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Topical eye medications causing allergic contact dermatitis.

Malin Glindvad Ahlström1, Lone Skov2, Steffen Heegaard3

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Allergic contact dermatitis (ACD) from eye drops is often missed. Phenylephrine, timolol, and ketotifen were common culprits in patients experiencing eye region symptoms.

Keywords:
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Area of Science:

  • Ophthalmology
  • Dermatology
  • Allergology

Background:

  • Allergic contact dermatitis (ACD) affecting the eye region due to topical eye medications presents diagnostic challenges.
  • This condition is frequently overlooked in clinical practice.

Purpose of the Study:

  • To investigate the characteristics of patients with ACD caused by topical eye medications.
  • To identify the specific causative allergens in a Danish tertiary dermatology setting.

Main Methods:

  • A retrospective analysis of 318 patients undergoing patch testing for suspected ACD from topical eye medications (2013-2021).
  • Testing included a specific eye medication series and individual suspected products.
  • Medical records of patch test-positive patients were reviewed.

Main Results:

  • 12.9% of patients tested positive for contact allergy to topical eye allergens.
  • Key allergens identified were phenylephrine (6.9%), timolol (2.5%), and ketotifen (1.6%).
  • Commonly associated conditions included cataract (29.3%) and glaucoma (24.4%), with frequent prior reactions.

Conclusions:

  • Patch testing with common eye medication ingredients and products is crucial for diagnosing ACD in patients with eye region symptoms.
  • This diagnostic approach aids in identifying allergens in individuals using topical eye treatments.