Self-induced corneal crystals - A case report

The occurrence of crystalline inclusions in the conjunctiva and cornea has been previously demonstrated in systemic disorders such as cystinosis. gout, multiple myeloma, dysproteinemia, benign monoclonal gammopathy, cryoglobulinemia, reticulohistiocytoses. malignant plasmacytoma of the conjunctiva, after use of and-leprosy medications, and in chrysiasis.(1-4) An unusual form of crystalline keratopathy that appeared after accidental injury with sap of the Dieffenbachia plant has been described in two reports.(5,6) We report the case of a 40-year-old woman who presented with bilateral, asymmetric conjunctivitis and corneal crystals. Investigations did not reveal an associated systemic abnormality, leading to a suspicion of self-induced keratoconjunctivitis. She was admitted and patching of the worst affected eve resulted in resolution of corneal crystals, confirming the clinical diagnosis. This unusual form of keratoconjunctivitis artifacta can lead to diagnostic confusion if the physician is unaware of the possibility of plant sap-induced crystalline keratopathy.