Vinblastine toxicity to the ocular surface

Local ocular exposure to antineoplastic drugs occurs either during regular use of some of these drugs in ophthalmology or accidentally during the general use of these drugs. Many ocular side effects have been described after such intentional or accidental exposures. We describe a case of accidental ocular trauma by vinblastine. As in one of the only two previously published cases of ocular trauma by vinblastine, our patient showed acute keratopathy with a drop in visual acuity followed by the development of dry eyes and a subepithelial corneal scar. In addition, in an attempt to further evaluate the clinical course and the benefits of steroid treatment, nine rabbits were studied after ocular instillation of vinblastine. After the trauma, local steroid treatment was given in one eye of each rabbit; the second eye served as a control. The animal studies showed acute conjunctivitis and keratopathy with increasing severity in the first days and improvement thereafter. That course was similar to the one manifested in our patient. Local steroid treatment in the rabbit eye had no effect as compared with the control group. A possible mechanism for the induction of dry eyes is discussed.