Coral Conundrum: Treating Palytoxin-Induced Chemical Keratitis
(HealthDay News) — In a letter to the editor published online April 30 in Clinical and Experimental Ophthalmology, unilateral palytoxin-induced chemical keratitis is described after a coral expressed its toxin into the patient's eye.
Nadia L. Chaudhry, from the Manchester Royal Eye Hospital in the United Kingdom, and colleagues described the case of a 45-year-old Caucasian female coral farmer who presented one day after a coral (Palythoa sp) expressed a toxin directly into her left eye.
On examination, visual acuity in the affected eye was 6/5; eyelid swelling, conjunctival chemosis and injection, diffuse punctate epithelial erosions, and a circumferential marginal ulcer were seen on slit lamp examination. The researchers diagnosed the patient with unilateral chemical keratitis. Topical ofloxacin eye drops were prescribed six times per day, along with hourly preservative-free lubricants. The patient felt subjectively worse the next day and was started on prednisolone eye drops twice/day. The pain decreased three days later, but there was still a 360-degree circumferential marginal infiltrate. Prednisolone eye drops were increased to four times/day. The eye looked white and quiet with mild peripheral corneal scarring and persistent corneal vascularization four weeks later. Over three months the steroids were tapered; the clinical picture remained unchanged.
"This case draws attention to the danger of their toxins and we recommend the use of protective equipment (face mask, goggles, and gloves) whilst handling these coral," the authors write.