Sclerokeratitis secondary to inadvertent hydrogen peroxide exposure: A rare case report

Chemical injuries to the cornea can lead to significant complications, including corneal edema, neovascularization, and persistent epithelial defects, which can severely impair vision and quality of life. However, not all chemical injuries result in severe sequelae. We present a 21-year-old female who was urgently referred to the ophthalmology clinic with complaints of left ocular pain and blurred vision that occurred during a teeth-whitening procedure involving hydrogen peroxide (H₂O₂) in a dental clinic. Slit lamp exam of the left eye revealed mild conjunctival injection and a distinct appearance of confluent intra-stromal fine air bubbles confined to the nasal cornea and adjacent sclera, consistent with chemical-induced sclerokeratitis. The patient was managed with topical prednisolone acetate 1%, moxifloxacin 0.5%, and lubricating eye drops. She regained 20/20 vision with complete resolution of the corneoscleral emphysema in a short period of time.