2009 OMIG, Abstract 19

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Itchy Eyes. Really Itchy Eyes: Poison Ivy Keratitis.
S.L. Williamson, R.S. Weinberg
Johns Hopkins University School of Medicine, Wilmer Eye Institute, and Johns Hopkins Bayview Medical Center, Baltimore, MD        

Purpose: To describe the clinical course of a patient who presented with bilateral corneal defects and decreased visual acuity coincident with poison ivy dermatitis of the hands and face.
Methods: Case report.
Results: A 35-year-old man presented with bilateral eye pain, pruritis and decreased vision. A physical exam revealed significant eyelid edema and vesicles on his lids, forehead, face and hands. Visual acuity was 20/200 in the right eye and counting fingers in the left, and slit microscopy demonstrated large corneal epithelial defects bilaterally with 1+ striae. Erythromycin ophthalmic ointment was started four times a day, and the patient was counseled to use frequent ice packs and artificial tears. Examination at one week revealed improved visual acuity, although not to baseline, superficial punctate keratitis, and stromal haze. The punctate keratitis resolved after 4 weeks, but a stromal haze persisted for 3 months. The patient reported persistent photophobia, and visual acuity remained slightly decreased from baseline. Lanolin and preservative free ointment was recommended initially, followed by a prescription for topical fluoromethalone. Examination at 3 months revealed minimal corneal haze and visual acuity of 20/30.
Conclusions: To the best of our knowledge, this is the only reported case of keratitis coincident with Toxicodendron radicans hand and facial dermatitis.  

Disclosure Code: N.