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ARTICLE
Year : 1970  |  Volume : 18  |  Issue : 1  |  Page : 15-16

Toxic iridocyclitis caused by calotropis


Department of Ophthalmology, S. P. Medical College and Associated Hospitals, Bikaner, India

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VPS Tomar
Department of Ophthalmology, S. P. Medical College and Associated Hospitals, Bikaner
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Tomar V, Agarwal P K, Agarwal B L. Toxic iridocyclitis caused by calotropis. Indian J Ophthalmol 1970;18:15-6

How to cite this URL:
Tomar V, Agarwal P K, Agarwal B L. Toxic iridocyclitis caused by calotropis. Indian J Ophthalmol [serial online] 1970 [cited 2020 Jul 7];18:15-6. Available from: http://www.ijo.in/text.asp?1970/18/1/15/35053

Calotropis (Madar, Akdo) is a wild plant found throughout India. It occurs in two forms, Calotropis Gigantea which grows in waste lands and Calotropis Procera which generally grows in desert areas. Both these plants belong to Asclepiadaceae tamily and are closely similar to each other in chemical and physiological action. (Modi [1] ). Their active principles are Calactin, Calotropin, Calotoxin, and Uscharidin. (Watt and Breyer­Brandwij k [4] ).

A thick milky juice exudes on crushing the fresh leaves and stalk of these plants. According to Naidu [2] , the juice is acid in reaction, has specific gravity of 1021, and contains 14.8% solids. On heating or after keeping it for some time, the juice forms into a white coagulum. leaving a clear serum. The coagulum yields a yellowish brown resin and a snow-­white crystalline substance. The resin is slightly poisonous, about 8 gm. being necessary to kill a frog weighing about 20 gm. The crystalline substance is insoluble in water but is soluble in alcohol, acetone, ether and chloroform, and is non poisonous.

The serum which contains 3% solids, is highly toxic, 0.05 ml. being enough to kill a frog weighing about 10 gm., in a few minutes. (Modi [1] ). A white crystalline substance named Gigantin was isolated from serum by Pitchandi [3]. Gigantin is sparingly soluble in water but is soluble in alcohol. It is one of the most virulent poisons, being 15 to 20 times as poisonous as strychnine (Modi [1] ) .

The flowers, leaves, rootbark, and milky juice of calotropis are extensively used in the form of poultice, tincture, powder, and snuff, by practioners of indigenous medicine and also by quacks and laymen. The juice is used as a vesicant, as a depilatory, as a remedy for skin affections, and as a counter irritant and rubifacient for relief of pain. From the medico-legal point of view the juice is used for procuring criminal abortion, for purposes of suicide, infanticide, and homicide, and as cattle and arrow poison.

The purpose of this paper is to report an interesting case of toxic irido--cyclitis which occured after accidental application of calotropis juice in the eye.


  Case Report Top


M. C. one year old child was being treated for burns in the right hand, by some quack who applied calotropis juice to the burnt area as a remedy for burns. The child accidentally rubbed the right eye with the same hand and suddenly the right eye became red and painful. As stated by the mother, the child had no trouble with his eyes before. Examination of the right eye showed marked conges­tion and chemosis of bulbar conjunc­tiva. The cornea was hazy and there was marked ciliary flush. The ante­rior chamber was deep, pupil was constricted, and the iris was muddy. Slit lamp examination showed a large number of K.P.'s, and heavy aqueous flare. The left eye was normal.

The child was put on 1% atropine and hydrocortisone ointment and local fomentation, three times a day 0.5 cc of decadron was also injected subjunc­tivally, daily for three days. Within a week all the signs and symptoms subsided but an atrophic depigmented patch of iris remained.


  Comments Top


When administered internally, calo­tropis acts as a gastro-intestinal irritant and cerebrospinal poison. When dropped in the eye it produces severe irritation and chemosis of conjunctiva and anaesthesia, and the inflammatory reaction may involve the eye sight. This is the first case of iridocyclitis and atrophy of iris occurring after application of calo­tropis juice in the eye, that the authors have seen.


  Summary Top


A case of toxic iridocyclitis and atrophy of iris which occurred after accidental application of calotropis juice in the eye, has been reported. The condition subsided after treatment with atropine and cortisone.

 
  References Top

1.
Modi, N.J.; (1967) Modi's Text Book of Medical Jurisprudence and Toxicology, XVI edn. p.609-12. M. M. Tripathi Private Ltd. Bombay.  Back to cited text no. 1
    
2.
Naidu, R;(1936) Madras chemical exa­miner's annual report p.13  Back to cited text no. 2
    
3.
Pitchandi, N, (1948) J1. and proc. Inst. Chem. Vol.xx, p. 34  Back to cited text no. 3
    
4.
Watt, J.M; and Breyer-Brandwijk, MG; (1962) The medicinal and poisonous plants of southern and eastern Africa, 2nd.edn. P. 127, E & S Livingstone, Edinburgh and London.  Back to cited text no. 4
    




 

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