Custard apple seeds induced toxic keratoconjunctivitis

Abstract

The patient developed severe symptoms of toxic keratoconjunctivitis within 6-12 h following accidental ocular exposure to custard apple seeds (Annona squamosa) which are used as a remedy for lice/dandruff in some parts of India. A 12 year-old female child was diagnosed with custard apple seed-induced toxic keratoconjunctivitis. A patient with informed consent was enrolled. She was advised to use topical antibiotics, lubricating agents and cycloplegic eyedrops. She responded well to treatment and keratoconjunctivitis resolved in 3 weeks with complete restoration of vision in both eyes. This case highlights the importance of prevailing traditional practices. Simple health education and more public awareness of harmful effects of custard apple seeds should be created to prevent such chemical injury.