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Case Reports
. 2009 May-Jun;57(3):232-4.
doi: 10.4103/0301-4738.49402.

Ocular toxicity by latex of Calotropis procera (Sodom apple)

Samar K Basak  1 , Arup Bhaumik, Ayan Mohanta, Prashant Singhal
Affiliations
Case Reports

Ocular toxicity by latex of Calotropis procera (Sodom apple)

Samar K Basak et al. Indian J Ophthalmol. 2009 May-Jun.

Abstract

We report the spectrum of ocular toxicity following accidental inoculation of latex of Calotropis procera (Sodom apple) in 29 eyes between January 2003 and December 2006. All patients presented with sudden painless dimness of vision with photophobia. Twenty-five (86%) patients had initial visual acuity of less than 20/60. All eyes had conjunctival congestion and mild to severe corneal edema with Descemet's folds. Three (10%) eyes had an epithelial defect, nine (31%) had iridocyclitis, and seven (24%) had associated secondary glaucoma. After treatment with topical corticosteroids, antiglaucoma agents, cycloplegics, hypertonic saline and tears supplements, 27 (93%) eyes recovered completely within 3-14 days. After three months, 17 (74%) out of 23 eyes showed a significant low endothelial cell count compared to the normal fellow eye ( P 0.001). The latex of Calotropis procera causes significant ocular morbidity which may be preventable by simple health education. The long-term effect on corneal endothelium has to be studied further.

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Figures

Figure 1a
Figure 1a
Flower and leaves of Calotropis procera
Figure 1b
Figure 1b
Garland of Calotropis procera flowers to worship Lord Shiva
Figure 2a and 2b
Figure 2a and 2b
Corneal edema and severe Descemet's folds in a patient after 48 hours
Figure 3a
Figure 3a
Right eye of one patient: specular microscopy shows normal endothelial cell count and morphology
Figure 3b
Figure 3b
Left eye of the same patient six month after the injury: specular microscopy shows polymegathism and pleomorphism with low endothelial cell count and increased corneal thickness
See this image and copyright information in PMC

Comment in

  • Ocular toxicity of Calotropis--missing links.
    Lakhtakia S, Dwivedi PC, Choudhary P, Chalisgaonkar C, Rahud J. Lakhtakia S, et al. Indian J Ophthalmol. 2010 Mar-Apr;58(2):169; author reply 169. doi: 10.4103/0301-4738.60074. Indian J Ophthalmol. 2010. PMID: 20195051 Free PMC article. No abstract available.

References

    1. Available from: http://en.wikipedia.org/wiki/calotropis_procera. [last accessed on 2007 Jul 11]
    1. Available from: http://www.himalayahealthcare.com/herbfinder/h_calotropis.htm. [last accessed on 2007 Jul 11]
    1. Muthayya RE. Madar keratitis. Proc Indian Ophthalmic Soc. 1949;10:44–7.
    1. Duke-Elder S. Injuries, Part II. Vol 14. London: Henry Kimpton; 1978. System of ophthalmology; p. 1186.
    1. Biedner B, Rothkoff L, Witztum A. Calotropis procera (Sodom apple) latex keratoconjunctivitis. Isr J Med Sci. 1977;13:914–6. - PubMed

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