{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T15:20:28Z","timestamp":1758122428675,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Issues<\/jats:title><jats:p>Use of crack cocaine and associated medical complications persists globally. Some reports in medical literature describe a sight\u2010threatening condition commonly referred to as \u2018crack eye\u2019 or \u2018crack eye syndrome\u2019. The purpose of this review is to describe what is known about crack eye from case reports in peer\u2010reviewed literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Approach<\/jats:title><jats:p>A structured search was completed in MEDLINE, TOXLINE, EMBASE, PsychInfo, Scopus and Biomed Central, to collect case reports and case series on corneal complications attributed to crack cocaine smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Findings<\/jats:title><jats:p>Of 111 articles screened, 11 contained case reports or series. Thirty individual cases of \u2018crack eye\u2019 were reported. The majority (63%) of cases had bilateral involvement; 83% of all cases with microbial culture results had corneal infections. Aggressive treatment caused an improvement in 95% of all cases and 23% of all cases were lost to follow\u00a0up. Of those who received treatment for corneal complications associated with crack cocaine, 22% remained with significant visual impairment (hand motions only) in the affected eye.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>Clinicians should consider crack cocaine involvement in patients presenting with corneal disease without known predisposing factors, and elicit comprehensive drug histories to prevent a reduction in visual acuity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Corneal complications of crack cocaine smoking are caused by a number of synergistic factors, including direct toxicity of crack cocaine vapours to surface cells, impairment of neurogenic support to corneal epithelial integrity, desiccation of the eye surface due to diminished blinking reflex, low level chemical burns and mechanical denudement of surface cells through eye rubbing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13366","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T06:38:46Z","timestamp":1627886326000},"page":"347-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Smoke Gets in the Eye: A systematic review of case reports of ocular complications of crack cocaine use"],"prefix":"10.1111","volume":"41","author":[{"given":"Hemant","family":"Gohil","sequence":"first","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miroslav","family":"Miskovic","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane A.","family":"Buxton","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia  Vancouver Canada"},{"name":"British Columbia Centre for Disease Control  Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon P.","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, Faculty of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-3681","authenticated-orcid":false,"given":"Carol","family":"Strike","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2013.09.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(89)90871-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0773.1993.tb01331.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-7295.2012.00506.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/092986712803988839"},{"key":"e_1_2_9_7_1","first-page":"494","article-title":"Metabolomics of cocaine: implications in toxicity","volume":"25","author":"Dinis\u2010Oliveira RJ","year":"2015","journal-title":"Toxicol Mech Methods"},{"key":"e_1_2_9_8_1","unstructured":"StrikeC HopkinsS WatsonTM et al.Best practice recommendations for Canadian harm reduction programs that provide service to people who use drugs and are at risk for HIV HCV and other harms: part 1. 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