ascorbic-acid and Corneal-Edema

A 40-years-old female patient was referred to the cornea clinic as a probable case of bilateral keratitis. The patient had a history of headache followed by acute onset of redness, pain and discharge from both eyes for 15 days. The patient was diagnosed as bilateral keratitis by the first contact physician and was started on topical antibiotics, cycloplegics and lubricating eye-drops. At presentation, both eyes had visual acuity of perception of light, conjunctival congestion, limbal blanching, diffuse corneal oedema and epithelial defect. A detailed history revealed application of Vicks VapoRub [topical ayurvedic analgesic which contains (per 100 g of product) menthol (2.82 g), camphor (5.25 g) and eucalyptol (1.49 mL) and excipients include thymol (0.1 g), turpentine oil (5.57 mL), nutmeg oil (0.54 mL), cedar wood oil and petrolatum)] on the forehead and eyelids for headache several times over 2-3 days before the onset. The patient further confirmed the accidental application of the ointment in the eyes. A provisional diagnosis of acute chemical injury with Vicks VapoRub was made and treatment with topical antibiotic, cycloplegic, steroid, lubricant and vitamin C was started. On follow-up, both eyes showed gradual resolution of corneal oedema and epithelial defect. Visual acuity improved in the left eye to 6/60 with no change in right eye due to corneal haze.

Topics: Acute Disease; Administration, Topical; Adult; Anti-Bacterial Agents; Ascorbic Acid; Burns, Chemical; Corneal Edema; Diagnosis, Differential; Female; Headache; Humans; Keratitis; Lubricant Eye Drops; Medicine, Ayurvedic; Mydriatics; Steroids; Treatment Outcome; Visual Acuity

Topics: Accidents, Traffic; Aged; Air Bags; Anti-Bacterial Agents; Antioxidants; Ascorbic Acid; Burns, Chemical; Chloramphenicol; Conjunctiva; Conjunctivitis; Corneal Edema; Eye Burns; Female; Glucocorticoids; Humans; Lubricants; Male; Ophthalmic Solutions; Prednisolone; Sodium Hydroxide

To establish an experimental model for sulfur mustard-induced acute and delayed ocular lesions in rabbits.. Rabbit eyes were exposed to sulfur mustard (HD) vapor (370, 420 microg/l) for a period of two minutes. A three months follow-up study was carried out, based on the evaluation of clinical, biochemical and histological parameters.. HD exposure initiated typical clinical symptoms within 2-6 hrs, characterized by eye closure, eyelid swelling, conjunctival hyperemia, corneal erosions and inflammation. The clinical signs were significantly dose-dependent and reached a peak at 24--72 hrs post exposure. Biochemical evaluation of the aqueous humor exhibited an inflammatory reaction and oxidative stress at 4 hrs after exposure, subsiding at 28 hrs after exposure. Histological examination of corneas at 48 hrs revealed epithelial denudation and marked stromal edema, accompanied by cellular infiltration. Epithelial regeneration started after 72 hrs, and recovery was almost completed within 1--2 weeks, depending on the HD dose. A second phase of pathological processes started as early as two weeks post exposure and was characterized by corneal edema, opacity, recurrent erosions and neovascularization. The delayed injuries were found in 25 and 40% of the eyes respectively, and when appearing, were more severe than the initial ones.. The development of HD-induced ocular lesions in rabbits is similar to the lesions described in human casualties. Quantitative analysis of the various clinical parameters emphasizes the contribution of each tissue to the overall toxic picture. Our experimental model is useful for studying the pathological mechanisms of HD-ocular lesions, and may serve for testing potential therapies.

Topics: Acute Disease; Animals; Ascorbic Acid; Cornea; Corneal Edema; Corneal Neovascularization; Corneal Opacity; Dermatologic Agents; Dose-Response Relationship, Drug; Eye Proteins; Female; Glutathione; Models, Animal; Mustard Gas; Rabbits; Time Factors