An Unusual Presentation of Bilateral Chemical Burn Caused by Alkaline Ointment

Purpose: To report a case suffered from severe anterior segment inflammation with intact corneal epithelium resembling toxic anterior segment syndrome (TASS) caused by mistankenly using Chinese herbal ointment onto both eyes for several days. Methods: case report. Results: A 77-year-old female patient without ocular opearation history before suffered from bilateral progressively severe blurred vision without pain by mistakenly applied Chinese herbal ointment onto both her eyes for several days. There were no defects in the corneal epithelium initailly; however, diffuse corneal edema , severe injected conjunctiva. severe anterior chamber cells and flares, and fibrins coating on the anterior surface of lens mimicking toxic anterior segment syndrome were noted. The ocular surface was found to be alkaline when examined using strips of pH paper. B-scan ultrasonography revealed that the vitreous body was clear, with no opacity. However, corneal melting and perforation developed progressively even after repeated irrigation daily. Anterior chamber inflammation was not subsided until penetrating keratoplasty had been perormed bilaterally.