Abstract
Purpose :
The purpose of this study is to present the first report of ocular surface injuries from a new, non-lethal, law enforcement, ammonium propionate chemical spray called Repuls, which is being used in place of traditional pepper spray.
Methods :
This is a retrospective chart review of 3 patients seen within a 9 month period; all with significant ocular surface injuries due to exposure to Repuls. Data including duration of ocular exposure, extent of ocular surface damage, required therapies, and time to recovery were extracted from the medical records and compared to reports of ocular surface injuries from classic oleoresin capsicum pepper sprays.
Results :
All three patients had significant ocular surface injuries due to ocular exposure to Repuls during law-enforcement training events with delayed recovery compared to traditional pepper spray. The first subject sustained 1 hour of ocular exposure to Repuls prior to ocular water irrigation and developed a corneal epithelial defect that persisted for 5 days. She required 38 days of topical steroid therapy for corneal haze with persistent corneal changes noted 84 days post-exposure. The second patient sustained seconds of ocular exposure to Repuls prior to water irrigation and had a corneal epithelial defect that persisted for more than 6 days. She required 154 days of topical steroid therapy for corneal haze, 26 days of topical amniotic membrane placement, and had persistent corneal changes noted 97 days post-exposure. The third patient sustained seconds of ocular exposure to Repuls prior to water irrigation and had corneal epithelial defects that persisted less than 3 days. He did not require topical steroids or amniotic membrane and had a normal corneal exam at 17 days post-exposure. All subjects regained 20/20 vision.
Conclusions :
This is the first report in the literature regarding a new law enforcement chemical product, Repuls. The presentation of these presumed ocular surface acid burns is extremely important given that this is a new product, the injuries were sustained within close temporal proximity, and are more severe than prior reports of oleoresin capsicum pepper spray-related ocular injuries. These case presentations highlight the need to define the safe use of this new, law-enforcement, chemical spray.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.