Xylene keratopathy: a case report and review of the literature

PURPOSE: To report a case of direct contact xylene-related vacuolar keratopathy. METHODS: Interventional case report and review of the literature. RESULTS: Xylene keratopathy is a distinct clinical entity characterized by significantly decreased visual acuity, increased corneal thickness, and the presence of corneal epithelial and stromal vacuoles on a diffuse gray stromal background. The vacuoles are diffusely scattered, subtle, and clear on slit-lamp examination. Occasionally, white, round, denser areas can also be observed. Xylene keratopathy disappeared gradually over 4 weeks with topical steroid treatment and did not cause permanent sequelae. CONCLUSIONS: Xylene exposure should be considered as possible etiologic agent of vacuolar epithelial and stromal keratopathy. Exposure may occur directly as a splash of liquid or through its vapors.