Acute Bilateral Toxic Endotheliitis Following Alcohol Consumption

Ocul Immunol Inflamm. 2018;26(2):269-272. doi: 10.1080/09273948.2016.1201121. Epub 2016 Aug 5.

Abstract

A 28-year-old male farmer presented to our emergency service with bilateral painful visual loss for the past 7 days that occurred suddenly after alcohol consumption. Examination showed bilateral central corneal epithelial defects, 3+ stromal edema, and cortical cataracts. After treatment with oral and topical corticosteroids for 4 weeks the corneal edema had subsided completely with mild anterior stromal scarring. Rapid progression of cataract to intumescent stage warranted sequential cataract surgeries 1 and 2 months after first presentation. Postoperatively, visual acuity recovered to 20/20 and 20/30 in the right and left eye respectively. This case highlights the extremely rare presentation of bilateral alcohol-induced toxic endothelitis, which recovered after intensive corticosteroid therapy.

Keywords: Alcohol keratitis; binge drinking; corneal edema; intumescent cataract; toxic endothelitis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Alcohol Drinking / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Cataract / chemically induced*
  • Cataract / diagnosis
  • Cataract Extraction
  • Corneal Edema / chemically induced*
  • Corneal Edema / diagnosis
  • Corneal Edema / drug therapy
  • Drug Combinations
  • Endothelium, Corneal / drug effects*
  • Endothelium, Corneal / pathology
  • Ethanol / toxicity*
  • Glucocorticoids / therapeutic use
  • Humans
  • Keratitis / chemically induced*
  • Keratitis / diagnosis
  • Keratitis / drug therapy
  • Male
  • Methylprednisolone / therapeutic use
  • Ofloxacin / therapeutic use
  • Parasympatholytics / therapeutic use
  • Prednisolone / analogs & derivatives
  • Prednisolone / therapeutic use
  • Tropanes / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Glucocorticoids
  • Parasympatholytics
  • Tropanes
  • Ethanol
  • prednisolone acetate
  • homatropine
  • Prednisolone
  • Ofloxacin
  • Methylprednisolone