Correspondence

Chemical Keratoconjunctivitis from a “Foam Party”

N Engl J Med 1996; 334:474-475February 15, 1996

Article

To the Editor:

Six young men presented with various degrees of keratoconjunctivitis due to alkaline chemical burns. They had received these injuries during an evening of dancing on a dance floor covered with several feet of foam, similar in appearance to the suds in a bubble bath, raining from the ceiling. At a “foam party,” as such a dance is called, much of patrons' bodies may be covered with foam. Although the actual chemical or detergent was not identified, it was an alkaline agent. The patients had been provided with an unknown eye drop at the club (possibly artificial tears).

The patients were between the ages of 19 and 29 years (Table 1Table 1Characteristics of the Patients and Results of Eye Examinations.). They were seen four days after the incident occurred and reported eye irritation and decreased visual acuity. Their best corrected visual acuity ranged from 20/30 to 20/200. Ocular examination revealed a normal pH in five of the six; the other had a pH of 8.5 in his right eye and 8.0 in his left eye. This patient was one of two with frank corneal epithelial defects. All the patients had moderate conjunctival injection. Corneal involvement ranged from punctate epithelial defects (seen in all the patients) to frank corneal epithelial defects (seen in two patients).

The patients were treated with bacitracin ophthalmic ointment, and the eyes of the two with corneal epithelial defects were patched. Later, a topical steroid was added and the antibiotic changed to ciprofloxacin hydrochloride ophthalmic drops. Over a period of two weeks, visual acuity improved and pain and corneal epithelial defects resolved. Residual basement-membrane scarring, the only noticeable permanent change, developed in the two patients with frank corneal epithelial defects.

Eye irritation from a foam party was recently a topic of local television news in Houston. Such foam parties are a current fad. We believe such cases should be considered alkali chemical injuries and referred to an ophthalmologist immediately for treatment.

J. Christian Cather, M.D.
Richard W. Yee, M.D.
H. Kilimanjaro-Davis, M.D.
Hermann Eye Center, Houston, TX 77030-1501