Corneal and conjunctival toxicity from hydrogen peroxide: a patient with chronic self-induced injury.

PURPOSE: To report a patient with severe corneal and conjunctival toxicity from long-term, habitual use of hydrogen peroxide as an eye wash.

DESIGN

Observational case report.

INTERVENTION AND TESTING: Serial examinations of the cornea, conjunctiva, and ocular adnexa were done. Penetrating keratoplasty with amniotic membrane transplantation was performed.

MAIN OUTCOME MEASURES: Ocular inflammation, pain, and visual acuity outcome.

RESULTS

Bilateral corneal and conjunctival inflammation and scarring mimicking ocular-cicatricial pemphigoid were noted. Formation of a descemetocele after starting treatment with low-dose topical steroids required emergent penetrating keratoplasty with amniotic membrane transplantation.

CONCLUSIONS

This is the first reported case of ocular surface toxicity in a patient after deliberate chronic use of high-dose hydrogen peroxide. It highlights the value of obtaining a thorough medical and social history and the importance of direct questioning about the use of any medications or agents on the eyes before making a diagnosis or initiating therapy.