Ocular Injury due to Potassium Permanganate Granules

Purpose: We report a rare case of ocular injury due to potassium permanganate (KMnO4) granules in a child. Methods: This is a retrospective case report. Results: A 2-year-old boy was transferred to our emergency room with severe pain in his right eye, inflamed eyelids, and brownish stains on his fin...

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Main Authors: Chareenun Chirapapaisan, Pinnita Prabhasawat, Sabong Srivannaboon, Vatookarn Roongpoovapatr, Piyada Chitsuthipakorn
Format: Article
Language:English
Published: Karger Publishers 2018-02-01
Series:Case Reports in Ophthalmology
Subjects:
Online Access:https://www.karger.com/Article/FullText/486922
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author Chareenun Chirapapaisan
Pinnita Prabhasawat
Sabong Srivannaboon
Vatookarn Roongpoovapatr
Piyada Chitsuthipakorn
author_facet Chareenun Chirapapaisan
Pinnita Prabhasawat
Sabong Srivannaboon
Vatookarn Roongpoovapatr
Piyada Chitsuthipakorn
author_sort Chareenun Chirapapaisan
collection DOAJ
description Purpose: We report a rare case of ocular injury due to potassium permanganate (KMnO4) granules in a child. Methods: This is a retrospective case report. Results: A 2-year-old boy was transferred to our emergency room with severe pain in his right eye, inflamed eyelids, and brownish stains on his fingers. Chemical injury was suspected. Copious eye irrigation was immediately performed. Diffuse brownish splotches were then observed at the inferior bulbar conjunctiva. Otherwise, systemic organs were intact. Complete eye exam under general anesthesia revealed a 5-mm epithelial defect at the central cornea, along with generalized conjunctival injection and limbal ischemia, inferiorly. Multiple semi-dissolved granules of KMnO4 trapped in the inferior fornix were identified. The chemical particles were gradually washed out and removed; however, the brownish stains remained. The patient received preservative-free steroid, antibiotic eye drops, and lubricants as regular management for mild to moderate degree of ocular burn. Pseudomembrane developed early and transformed into symblepharon within a few days after the injury. Membrane adhesion was lysed, and more aggressive medications were then substituted. Commercial amniotic membrane (PROKERA®) was also applied to promote wound healing and to prevent recurrence of symblepharon. The ocular surface was eventually restored, and corneal transparency was preserved. Conclusion: Ocular injury with the granular form of KMnO4 is rare. Its toxicity is comparable to concentrated KMnO4 solution. However, the dissolved particles that had been absorbed in the stained conjunctiva were continuously released and damaged the ocular surface more than we primarily anticipated. Awareness of this condition and prompt management yield a good treatment outcome.
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spelling doaj.art-42882508a19d43e5b819188bbcef14622022-12-22T02:47:45ZengKarger PublishersCase Reports in Ophthalmology1663-26992018-02-019113814310.1159/000486922486922Ocular Injury due to Potassium Permanganate GranulesChareenun ChirapapaisanPinnita PrabhasawatSabong SrivannaboonVatookarn RoongpoovapatrPiyada ChitsuthipakornPurpose: We report a rare case of ocular injury due to potassium permanganate (KMnO4) granules in a child. Methods: This is a retrospective case report. Results: A 2-year-old boy was transferred to our emergency room with severe pain in his right eye, inflamed eyelids, and brownish stains on his fingers. Chemical injury was suspected. Copious eye irrigation was immediately performed. Diffuse brownish splotches were then observed at the inferior bulbar conjunctiva. Otherwise, systemic organs were intact. Complete eye exam under general anesthesia revealed a 5-mm epithelial defect at the central cornea, along with generalized conjunctival injection and limbal ischemia, inferiorly. Multiple semi-dissolved granules of KMnO4 trapped in the inferior fornix were identified. The chemical particles were gradually washed out and removed; however, the brownish stains remained. The patient received preservative-free steroid, antibiotic eye drops, and lubricants as regular management for mild to moderate degree of ocular burn. Pseudomembrane developed early and transformed into symblepharon within a few days after the injury. Membrane adhesion was lysed, and more aggressive medications were then substituted. Commercial amniotic membrane (PROKERA®) was also applied to promote wound healing and to prevent recurrence of symblepharon. The ocular surface was eventually restored, and corneal transparency was preserved. Conclusion: Ocular injury with the granular form of KMnO4 is rare. Its toxicity is comparable to concentrated KMnO4 solution. However, the dissolved particles that had been absorbed in the stained conjunctiva were continuously released and damaged the ocular surface more than we primarily anticipated. Awareness of this condition and prompt management yield a good treatment outcome.https://www.karger.com/Article/FullText/486922Ocular injuryBurnPotassium permanganate (KMnO4)Granules
spellingShingle Chareenun Chirapapaisan
Pinnita Prabhasawat
Sabong Srivannaboon
Vatookarn Roongpoovapatr
Piyada Chitsuthipakorn
Ocular Injury due to Potassium Permanganate Granules
Case Reports in Ophthalmology
Ocular injury
Burn
Potassium permanganate (KMnO4)
Granules
title Ocular Injury due to Potassium Permanganate Granules
title_full Ocular Injury due to Potassium Permanganate Granules
title_fullStr Ocular Injury due to Potassium Permanganate Granules
title_full_unstemmed Ocular Injury due to Potassium Permanganate Granules
title_short Ocular Injury due to Potassium Permanganate Granules
title_sort ocular injury due to potassium permanganate granules
topic Ocular injury
Burn
Potassium permanganate (KMnO4)
Granules
url https://www.karger.com/Article/FullText/486922
work_keys_str_mv AT chareenunchirapapaisan ocularinjuryduetopotassiumpermanganategranules
AT pinnitaprabhasawat ocularinjuryduetopotassiumpermanganategranules
AT sabongsrivannaboon ocularinjuryduetopotassiumpermanganategranules
AT vatookarnroongpoovapatr ocularinjuryduetopotassiumpermanganategranules
AT piyadachitsuthipakorn ocularinjuryduetopotassiumpermanganategranules