Toxic effect of Cadmium found in eyeliner to the eye of a 21 year old Saudi woman: A case report

Abstract

Purpose: To raise the issue of increased use of traditional medicine while the Tertiary care hospitals are available to provide the appropriate care for each clinical condition. Eyeliner (Kohl) is an Arabic word denoting a fine powder with a texture and appearance similar to mascara. It is usually worn on the lid margins or inside the conjunctival sac by Middle and Far Eastern and in East Africans populations for different purposes like beauty or religious and as a treatment for many eye diseases.

Summary: We report a case of a lady who put traditional locally prepared eyeliner in her eye that resulted in severe corneal edema and faint scaring. On toxicology analysis it was discovered to contain toxic levels of Cadmium (Cd) and Lead (Pb).

Conclusion: Cd is a heavy toxic metal like Pb but has never been reported as a component of eyeliners. The most likely possible cause of the corneal clinical picture in our case is due to the toxic effect of Cd found in the traditional eyeliner (Kohl) used in Saudi Arabia.

Keywords: Cadmium; Eye; Eyeliner; Kohl; Toxic effect.

Figure 1

Biomicroscopy photo of right eye cornea at the initial presentation showing cloudy cornea.

Figure 2

Photo of the sample of the used eye liner (Kohl) showing the pink color on finger.

Figure 3a

Specular microscopy photo of the right eye showing the distorted shape of the endothelial cells.

Figure 3b

Specular microscopy photo of the normal left eye showing normal appearance of the endothelial cells.

Figure 4

Slit Lamb photo of the almost normal cornea at 3 months later.