A 20-year-old dental assistant had a severe case of anterior segment inflammation believed to be caused by bentonite, a component of Prophypaste. The patient's clinical course as well as animal studies, implicated bentonite as the offending agent.
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A 20-year-old dental assistant noted a foreign body sensation in her right eye while using a slow-speed drill to polish a patient's teeth with Prophypaste, She was not wearing spectacles. She immediately noticed decreased vision and photophobia and consulted her ophthalmologist who removed several opaque deposits superficially embedded in her right cornea within two hours after the injury. There was no evidence of corneal perforation or iritis. There was a residual superficial corneal infiltrate noted paracentrally, and her visual acuity was reduced to 6/21 ('1fJ170). During the next few days, an anterior uveitis developed and was treated with topically administered 1% prednisolone acetate and 1% atropine. The iritis became so severe that on two occasions parenteral adrenocorticotrophin was given. Three weeks after the injury the eye had slowly improved; the medications were gradually tapered and the patient returned to work. Two days after the cessation of topically administered ~~icosteroids (one month after the foreign body injury) a severe anterior uveitis recurred and she was referred to us. Visual acuity in the right eye was hand ~?tions at 1 foot. The conjunctiva was moderately injected, The cornea was edematous with a superfl-~ial, peripheral ~glike stromal infiltrate and a deep inferior stromal infiltrate (Fig. 1). A superficial opacity was noted at the site of the original injury. A From the Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota. This study was supported in part by Research to Prevent Blindness, Inc., and the Minnesota Lions Club (Dr. Doughman).
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