Custard apple seeds (Annona squamosa)-induced bilateral toxic keratopathy

Custard apple seeds are a natural remedy for head lice infestation in some parts of India. We report a case of a patient with accidental bilateral ocular exposure to custard apple seeds powder. The patient developed toxic bilateral keratopathy, which was treated with topical antibiotics, lubricants, and low-dose steroids. The patient responded well to the treatment. This report is intended to educate the patients regarding the potential toxic effects of custard apple seeds and increase the awareness of public on traditional harmful practices in this regard.