Acute Central Toxic Keratopathy Induced by Exposure to Chinese Herbal Medicine Fluid for Verruca Plana: A Case Report.

Purpose: The purpose of this study was to report a case of acute central toxic keratopathy due to exposure to Chinese herbal medicine fluid treating verruca plana. Methods: A 46-year-old woman presented with pain and blurred vision in her right eye for 3 days. Her right eye was unintentionally exposed to a medication in liquid form treating the verruca plana on her eyelids. The drug was a compound preparation with complex Chinese herbal medicinal ingredients. Results: Slit lamp examination showed central diffuse corneal subepithelial haze with granular shapes and anterior stromal opacity. Corresponding with her clinical manifestations, anterior segment optical coherence tomography revealed diffuse abnormal highly reflective signal in the anterior stroma within 349 μm and in vivo confocal microscopy found inflammatory infiltration in the subepithelial and the anterior stromal layer. Thus, tobramycin dexamethasone eye drops and artificial tears were prescribed for her, which proved effective. Her clinical symptoms and signs were both resolved after steroid treatment and remained stable at the 1-month follow-up. Conclusion: Acute central toxic keratopathy could occur after exposure to Chinese herbal medicine fluid, and enhanced topical steroid treatment worked well for alleviating inflammation and reducing corneal opacity.