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A 'black cornea' secondary to topical epinephrine
Summary
Topical epinephrine therapy can cause a black cornea due to melanin deposition, not adrenochrome. This study analyzes the pigment and suggests a new binding hypothesis for this ocular side effect.
Area of Science:
- Ophthalmology
- Biochemistry
- Dermatology
Background:
- Topical epinephrine is used to treat glaucoma and other ocular conditions.
- A 'black cornea' has been anecdotally associated with epinephrine use.
- Previous hypotheses suggested adrenochrome as the causative pigment.
Observation:
- A case of black cornea secondary to topical epinephrine therapy was observed.
- The corneal lesion was surgically excised and analyzed biochemically.
Findings:
- Biochemical analysis confirmed the pigment is melanin.
- The pigment is not adrenochrome, challenging previous assumptions.
- A novel hypothesis of epinephrine-melanin binding is proposed to explain the pathogenesis.
Implications:
- This finding clarifies the etiology of black cornea in patients using topical epinephrine.
- Understanding the melanin deposition mechanism can inform future therapeutic strategies.
- Further research into epinephrine-melanin interactions may prevent or manage this ocular side effect.