Unexpected Culprit In Whitish Corneal Ulcer

To report the development of Gatifloxacin induced corneal precipitates in a patient with traumatic corneal ulcer.

To introduce the use of ethylene-diamine-tetra-acetic acid (EDTA) in removal of eye drops induced corneal precipitates.

Ophthalmology department -Kasr Alainy- Cairo university hospitals

We report a case of male thirty-five years old, medically free presented with traumatic corneal ulcer 4x5 mm that was managed by topical gatifloxacin eyedrops.

The epithelial defect remained of the same size for two weeks and moreover the ulcer became whitish in colour and raised over the cornea.

The case was diagnosed as gatifloxacin induced corneal plaque that was imaged using an anterior segment ocular coherence tomography.

The plaque didn't resolve after discontinuation of the treatment so debridment was tried and it was very adherent to the corneal tissues so ethylene-diamine-tetra-acetic acid (EDTA) solution 2 % was applied over it for 2 minutes and it dissolved the precipitates without the need of actual scrapping.and we found no reports in literature reporting this use of EDTA.

We resreve the success of EDTA in removal of the plaque to being a metal ion chelator that can chelate many ions including calcium.

key words: pathology of the cornea ,corneal ulcer

We conclude that the newer generation Gatifloxacin eye drops can be associated with the development of eye drops induced corneal precipitates.

We introduce a new use for EDTA solution to be used for removal of such precipitates that fail to resolve conservatively.