A Cross Sectional Descriptive Study Of Unusual chemical keratitis Following Exposure To Diafenthiuron 50 WP Insecticide ln Farming Community In and Around Bidar District.

Abstract

Background:Diafenthiuron is an insecticide commonly used in cotton cultivation. Occupational exposure to its fumes or vapours may cause ocular surface toxicity and chemical keratitis. This study describes the clinical features, visual impairment, management, and outcomes of unusual chemical keratitis following exposure to Diafenthiuron 50 WP insecticide among individuals from agricultural communities in and around Bidar district.

Methods: A cross-sectional descriptive study was conducted at Megur Eye Care Centre, Bidar, from September 16, 2023, to December 15, 2023. Fifteen patients involving 26 eyes with chemical keratitis following exposure to Diafenthiuron insecticide fumes or vapour were evaluated. Visual acuity and slit-lamp examination with fluorescein staining were performed. Patients were treated with antimicrobial-steroid eye drops in tapering doses, lubricating eye drops and gel, analgesics, and vitamin C. Bandage contact lenses were used in eyes with epithelial defects and severe punctate erosions. Follow-up examinations were performed on the fifth day and at 15 days.

Results: Twenty of the 26 eyes had punctate corneal erosions, while six eyes had epithelial defects. At initial presentation, four eyes had severe visual impairment (<6/60), 15 had moderate visual impairment (6/12p to 6/60), and seven had mild visual impairment (≤6/12). Patients commonly presented with severe ocular pain, burning, watering, redness, blurred vision, and photophobia. All patients demonstrated good visual acuity at the final follow-up.

Conclusion: Diafenthiuron exposure can cause an unusual form of chemical keratitis characterized predominantly by punctate corneal erosions and, in some cases, epithelial defects. Although the condition showed a favourable short-term visual outcome in this study, awareness regarding the ocular hazards of pesticide exposure and appropriate protective measures is important among agricultural workers, particularly during the cotton harvesting season. Collaboration with local agricultural authorities may help reduce accidental ocular exposure.