Keratouveitis caused by Euphorbia milii sap: case report and overview

Abstract

Objective: To report a case of anterior uveitis caused by Euphorbia milii sap and review all reported cases of keratouveitis related to this species.Methods: A 64-year-old male patient presented with a 10-day history of reduced visual acuity, pain, and photophobia in the left eye after an accidental contact with Euphorbia milii sap. Best-corrected visual acuity was initially 20/200. Upon examination, ciliary injection, mild corneal edema; fine keratic precipitates, and significant anterior chamber reaction. There was no vitritis, and fundoscopy was unremarkable. The patient initiated on topical steroid and tropicamide.Results: Best-corrected visual acuity in left eye improved to 20/20 after using eyedrops for 3 weeks, associated with complete resolution of anterior uveitis. Over the following 6 months, best-corrected visual acuity remained stable, and no evidence of recurrent inflammation was observed. Conclusion:To the best of our knowledge, this is the third reported case of keratouveitis caused by Euphorbia milii sap. As observed in other cases of keratouveitis caused by sap of this species, the clinical course is benign and characterized by moderate reaction of the anterior chamber, and corneal involvement of variable intensity.

Medicinal Plants Used for Eye Conditions in Mexico—A Review

“…Such adverse reactions highlight the need for cautious and informed use of these plants for ocular conditions. Therefore, it is crucial to assess toxicological studies, particularly with members of the Euphorbia genus and other plant species known to contain milky sap or latex, which have been associated with keratouveitis from accidental ocular exposure [117,118]. The combination of pharmacological efficacy and safety assessment will be pivotal in determining which medicinal plants can be effectively and safely used as complementary or alternative therapies for ocular conditions.…”