# Chemical ocular trauma outbreak caused by cosmetic hair braiding and modeling ointments in Brazil

## TL;DR

A study in Brazil found that cosmetic hair ointments caused severe eye injuries, with most patients needing treatment for pain, inflammation, and corneal damage.

## Contribution

The paper reports an unprecedented outbreak of chemical eye injuries linked to specific cosmetic hair products in Brazil.

## Key findings

- Most patients experienced intense pain and photophobia, with high rates of keratitis and corneal abrasions.
- Over 80% of patients were prescribed lubricants, antibiotics, and re-epithelialization ointments.
- Approximately one-third of patients received additional treatment with corticosteroids or vitamin C.

## Abstract

To report the ophthalmological signs, symptoms, and clinical management
observed during an unprecedented outbreak of chemical ocular injuries
related to cosmetic hair ointments in Brazil.

This descriptive, cross-sectional study reviewed medical records of patients
treated at the emergency center of Fundação Altino
Ventura for chemical ocular trauma associated with cosmetic
hair ointment use between February 2022 and February 2023. Records with
incomplete medical information were excluded.

The study included 168 patients (95.2% [n=160] female), with a mean age of
30.8 ± 9.7 years. The most frequently reported symptoms at
presentation were pain (167/168, 99.4%) and photophobia (92/168, 54.8%).
Severe pain was reported by 137 patients (80%). Keratitis was present in 280
of 336 eyes (83.3%), conjunctival hyperemia in 256 eyes (76.4%), and corneal
abrasions in 174 eyes (51.8%). A decrease in visual acuity (worse than
20/25) was documented in 18.5% (31/168) of cases. Lubricants, antibiotics,
and re-epithelialization ointments were prescribed to 64.8% (109/168) of the
patients. Topical corticosteroids and oral vitamin C were administered to
34% (57/168) and 1.2% (2/168) of patients, respectively. Followup visits
were required in 19% (33/168) of cases.

The outbreak of chemical ocular injuries linked to cosmetic ointments used
for braiding and hair modeling in Brazil was marked by intense ocular pain,
conjunctival hyperemia, keratitis, and corneal abrasions. Most patients were
treated with lubricants, antibiotics, and re-epithelialization ointments,
although approximately one-fifth required followup care, and one-third
received additional treatment with either topical corticosteroids and/or
oral vitamin C.