Keratoconjunctivitis Resulting From the Sap of Candelebra Cactus and the Pencil Tree

Abstract
Introduction The toxic effects of the topical application of plant juice on the human eye have been mentioned previously in the ophthalmic literature. Wong1 and Crawford2 reported on crown flower (Calotropis gigantea) keratoconjunctivitis. Roberg3 reported a case of conjunctivitis caused by corn cockle (Agrostemmae githago). Muthayya4 reported on madar (Calotropis gigantea) keratitis, and Grana5 on beach apple (Hippomane mancinella) conjunctivitis in soldiers. Our concern is with the more common Euphorbia. The genus Euphorbia contains nearly 1,000 species. Some of these plants are familiar as ornamental plants, ie, the poinsettia (E pulcherrima), the crown of thorns (E milii), the candelebra cactus (E lactea) (Fig 1 and 2), and the pencil tree (E tirucalli)6,7 (Fig 3 and 4). These plants characteristically produce a sticky, acrid, milky juice. This juice exudes in copious quantities from any wound in the two common South Florida species E lactea and