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    By Rasik B. Vajpayee, MD; Namrata Sharma,, MD MBBS; Tushar Agarwal, MD; Vishal Jhanji, MD
    AAO 2014
    Comprehensive Ophthalmology

    Chuna, calcium hydroxide paste, is a chewing tobacco additive marketed in pouches that, if burst, can cause severe ocular burns, especially among children who play with them. Despite irrigation with saline, it is difficult to remove, as it sticks on hydration. This video demonstrates techniques to remove chuna from fornices, tarsal plates, conjunctival and corneal surfaces, and intrastromal and intracameral sites. Despite removal, even after stem cell transplantation and keratoplasty, results are dismal. Doctors need to know that chuna injury cases must have residual particles removed meticulously. Manufacturers need to print explicit warnings on packets ("to be kept out of reach of children") to address this preventable cause of blindness.