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Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome

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Long-lasting allergic contact blepharoconjunctivitis to phenylephrine eyedrops.

N Raison-Peyron¹, A Du Thanh, P Demoly

¹Department of Dermatology and Allergology, Hôpital Saint Eloi, Montpellier, France. nadia-raison@wanadoo.fr

|March 4, 2009

Summary

Allergic contact dermatitis from mydriatic eyedrops, particularly phenylephrine, is uncommon. This report details two rare cases of chronic blepharoconjunctivitis caused by phenylephrine eyedrops.

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Area of Science:

Ophthalmology
Dermatology
Allergology

Background:

Mydriatic eyedrops are widely used in ophthalmology.
Allergic contact dermatitis (ACD) is a rare adverse effect of these drops.
Phenylephrine is the most frequently implicated agent in reported cases.

Observation:

Two cases of ACD due to phenylephrine eyedrops are presented.
The patients exhibited an unusual, chronic, and debilitating blepharoconjunctivitis.
Symptoms persisted despite discontinuation of the suspected agent.

Findings:

Phenylephrine-induced allergic contact dermatitis can manifest as severe, chronic blepharoconjunctivitis.
The clinical presentation may be atypical and prolonged.
Diagnosis requires careful clinical evaluation and patch testing.

Implications:

Ophthalmologists should consider ACD from phenylephrine eyedrops in refractory blepharoconjunctivitis.
Awareness of this rare side effect is crucial for accurate diagnosis and management.
Further research may elucidate the mechanisms behind this unusual presentation.