Benoxinate-Induced Keratopathy: Clinical Patterns and Management, a Cairo University Residents' Report

Purpose: To describe clinical characteristics, patterns, and management options in benoxinate-induced keratopathy. Methods: Retrospective single-center study in which patients using benoxinate hydrochloride 0.4% for greater than 1 month and present with keratopathy and/or corneal complications were enrolled. Results: A total of 36 eyes were included, 90.5% belonged to welders. Median corrected distance visual acuity (CDVA) was 2.3 logMAR (hand motion). Secondary corneal abscess was present in 47.2% of eyes and 66.7% of eyes showed ring-shaped corneal deposits. Approximately 13.9% had corneal perforation at presentation and 22.3% had marked corneal thinning. All eyes except one had varying degrees of epithelial defects, mean defect 50.7±38.1 mm 2 . Approximately 47.2% received medical treatment and 52.7% were treated surgically. Size of epithelial defect was correlated to CDVA and presence of abscess ( P =0.007 and 0.041). Choice of management was affected by size of epithelial defect and CDVA ( P <0.001 and=0.006). CDVA did not improve after reepithelialization ( P =0.157). Conclusion: Benoxinate-induced keratopathy is a potentially blinding and preventable disease. Stricter laws preventing over the counter availability is needed.