An Unusual Presentation of Bilateral Chemical Burn Caused by Alkaline Ointment

鹼性藥膏造成的雙眼鹼性灼傷之不尋常表現

黃柔蓁(Jou-Cheng Huang) ； 周宗賢(Tsung-Hsien Chou) ； 賴麗如(Li-Ju Lai)

《中華民國眼科醫學會雜誌》 50卷1期 (2011/04) Pp. 168-172

https://doi.org/10.30048/ACTASOS.201104.0025

摘要

目的：報告一病例在塗抹不明傳統草藥藥膏於眼部造成前房之發炎反應但仍保持完整角膜上皮之不尋常鹼性灼傷表現。方法：病例報告。結果：一名77歲女性病患幾天前誤用某種不明傳統草藥藥膏塗抹於雙眼，角膜上皮並無缺損但有瀰漫性的角膜水腫和嚴重的前房發炎反應，如同毒性前房症候群的表現，並有前房積血及纖維蛋白覆蓋於水晶體表面，眼表面經酸鹼試紙測試發現微弱鹼性反應，超音波檢查眼內玻璃體清澈無混濁，在重複大量沖洗後，雙眠角膜仍逐漸溶解並穿孔。結論：眼表的異常酸鹼狀態可能會造成嚴重的前房發炎反應，無論致病因素為不明的草藥成分或是鹼性成分，治療首要目標皆為恢復眼表面的正常酸鹼值並及時使用抗發炎藥物如類固醇藥物。

並列摘要

Purpose: To report a case suffered from severe anterior segment inflammation with intact corneal epithelium resembling toxic anterior segment syndrome (TASS) caused by mistankenly using Chinese herbal ointment onto both eyes for several days. Methods: case report. Results: A 77-year-old female patient without ocular opearation history before suffered from bilateral progressively severe blurred vision without pain by mistakenly applied Chinese herbal ointment onto both her eyes for several days. There were no defects in the corneal epithelium initailly; however, diffuse corneal edema , severe injected conjunctiva. severe anterior chamber cells and flares, and fibrins coating on the anterior surface of lens mimicking toxic anterior segment syndrome were noted. The ocular surface was found to be alkaline when examined using strips of pH paper. B-scan ultrasonography revealed that the vitreous body was clear, with no opacity. However, corneal melting and perforation developed progressively even after repeated irrigation daily. Anterior chamber inflammation was not subsided until penetrating keratoplasty had been perormed bilaterally.

並列關鍵字

Chemical burn,Alkali ； Anterior chamber inflammation ； Toxic anterior segment syndrome