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

## TL;DR

A woman developed eye inflammation and corneal haze after exposure to a Chinese herbal medicine fluid, which was effectively treated with steroid eye drops.

## Contribution

This case report highlights a rare adverse effect of Chinese herbal medicine fluid causing acute toxic keratopathy and its successful treatment.

## Key findings

- Exposure to Chinese herbal medicine fluid caused central diffuse corneal subepithelial haze and stromal opacity.
- Treatment with tobramycin dexamethasone eye drops resolved symptoms and corneal opacity within a month.
- In vivo confocal microscopy confirmed inflammatory infiltration in the cornea following exposure.

## Abstract

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.