Current dilemmas and controversies in allergic contact dermatitis to ophthalmic medications

Contact dermatitis in patients undergoing serial intravitreal injections

“…Both mydriatic drugs are routinely used in the outpatient department in every patient in need of a fundus examination. Reactions to mydriatic topical drugs, in particular phenylephrine, have been shown in the past . Recent observations , and especially the observations in our patient population in need of serial intravitreal anti‐VEGF injections, suggest a striking increase in the frequency of contact dermatitis.…”

Sensitization from ketotifen fumarate in eye drops presenting as chronic conjunctivitis

“…However, one case of sensitization resulting from continuous use of ketotifen fumarate‐ containing eye drops, which only presented as bilateral periorbital erythema with well‐circumscribed margins, has been reported . Allergic contact dermatitis on the eyelids in association with conjunctivitis following the use of ophthalmic preparations is a common feature , whereas conjunctival involvement alone is a rare finding . However, this has already been described for other allergens, for example contact lens solutions , and also following airborne exposure to acrylic monomers in ultraviolet‐cured paint and epoxy resins .…”

Allergic contact dermatitis caused by topical ophthalmic medications: Keep an eye on it!

“…Allergic contact dermatitis (ACD) caused by topical ophthalmic medications, which is often overlooked in eye diseases, is most often characterized by eczematous lesions involving the eyelids or periorbital skin, whereas conjunctivitis only rarely occurs . In order to identify the most common culprits, the results of patch tests performed in our tertiary referral patch test clinic between 1990 and 2016 were retrospectively analysed, with a focus on both the active principles and non‐active components (excipients) of topical ophthalmic medications.…”