Crack eye syndrome.

Background: Cocaine is an alkaloid prepared from the leaves of the Erythroxylon coca plant. It is widely recognized as one of the most dangerous illicit drugs in use today. The U.S. Substance Abuse and Mental Health Services Administration estimates that 23.5 million Americans have used cocaine at some time in their life. Corneal defects from crack cocaine were first described in 1989 and later named crack eye syndrome in 1993.

Case report: A 40-year-old man reported to the eye clinic reporting vigorous eye rubbing after repeated exposure to and use of crack cocaine. A corneal infiltrate with an overlying epithelial defect developed and the man was treated with ciprofloxacin, homatropine, and diclofenac. This case presents background information concerning the systemic and ocular manifestations of cocaine, as well as the clinical presentations of crack eye syndrome, with recommendations on treatment.

Conclusions: A thorough social history should be elicited when patients who have unilateral or bilateral corneal defects of unknown origin are examined, or when treating persons with no other known risk factors for corneal disruption. Prompt recognition and treatment are the main factors in successful management of crack eye syndrome.