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Systemic Paraquat Intoxication Presenting with Peripheral Ulcerative Keratitis: A Case Report and Literature Review

ABSTRACT Purpose To describe a rare case of systemic paraquat poisoning presenting with peripheral ulcerative keratitis Methods Case report and literature review Results Two days after a mouthful of paraquat ingestion, a 48-year-old man presented with painful oral ulcers, abnormal liver functions, and acute kidney injury, followed by the development of crescent-shaped corneal erosions along the limbus and progressive visual impairment in both eyes. Paraquat-induced peripheral ulcerative keratitis was suspected and the patient was treated with intensive topical steroid along with systemic steroid. He recovered completely with good visual outcomes after treatment. Conclusions Peripheral ulcerative keratitis is usually an immune-mediated ocular condition, and may be a complication associated with systemic paraquat poisoning. Proper diagnosis and adequate treatment are important for visual recovery.