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Toxic Keratoconjunctivitis
Grace L Paley1, Anthony J Lubniewski, James J Reidy
1Department of Ophthalmology and Visual Sciences (G.L.P., A.J.L.), Washington University in St. Louis, St, Louis, MO; and Department of Ophthalmology and Visual Science (J.J.R., A.V.F.), University of Chicago, Chicago, IL.
Abstract:
Toxic keratoconjunctivitis (TK) is an underrecognized complication of ophthalmic drug use and various environmental or occupational exposures. A detailed history and clinical examination are important to identify the offending agent(s). Common drug-related causes of TK include preservatives in ophthalmic medications, topical antimicrobials, and topical anesthetics. Alternatives to benzalkonium chloride as well as preservative-free formulations should be considered in patients requiring long-term topical medication. More advanced cases of TK may require preservative-free topical steroids and/or antibiotics, and occasionally surgical intervention. Early recognition and appropriate management of TK may help prevent permanent ocular and visual damage.
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