Objective: To report the spectrum of clinical findings in patients with ocular inflammation caused by plant sap from Euphorbia species. Design: Clinical case series. Setting: Ophthalmology emergency referrals in the United Kingdom. Patients: We examined 7 patients, all of whom gave a history of recent ocular exposure to the sap of Euphorbia species. Interventions: All patients were treated with antibiotic drops or ointment (chloramphenicol). Cycloplegic and steroid drops were also used for some

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... patients. Patients were observed until all signs and symptoms had resolved. Main Outcome Measures: Symptoms, visual acuity, and clinical signs of inflammation. All patients provided a specimen of the plant for formal identification. Results: Initial symptoms were generally burning or stinging pain with blurred vision. In most cases, visual acuity was reduced between 1 and 2 Snellen lines. In 1 patient with agerelatedmaculopathy,acuitydroppedfrom20/80tohandmotions before recovering. Clinical findings varied from a mild epithelial keratoconjunctivitis to a severe keratitis with stromaledema,epithelialsloughing,andanterioruveitis.Allsigns and symptoms had resolved by 1 to 2 weeks. Conclusions: These cases illustrate the range of severity of Euphorbia sap keratouveitis. The condition seems to be self-limiting when managed supportively. People who work with Euphorbia plant species should wear eye protection. Clinicians managing keratopathy caused by Euphorbia species should be aware of the danger of sight-threatening infection and uveitis, particularly during the first few days.