16th century.
Purpose of the Study:
- To review the ocular injuries caused by Manchineel tree exposure.
- To assess the long-term visual prognosis following Manchineel keratoconjunctivitis.
Main Methods:
- Retrospective review of 12 patients with ocular injuries from Manchineel exposure (1985-1990).
- Analysis of treatment methods including lavage, cycloplegia, and topical antibiotics.
- Evaluation of corneal damage, healing time, and final visual acuity.
Main Results:
- 16 out of 20 Manchineel exposure episodes affected the cornea, ranging from epithelial defects to stromal infiltration.
- Epithelial healing occurred within a mean of 3.75 days.
- Despite acute severity, final visual acuity was excellent (6/9 or better) in most cases, with one exception due to glaucoma.
Conclusions:
- Manchineel keratoconjunctivitis can cause significant acute corneal damage.
- Prompt treatment leads to excellent long-term visual outcomes in most cases.
- The study highlights the importance of recognizing and managing Manchineel-induced ocular toxicity.