Case Report

Bilateral Irreversible Blindness Following Urine Therapy to the Eyes

Fadamiro, Christianah Olufunmilayo

Pak J Ophthalmol 2018, Vol. 34, No. 2

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See end of article for authors affiliations …..……………………….. Correspondence to: Fadamiro, Christianah Olufunmilayo FWACS (Ophthal), FMC (Ophthal) Ophthalmologist Ophthalmology/ Ekiti State University Teaching Hospital, Ado-Ekiti Email: Joechrisdamiro@yahoo.com

This is a case report of a 36-year-old Nigerian photographer who suffered irreversible blindness following the use of urine as therapy for red eyes, the aftermath was devastating to the eyes, despite the resultant visual loss, and the eyes were disfigured due to bilateral anterior staphyloma. This is an avoidable case of blindness due to use of toxic agent on the eyes and calls for need of public enlightenment and eye health education on the use of self remedies for eye ailments and its untoward effects. Keywords: Blindness, Urine therapy, self-remedy.

The use of toxic agents on the eyes for ailments is a common practice in developing countries^1-3. The effect of such agents is usually devastating to the ocular tissues and can invariably lead to blindness or disfigurement of the eyes^4,5. Such toxic agents vary from one environment to the other. It can be chemical in nature or products from animals or human beings^6-8.

This case report is to highlight the disastrous effect of the use of urine on the eyes and sensitize the public on the need to avoid self-remedy for eye disorders especially toxic agents.

CASE REPORT

A 36 year old male photographer presented to the eye clinic of Ekiti State University Teaching Hospital on 12 September 2017 with loss of vision in both eyes with associated bulging of the eyes of six months’ duration.

He claimed he initially had pain, redness and discharge of both eyes of a few days’ duration for which he applied some medications, which he could not ascertain. When he realized there was no improvement, he decided to be applying his personal urine; he was questioned on why he applied urine, and the reasons given bordered solely on ignorance and misinformation.

When he realized that he could no longer see with the eyes following the application of the urine for some days, he decided to visit the primary health centre in his village and was given some eye medication, which he used for some months to no avail. He also sought spiritual help where he was given anointed olive oil without improvement.

He was consequently brought to our clinic by one of our patients who had successful cataract surgery some years back.

Clinical examination revealed an anxious looking blind young man, his visual acuity in both eyes were hand movement. The eyes were examined using both pen light and slit lamp microscope, the conjunctiva were moderately injected, the two eyes had anterior staphyloma with disorganization of the anterior segment, no further details of the other structures in the eyes.

He was placed on Gutt Ciprofloxacin 8 hourly, Oc chloramphenicol 12 hourly to both eyes, oral vitamin

Figure A Anterior view of the patient. Figure B Lateral view of the patient

Fig. A & B: Photographs of the patient’s eyes showing bilateral anterior staphyloma.

A 200,000, IU daily and vitamin C 200 mg tab 8 hourly for 2 weeks as palliatives, after which he was asked to come for follow-up.

At follow up, the patient was less anxious, even though there was no visual improvement or resolution of the anterior staphyloma. He was counseled and referred to the blind institution in the state for further rehabilitation.

DISCUSSION

The use of toxic agents as remedy for some eye conditions have been reported by various authors worldwide^1-4 Such remedies are often fraught with complications that can either lead to visual loss or impairment^4-7.

Common agents used as remedy include; chemical substances, homemade remedy, plant extracts and animal’s products, such as urine^4,7-9 The use of urine on the eye can transform a mild ocular infection into a devastating one as in this case because urine itself has ammonia which is toxic aside from the fact that the patient may be harboring some pathogenic bacterial in his urine which will further compound the keratitis.

Reasons why patients indulge in this unwholesome act include ignorance, poverty, inaccessibility to an eye care facility and some local beliefs^{7, 8, 10}.

In this case, the patient resides in a village where there is no eye care facility and having used some self-prescribed medication without prompt relief, he resulted into the use of personal urine, which was recommended by a family member with the belief that it will ameliorate the eye condition.

The resultant effect of visual loss coupled with disfigurement of the eye, which is a cosmetic embarrassment to this patient is avoidable. This kind of harmful practice is a common trend in the environment^{7, 8, 9} and there is need to institute actions that will forestall it.

CONCLUSION

There is need to create public awareness on the danger of using harmful agents and other inappropriate medication as remedy for eye ailment.

This can be achieved through public media and educating people in some large gathering such as schools, churches and mosques.

Furthermore there is need to incorporate primary eye care in all available primary health care facilities and motivate people to utilize them.

Author’s Affiliation

Dr. Fadamiro, Christianah Olufunmilayo

FWACS (Ophthal), FMC (Ophthal)

Ophthalmologist

Ophthalmology/Ekiti State University Teaching Hospital, Ado-Ekiti.

Role of Author

Dr. Fadamiro, Christianah Olufunmilayo

100% contribution by the sole author.

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