Lim Gerald C S, Chen Yeong-Fong, Liu Laura, Huang Samuel C M, Lin Ken-Kuo, Hsiao Ching-Hsi
Department of Ophthalmology, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.
Cornea. 2006 Dec;25(10):1254-6. doi: 10.1097/01.ico.0000230325.67074.e4.
To report a case of camphor-related self-inflicted keratoconjunctivitis secondary to delusions of parasitosis.
A 61-year-old man with delusions of parasitosis suffered from camphor-related self-inflicted ocular trauma that manifested with corneal epithelial defects and secondary anterior chamber reaction. Two episodes of exacerbation of the ocular conditions related to the use of camphor occurred. The left eye had secondary infection with Sternotrophomonas maltophilia and Staphylococcus aureus in the second episode of exacerbation.
The right eye recovered well with the treatment of topical lubricants and corticosteroids and had best-corrected visual acuity (BCVA) of 20/25. The infection of the left eye led to corneal perforation, necessitating penetrating keratoplasty; BCVA was hand motions because of a mature cataract. Olanzapine therapy for 1 month to decrease the delusions of parasitosis and 24-hour watch to prevent the use of camphor led to the resolution of self-inflicted keratoconjunctivitis in the patient.
Delusions of parasitosis may lead to vision-threatening self-inflicted ocular trauma. This may be the first case report of pure camphor-related self-inflicted toxic keratoconjunctivitis.
报告一例因寄生虫妄想症导致的樟脑相关的自我致伤性角膜结膜炎病例。
一名患有寄生虫妄想症的61岁男性因樟脑相关的自我致伤性眼外伤就诊，表现为角膜上皮缺损和继发性前房反应。与使用樟脑相关的眼部病情出现了两次加重。在第二次病情加重时，左眼继发嗜麦芽窄食单胞菌和金黄色葡萄球菌感染。
右眼经局部润滑剂和皮质类固醇治疗后恢复良好，最佳矫正视力（BCVA）为20/25。左眼感染导致角膜穿孔，需要进行穿透性角膜移植术；由于成熟白内障，BCVA为手动视力。使用奥氮平治疗1个月以减少寄生虫妄想症，并进行24小时监护以防止使用樟脑，患者的自我致伤性角膜结膜炎得以缓解。
寄生虫妄想症可能导致威胁视力的自我致伤性眼外伤。这可能是首例单纯樟脑相关的自我致伤性中毒性角膜结膜炎病例报告。
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