Keratoconjunctivitis Caused By Dieffenbachia Plant Sap: A Case Series.

BACKGROUND Over 5000 plant species produce milky latex sap utilized in decoration and various industries. Sap exposure, however, can elicit toxic reactions, including acute keratoconjunctivitis and corneal stromal infiltration. The common ornamental plant Dieffenbachia can cause acute keratoconjunctivitis and the deposition of fine blue crystals within the corneal stroma. This report analyzes 3 cases of Dieffenbachia-induced keratitis and reviews existing literature on plant-induced keratitis. CASE REPORT Three patients presented with ocular irritation, pain, and redness following accidental exposure to Dieffenbachia sap. Clinical examination revealed chemosis and corneal edema in all cases. Slit-lamp microscopy identified fine, needle-like oxalate crystals located within the epithelial and stromal layers of the inferior cornea. The 3 patients received conservative management: ocular irrigation, topical antibiotics, and localized anti-inflammatory agents. The treatment protocol was altered, depending on the clinical ocular response. When symptoms gradual improved, anti-inflammatory medication was decreased by 1 to 2 doses after 1 to 2 weeks, throughout a treatment duration of 4 to 8 weeks. Complete resolution of crystal deposits in the cornea was observed after a 4- to 8-week follow-up period. All patients retained satisfactory visual acuity and exhibited no corneal opacities. CONCLUSIONS Patients with keratitis caused by Dieffenbachia sap typically achieve full recovery without complications, but the potential for crystal deposition in the cornea must be recognized. Safety measures, including protective eyewear, gloves, and long-sleeved clothing during plant maintenance are essential. Comprehensive knowledge of the pathogenesis and clinical trajectory of ocular Dieffenbachia exposure will enable ophthalmologists to optimize treatment strategies.