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November 1988

Corneal Toxicity From Hydrogen Peroxide-Soaked Tonometer Tips

Author Affiliations

Ann Arbor, Mich

Arch Ophthalmol. 1988;106(11):1505. doi:10.1001/archopht.1988.01060140673012

To the Editor.  —Hydrogen peroxide solution has been recommended as a disinfectant for tonometer tips, ophthalmic instruments, and trial contact lenses to prevent the transmission of viruses, especially human immunodeficiency virus.1 Commercially available hydrogen peroxide solutions are also used for home disinfection of contact lenses. We report a case in which an applanation tonometer tip soaked in hydrogen peroxide solution caused corneal toxicity.

Report of a Case.  —A 50-year-old man had undergone penetrating keratoplasty of the right eye six years previously for keratoconus. On follow-up examination, he had a clear graft with 20/20 visual acuity OD. During applanation tonometry he noted immediate discomfort and blurring of vision. As was customary in the clinic, the tonometer tip that was used had been left soaking in a plastic medicine cup containing 3% H2O2 solution (Hydrox Chemical Co, Elk Grove Village, Ill). The solution had evaporated overnight, and the

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