Toxic Keratopathy Associated with Abuse of Multiple Eye Drops-A Case Report

Purpose: To report the clinical course of a case of toxic keratopathy associated with abuse of multiple topical eye medications. Method: Case report Results: A 58-year-old male visited our out-patient department with complaints of blurred vision, redness, tearing and photophobia of both eyes. He had radial keratotomy 17 years ago and was diagnosed with primary open-angle glaucoma and herpetic keratitis two years previously. Two weeks before evaluation in our clinic, he developed stinging pain and tearing after using multiple eye drops prescribed by a hospital in mainland China. These drops included topical antibiotics, antiviral agents, antiglaucomatous agents and other drugs, such as fibroblast-growth factor. Multiple superficial punctate keratopathy, stromal edema and cell infiltrations were observed in both corneas. With a working diagnosis of toxic keratopathy, all previous medications were discontinued, and he was admitted immediately. Topical, preservative-free lubricants and mild steroids were applied. The corneal defect healed very slowly, and the vision improved. Conclusion: Toxic keratopathy may result from abusing multiple eye drops. Though the definite cause in this case was difficult to identify, cessation of all medications is the first treatment step.