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Periorbital contact dermatitis associated with long-term torical antiglaucoma medication: is preservative free formulation the answer?

Poster Details

First Author: E.Kanonidou GREECE

Co Author(s):    C. Petsou   I. Zampros   D. Koreas   T. Lalias   G. Sakkias  

Abstract Details

Purpose:

Contact dermatitis associated with topical antiglaucoma medication is a well-known but infrequently reported side effect of treatment. Our aim is to present a series of cases that developed periorbital contact dermatitis as a result of long-term topical antiglaucoma medication.

Setting:

Department of Ophthalmology, ‘’Hippokrateion’’ General Hospital of Thessaloniki, Thessaloniki, Greece.

Methods:

4 patients (2 men, 67 and 75 years old/2 women, 70 and 74 years) who suffered from primary open-angle glaucoma for an average period of 7 years participated in the study. All were under treatment with fixed combination of carbonic anhydrase inhibitor and beta-blocker for 4 years approximately. None mentioned history of atopy or allergy. All reported pruritus, erythema of the upper and lower eyelid bilaterally with extension to the cheek, with swelling and blisters and conjunctival hyperemia during the last year. Despite the appearance of symptoms, the patients were consistent with the treatment because of the satisfactory hypotonic outcome.

Results:

The patients were advised to discontinue the topical antiglaucoma medication and applied topical corticosteroids/moisturizing agents improved symptoms and signs in 3 weeks time. The antiglaucoma medication used was replaced by the corresponding formulation without preservatives, without recurrence of symptoms and maintenance of the good hypotonic effect (8 months later).

Conclusions:

Contact dermatitis should be included in the differential diagnosis in glaucomatous patients with erythema, swelling of eyelids and conjunctivitis even if the symptoms occur after long term topical treatment, especially in elderly patients. Management with replacement of the used formulation with the corresponding unpreserved indicates sensitivity to continuous contact with the preservative. In this series, the side effects did not affect the compliance of patients to treatment. However, it should be taken into consideration by the physician and treated.

Financial Disclosure:

NONE

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