Ocular Toxicity due to Accidental Exposure to Plant Latex by Calotropis procera and Calotropis gigantea
Correspondence Address :
Dr. Shruthi Amalagondhi Manjunatha,
Near Ambari Granites, 2nd Cross Jayanagar, South Tumkur-572102, Karnataka, India.
Introduction: Calotropis is a member of the milkweed or Asclepiadeae family. The latex of Calotropis gigantea (C gigantea) contains cardiac glycosides, fatty acids and calcium oxalate. The sap of Calotropis procera (C procera) produces acidic latex. Toxic effect of latex manifests after a few hours with diminution of vision due to corneal oedema with folds in Descemetâ€™s membrane.
Aim: To evaluate the ocular toxicity by the latex of calotropis procera and calotropis gigantea due to accidental exposure.
Materials and Methods: This was a prospective observational study conducted for a duration of six months (September 2018 to February 2019) on 18 patients with alleged accidental exposure to calotropis latex. The patients were examined in the Department of Ophthalmology, Mandya Institute of Medical Sciences (MIMS), Mandya, Karnataka, India. After a thorough saline wash under topical anaesthesia, visual acuity was measured by using Snellen's chart, then patients were subjected for slit lamp biomicroscopy examination, Intraocular Pressure (IOP) measurement and undilated fundus examination and the findings were noted. Demographic details like age and sex, activity at time of injury, mode of injury were noted and follow-up was done for a period of 30 days. Data were analysed using Epi info software and descriptive statistics like mean and percentage were calculated.
Results: Total 18 patients reported with calotropis associated eye toxicity, among which 11 (61.1%) were of C gigantea and seven (38.9%) were of C procera. Out of total, seven (38.9%) were males and 11 (61.1%) females. A total of 14 (77.8%) patients presented within 24 hours of injury. Eleven (61.1%) patients had involvement of both the eyes. The main symptoms were burning, irritation, foreign body sensation and diminution of vision. Best Corrected Visual Acuity (BCVA) varied from 6/9 to 6/60. Corneal oedema or striate keratopathy was the most common sign. Corneal oedema resolved in one week in case of C procera with use of topical corticosteroids except in three cases of C gigantea which took two weeks.
Conclusion: C procera and C gigantea causes significant corneal oedema and ocular morbidity. By simple health education and occupational precaution, we can prevent ocular morbidity.
Chemical injury, Corneal oedema, Striate keratopathy
Date of Submission: Mar 23, 2021
Date of Peer Review: May 20, 2021
Date of Acceptance: Jun 29, 2021
Date of Publishing: Sep 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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• iThenticate Software: Jul 23, 2021 (9%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
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- Academic Search Complete Database
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- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)