Department of Cornea and Refractive Services, Aravind Eye Hospital, Anna Nagar, Madurai, Tamil Nadu.
Cornea. 2019 Aug;38(8):948-950. doi: 10.1097/ICO.0000000000001981.
To report the clinical features and outcomes of toxic keratitis after application of powdered custard apple seeds for hair washing for head lice infestation.
Retrospective review of all patients with toxic keratitis after application of powdered custard apple seed for head lice infestation during the time period from January 2015 to December 2017. Demographic details, clinical features, and visual outcomes were documented.
Thirty-one eyes of 19 patients with toxic keratitis after application of crushed custard apple seeds for head lice infestation were included in the study. Eighteen females and 1 male with a median age of 14 years [interquartile range (IQR) 12-34 years] presented with severe epiphora, congestion, photophobia, and defective vision (median logMar visual acuity 0.4, IQR 0.2-0.8) after application of custard apple seed powder for hair washing. Ten eyes (32.2%) had an epithelial defect (median size 9 mm, IQR 5-12 mm), and 21 (67.7%) eyes had punctate epithelial erosions. All the patients were treated with topical antibiotics, and at 3 days follow-up, all of them had resolution of symptoms and signs with a median logarithm of the minimum angle of resolution (logMAR) visual acuity of 0 (IQR 0-0.2).
Health education about the harmful effect of this traditional practice for head lice infestation will prevent further similar events.
报告因应用番荔枝种子粉洗发除头虱而导致中毒性角膜炎的临床特征和转归。
回顾性分析 2015 年 1 月至 2017 年 12 月期间因应用番荔枝种子粉洗发除头虱而发生中毒性角膜炎的所有患者的资料。记录人口统计学资料、临床特征和视力结果。
本研究共纳入 19 例患者的 31 只眼，这些患者因应用番荔枝种子粉洗发除头虱而发生中毒性角膜炎。患者均为女性（18 例），1 例为男性，年龄中位数为 14 岁（四分位距 12-34 岁）。应用番荔枝种子粉洗发后，患者均出现严重溢泪、充血、畏光和视力下降（视力中位数 logMAR 为 0.4，四分位距 0.2-0.8）。10 只眼（32.2%）有上皮缺损（中位数大小为 9mm，四分位距 5-12mm），21 只眼（67.7%）有局灶性上皮糜烂。所有患者均接受了局部抗生素治疗，在 3 天随访时，所有患者的症状和体征均已缓解，视力中位数 logMAR 为 0（四分位距 0-0.2）。
对头虱传统治疗方法（即应用番荔枝种子粉洗发）的有害作用进行健康教育，将预防此类事件的再次发生。
