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2018 ; 9
(1
): 132-137
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Ocular Injury due to Potassium Permanganate Granules
#MMPMID29643795
Chirapapaisan C
; Prabhasawat P
; Srivannaboon S
; Roongpoovapatr V
; Chitsuthipakorn P
Case Rep Ophthalmol
2018[Jan]; 9
(1
): 132-137
PMID29643795
show ga
PURPOSE: We report a rare case of ocular injury due to potassium permanganate
(KMnO(4)) 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 KMnO(4) 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 (PROKERAŽ) 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 KMnO(4) is rare. Its toxicity is comparable to concentrated KMnO(4)
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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