Department of Ophthalmology, Christus University Center (Unichristus), Fortaleza, CE, Brazil.
Advanced Retina and Cataract Center (Centro Avançado de Retina e Catarata), Fortaleza, CE, Brazil.
Am J Case Rep. 2023 Jun 8;24:e940114. doi: 10.12659/AJCR.940114.
BACKGROUND Peracetic acid is among the disinfectants that irritate the upper respiratory tract, skin, and conjunctiva. It can cause symptoms of eye irritation, secondary to an inflammatory process that can lead to various manifestations. Irritation happens due to the high reduction potential of the acid, which causes the consequent release of reactive oxygen species. This fact serves to reinforce the importance of personal protective equipment when handling peracetic acid. CASE REPORT During an accident at work, a 21-year-old patient received a strong jet of disinfectant solution directly into both eyes. The composition of the disinfectant solution was 15% peracetic acid, 15-16% hydrogen peroxide, 22-23% acetic acid, and 16-17% horticultural sanitizers. Twenty-four hours after the incident, eye damage (punctate keratitis and low visual acuity) had occurred, and was treated by washing the eye with ice water and frequently applying lubricating eye drops. The next day, the patient returned with an improvement of irritative symptoms, but with a major complaint of low visual acuity in left eye, secondary to optic neuritis, detected by fundoscopy and confirmed by optical coherence tomography. In the following week, fluorescent angiography indicated the persistence of neuritis in the left eye. This was treated with prednisone, 40 mg/day, which brought about gradual improvement. Two months later, the patient returned with test results showing normal magnetic resonance imaging and negative serologies (for syphilis, HIV, and herpes virus), visual acuity 20/20 in both eyes, and normalization of angiography and optical coherence tomography parameters. CONCLUSIONS Until now, there have been no published studies demonstrating neuritis caused by direct contact of peracetic acid into the eyes. Therefore, this is the first report in the world literature of this manifestation of ocular exposure to peracetic acid. This is a chemical formulation that is widely useful and prevents the growth of various pathogens. Further investigation and studies on the subject should be encouraged to improve its management and use.
过氧乙酸是一种会刺激上呼吸道、皮肤和结膜的消毒剂。它会引起眼部刺激症状，这是一种炎症过程导致的各种表现。刺激是由于酸的高还原电位引起的，导致随后释放活性氧。这一事实证明在处理过氧乙酸时使用个人防护设备的重要性。
在一次工作事故中，一名 21 岁的患者的双眼被一股强烈的消毒剂溶液直接喷到。消毒剂的成分是 15%过氧乙酸、15-16%过氧化氢、22-23%乙酸和 16-17%园艺消毒剂。事故发生 24 小时后，眼部出现点状角膜炎和低视力等损伤，通过用冰水冲洗眼睛和频繁滴注润滑剂进行治疗。第二天，患者返回时刺激性症状有所改善，但左眼视力严重下降，这是视神经炎引起的，通过眼底检查和光学相干断层扫描得到证实。在接下来的一周，荧光血管造影显示左眼神经炎持续存在。使用泼尼松（40mg/天）进行治疗，病情逐渐改善。两个月后，患者返回时检查结果显示磁共振成像正常，血清学检查（梅毒、HIV 和疱疹病毒）阴性，双眼视力 20/20，血管造影和光学相干断层扫描参数正常。
到目前为止，还没有发表的研究表明过氧乙酸直接接触眼睛会导致神经炎。因此，这是世界文献中首次报道这种眼部接触过氧乙酸的表现。这是一种化学配方，广泛用于防止各种病原体的生长。应鼓励进一步研究该主题，以改善其管理和使用。
