A 27-year-old man in the United Arab Emirates experienced complete visual recovery after acute ocular keratopathy caused by accidental exposure to the latex of the Calotropis procera plant, a case highlighting the risks and effective management of this toxic injury in endemic regions.
Initial examination showed reduced visual acuity to 6/24, with inflammation on the eye’s surface and swelling of the cornea. Following prompt irrigation and treatment with topical corticosteroids, his vision improved to 6/9 within 24 hours and fully recovered to 6/6 within one week.
A Plant-Induced Corneal Injury
Exposure to the latex of Calotropis procera, also known as ushaar, is an uncommon but clinically significant cause of toxic keratopathy, particularly in the Middle East where the plant is prevalent. The latex contains bioactive compounds like calotropin and catotoxin, which trigger an intense inflammatory response. Clinically, the injury often presents in two phases: an initial burning sensation followed by a painless decrease in vision due to the latex’s anesthetic properties, leading to corneal swelling and folds in the membrane behind it.
The man in this case rushed to wash his eye with tap water and used over-the-counter lubricating drops before seeking medical help. At the hospital, his visual acuity was 6/24, with clear signs of conjunctival congestion and superficial punctate keratitis. Imaging of the eye supported the diagnosis of corneal involvement. The case shows that prompt irrigation minimizes continued exposure and that timely corticosteroid therapy prevents permanent damage.
Effective Treatment and Recovery
The patient’s treatment involved immediate and thorough ocular irrigation, followed by a regimen of topical steroids, antibiotics, and supportive care. This approach led to a rapid clinical improvement. Within one week, his vision returned to 6/6, the cornea became clear, and the corneal thickness, measured by specular microscopy, decreased from a swollen 621 µm at presentation to 562 µm.
This outcome aligns with existing literature showing that most patients recover well with early medical intervention. The case report from Cureus emphasizes that early presentation and prompt treatment are key to achieving a complete visual recovery. Another case reported in the NIH’s National Library of Medicine described a 74-year-old man in Saudi Arabia whose vision improved after similar treatment, though his recovery was more gradual.
A Growing Concern in the Region
Due to increasing urban landscaping, desert activities, and agricultural farming in the UAE, awareness of Calotropis procera’s effects is becoming more important. The plant is also found in other parts of the Middle East, and public education is considered essential to prevent delays in diagnosis and management of such injuries.
Published studies have reported a male predominance among patients with ocular Calotropis exposure, potentially reflecting differences in occupational and environmental exposure. However, accidental exposure can affect anyone handling the plant. The clinical presentation can vary, with some cases showing more severe conjunctival congestion and corneal folds than others, but the core treatment of prompt irrigation and early steroid use remains consistent for a favorable Consistent irrigation and early steroid use remain the standard approach for ensuring a favorable outcome in these cases.
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