Corneal Toxicity due to Datura Inoxia

PURPOSE: To report corneal toxicity following intentional inoculation of the juice of crushed leaves of datura (Datura Inoxia). CASE REPORT: A 70-year-old male presented with diminished vision, redness, watering, and photophobia in his right eye one day before his presentation. The patient had instilled the juice of datura leaves in his right eye to treat his ocular problems. Slit lamp examination revealed mild conjunctival and circumcorneal congestion, corneal edema, and folds in Descemet's membrane. The left eye was pseudophakic with an otherwise unremarkable examination. The patient was treated with dexamethasone, cycloplegics, and lubricants. The cornea did not sufficiently recover after one month of treatment leaving him with permanent corneal decompensation that required a referral for keratoplasty. The patient was followed up for six months. We hypothesize damage to the corneal endothelial Na+/K+-ATPase pump by tropane alkaloids as a cause for corneal decompensation. CONCLUSION: Awareness about toxicity of this commonly grown plant in the tropics and subtropics is essential in order to avoid blindness due to accidental or deliberate use.