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R. Javan, E. Jafari, N.G. Ghazi, L. Olsakovsky, S. Fallah; Acute Sulfate Keratopathy following Mineral Spring Water Bathing . Invest. Ophthalmol. Vis. Sci. 2006;47(13):69.
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© ARVO (1962-2015); The Authors (2016-present)
To describe a new keratopathy that developed following sulfate–rich spring water bathing for balneotherapy
Observational cases series of 10 patients who were referred to Khodadoust Eye Hospital in Shiraz, Iran because of ocular discomfort following hot water spring bathing
Nine males and 1 female, whose age varied from 16–36 years, underwent complete ocular evaluation. All 10 patients complained of tearing, red eyes and photophobia following balneotherapy which occurred 1 to 4 (mean 2.5) days prior to presentation. The immersion time in water ranged from 10 to 30 minutes including about half a minute during which the eyes were open. Snellen visual acuity ranged from 20/20 to 20/25. Slit lamp examination consistently disclosed brownish corneal deposits at the level of the basal epithelium in a pattern similar to that of drug induced cornea verticillata. These deposits were primarily located in the interpalpebral fissure zone and were bilateral in 9 (90%) of the patients and unilateral in only one. In addition, a variable degree of conjunctival injection was present in all cases. The corneal deposits resolved completely over a period of 7–16 days following exposure. Chemical analysis of the bathing water disclosed a sulfate level that significantly exceeded the maximum permissible value. In addition, epithelial scrapings from one of the affected eyes disclosed epithelial sulfate deposition.
This new complication associated with balneotherapy is benign and transient. In view of the reported findings, the term "acute sulfate keratopathy" is proposed. General ophthalmologists should be aware of this condition which manifests as cornea verticillata.
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